Enhancing Cross-Border Disease Surveillance and Response Between Niger and Nigeria: Addressing Heavy Metal Poisoning and Infectious Disease Outbreaks.

BackgroundThe West African Health Organization (WAHO) implemented a research development program in West Africa during 2009–2013 using the Knowledge for Better Health Research Capacity Development Framework, developed by Pang et al. (Bull World Health Organ 81(11):815–820, 2003), on strategies used to improve the research environment. The framework has the following components: stewardship, financing, sustainable resourcing and research utilization. This paper describes how WAHO implemented this research development program in the West African region to help improve the research environment and lessons learnt.MethodsThis is a retrospective review of the regional research development program using a triangulation of activity reports, an independent evaluation and the authors’ experiences with stakeholders. This program was designed to address gaps along the components of the framework and to improve partnership. The activities, results and challenges are summarised for each component of the framework. The independent evaluation was conducted using over 180 semi-structured interviews of key stakeholders in the West African region and activity reports. WAHO and major stakeholders validated these findings during a regional meeting.ResultsAll 15 ECOWAS countries benefited from this regional research development program. WAHO provided technical and financial support to eight countries to develop their policies, priorities and plans for research development to improve their research governance. WAHO, along with other technical and financial partners, organised many capacity-strengthening trainings in health systems research methodology, resource mobilization, ethical oversight and on HRWeb, a research information management platform. WAHO helped launch a regional network of health research institutions to improve collaboration between regional participating institutions. Further, WAHO developed strategic research partnerships and mobilised additional funding to support the program. The program supported 24 health research projects. High staff turnover, weak institutional capacities and ineffective collaboration were some of the challenges encountered during program activity implementation.ConclusionThe regional collaborative approach to health research development using this framework was effective given the challenges in the West African region. The achievements particularly with improved research partnerships and funding helped strengthen local health research environments. This highlights WAHO’s role and the common experiences in the West African region in improving health research.

Drug-resistant (DR) tuberculosis (TB) is a major public health concern globally, complicating TB control and management efforts. West Africa has historically faced difficulty in combating DR-TB due to limited diagnostic skills, insufficient access to excellent healthcare, and ineffective healthcare systems. This has aided in the emergence and dissemination of DR Mycobacterium tuberculosis complex (MTBC) strains in the region. In the past, DR-TB patients faced insufficient resources, fragmented efforts, and suboptimal treatment outcomes. However, current efforts to combat DR-TB in the region are promising. These efforts include strengthening diagnostic capacities, improving access to quality healthcare services, and implementing evidence-based treatment regimens for DR-TB. Additionally, many West African National TB control programs are collaborating with international partners to scale up laboratory infrastructure, enhance surveillance systems, and promote infection control measures. Moreso, novel TB drugs and regimens, such as bedaquiline and delamanid, are being introduced to improve treatment outcomes for DR-TB cases. Despite these obstacles, there is optimism for the future of DR-TB control in West Africa. Investments are being made to improve healthcare systems, expand laboratory capacity, and support TB research and innovation. West African institutions are now supporting knowledge sharing, capacity building, and resource mobilization through collaborative initiatives such as the West African Network for TB, AIDS, and Malaria (WANETAM), the West African Health Organization (WAHO), and other regional or global partners. These efforts hold promise for improved diagnostics, optimized treatment regimens, and provide better patient outcomes in the future where drug-resistant TB in WA can be effectively controlled, reducing the burden of the disease, and improving the health outcomes of affected individuals.

The emergence of COVID-19 highlights globalisation realties, where diseases may emerge from anywhere and rapidly spread globally. Lessons emphasise the necessity for strengthening regional and global collaboration and coordination to allow rapid risk identification, resource mobilisation and joint actions. We report the experience of the Regional Action through Data (RAD) partnership in fostering regional cooperation and collaboration to use data for battling infectious diseases and the effects of COVID-19. The Partnership comprised;BoadReach company, The West African Health Organization (WAHO) and the Intergovernmental Authority on Development (IGAD); Duke University Global Health Centre and the Jembi Health Systems, South Africa.Main objective:To address the problem of limited used of data to drive performance in healthcare service delivery in sub-Saharan Africa; by changing how and why data is collected, analysed, and then used to achieve results.Specific objectives:1. Regional level: To equip and empower IGAD and WAHO with evidence-based analytics to drive data use for evidence-based policy and program action in public health (regional level). 2. Patient-provider level: To deploy and implement a digital health solution for child-hood vaccination services focused on mobile cross-border populations along the Uganda-Kenya border.Engagement approaches used included; meetings, workshops, technical working groups, establishing monitoring system and annual implementation revision. Targeted training and capacity building were conducted. All activities were built on existing systems and structures to strengthen ownership and sustainability.Regional level achievements:1. Regional health data sharing and protection policy, 2. Strengthened regional health information platform. Patient provider level: Deployment of a cloud based digital health solution to enhance childhood access to vaccination services for cross border populations of Kenya and Uganda, 3. Both regions developed resource mobilisation plans for sustainability.RAD established the foundation for building trust and strengthening regional collaboration and coordination in health in Sub-Saharan Africa.

During the past few decades, there has been a dramatic increase in the number of regional partnerships in the United States to enhance economic development across local government jurisdictions. This trend has been mirrored by an increase in regional organizations in Europe, Asia and South America to enhance economic development, usually across national boundaries. While the literature has examined the formation, structure and activities of regional partnerships for economic development in the United States, this is the first study that attempts to measure their effectiveness across a large number of geographical areas using quantitative methods. The findings provide some evidence of their effectiveness in that there is a positive and significant relationship between regional partnerships and employment; the relationship between regional partnerships and income is positive but insignificant. This study may be informative in the further study of regional economic development organizations in other countries as well as regional partnerships and organizations in other policy arenas.

West Africa has adopted numerous strategies to counter maternal and infant mortality, provides national maternal and infant health programmes, and hosts many active technical and financial partners and non-governmental organisations. Despite this, maternal and infant morbidity and mortality indicators are still very high. In this commentary, internal actors and officials of the West African Health Organisation (WAHO) examine the regional organisation’s role in promoting research as a tool for strengthening maternal and infant health in West Africa.As a specialised institution of the Economic Community of West African States (ECOWAS) responsible for health issues, WAHO’s mission is to provide the sub-region’s population with the highest possible health standards by harmonising Member States’ policies, resource pooling, and cooperation among Member States and third countries to collectively and strategically combat the region’s health problems. To achieve this, WAHO’s main intervention strategy is that of facilitation, as this encourages the generation and use of evidence to inform decision-making and reinforce practice.WAHO’s analysis of interventions since 2000 showed that it had effected some changes in research governance, management and funding, as well as in individual and institutional capacity building, research dissemination, collaboration and exchanges between the various stakeholders. It also revealed several challenges such as process ownership, member countries’ commitment, weak individual and institutional capacity, mobilisation, and stakeholder commitment. To better strengthen evidence-based decision-making, in 2016, WAHO created a unique programme aimed at improving the production, dissemination and use of research information and results in health programme planning to ultimately improve population health.While WAHO’s experiences to date demonstrate how a regional health institution can integrate research promotion into the fight against maternal and infant mortality, the challenges the organisation has encountered also demonstrate the importance of cohesion among actors promoting such an initiative, the importance of leadership and commitment among member country actors steering the process, and the need for collaboration and coordination among all partners in member countries and in the region.

The introduction of the Sustainable Development Goals by the United Nations has set a global target for achieving Universal Health Coverage, requiring resilient health systems capable of addressing public health emergencies and ensuring health security. Public health surveillance, crucial for detecting and responding to infectious disease outbreaks, is key to building health system resilience. Due to the high levels of mobility and political instability in the Middle East and North Africa (MENA) region, unique challenges arise in cross-border health surveillance. This review aims to highlight the importance of cross-border public health surveillance in strengthening health systems across MENA to achieve equitable health outcomes.A mixed-methods approach was utilized, combining a systematic literature review with semi-structured in-depth interviews (IDIs) involving 28 stakeholders from seven MENA countries. The literature review adhered to PRISMA guidelines, while the IDIs provided qualitative insights into current surveillance practices and challenges. Findings from the literature review and IDIs were triangulated and analyzed using the WHO Health Systems Strengthening (HSS) Building Blocks Framework to identify key challenges and recommendations for improving cross-border surveillance.Results indicate that existing cross-border surveillance systems in MENA face challenges in data collection, analysis, and sharing, with disparities across countries based on income levels and political contexts. Key challenges include delayed and incomplete data sharing, insufficient funding across sectors, inadequate training, inconsistent data definitions, and limited integration of health data for mobile populations. Recommendations emphasize strengthened governance and leadership to facilitate regional cooperation and information sharing, sustainable financing for implementing a One Health approach, utilizing innovative information systems, workforce development to enhance data collection and analysis, and secure supply chains for medicines and vaccines and equitable service delivery for all mobile populations.In conclusion, the WHO HSS Building Block Framework provides a comprehensive approach to assessing and improving cross-border public health surveillance and enhancing health security and equity in MENA. Strengthening cross-border surveillance systems may help MENA countries meet IHR requirements, achieve greater health security, and advance health equity among all types of mobile populations. Despite limitations, the study offers critical insights for improving cross-border surveillance strategies in the region.

International partnership spanning various organizational and geographical boundaries has emerged as the dominant paradigm for organizing modern scientific research; and for undertaking international development policy. Academic collaboration has become ubiquitous, embedded in organizational cultures, and is increasingly organized in a wide variety of structural forms and for different purposes among individual researchers, academic institutions, international development agencies, and governments. Research partnerships can promote knowledge production and sharing; stimulate the pooling of financial and high level human resources across boundaries; and create synergies and complementarities among the diverse participants for mutual benefit. But research partnerships are hardly unproblematic. In practice, partnerships are highly dynamic and complex phenomena embedded with varying configurations of power and resource flow asymmetries and geopolitics; and these contestations can intensify where the cooperation involves entities from the North and those in the South. This paper suggests that strategic international research collaboration between research communities located within Africa and those in developed countries, as well as regional partnerships among African universities themselves, represent the most productive framework for reinvigorating and strengthening research capacity within sub-Saharan universities. Partnerships can also help reintegrate Africa more vigorously into the emerging global knowledge economy where the continent currently occupies a relatively undermined position or is excluded altogether. This paper is structured as follows. The first part attempts to define and conceptualize the phenomenon of research partnership and examines some of the forces that drive its rapid growth worldwide. The next part looks at the multiple asymmetries embedded within the politics of North–South research cooperation. The growing political and economic significance of knowledge partnership as the newly dominant policy tool within the broader terrain of international development is explored; followed thereafter by a brief overview of the difficulties of measuring the impacts of research cooperation. It concludes with a discussion of the resurgence of regional and international research and development partnerships in the contemporary African continent.

Despite a fundamental revolution in digital technology, along with an ancillary reduction in the cost of transmitting knowledge, the innovation literature on knowledge collaboration continues to hold on to the spatial localization of knowledge collaboration as a truism. Drawing on the open innovation literature and knowledge‐based view of firm innovation, this study explores key boundary conditions affecting the relationship between research and development (R&D) collaboration breadth, and product and process innovation. Using a large‐scale survey consisting of 25,813 observations of 14,784 firms in the United Kingdom during 2004–2020, we demonstrate that the breadth of knowledge collaboration with regional, national, and international partners directly affects product and process innovation. However, this relationship depends on the geographical location of the collaboration partner, the type of partner, and the firm's absorptive capacity. We found diminishing marginal returns to knowledge collaboration breadth for regional partners in product innovation, and an inverted U‐shaped relationship in R&D collaboration breadth with regional partners for process innovation and for national and international partners for product and process innovation. While investment in digital technologies only shifts the curve upwards, it is unlikely to change the direction of the relationship between R&D collaboration and a type of innovation outcome. On the contrary, an increase in the share of science, technology, engineering, and math graduates enables firms to leverage the negative effect of R&D collaboration breadth nationally and specifically for process innovation. Investment in digital technology and human capital increases absorptive capacity and reduces the transaction costs associated with over‐search and limited managerial capabilities and resources.

The COVID-19 pandemic has thrown into bold relief the need for an all-of-society response supported by regional and global partnerships to control the epidemic. Addressing the social determinants of health, Universal Health Coverage, the non-communicable disease (NCD) burden, the other communicable diseases and the achievement of the Sustainable Development Goals (SDGs) all would require a close collaboration among different sectors and stakeholders, including the private sector. Partnerships connote three fundamental themes—a relative equality between the partners, mutual commitment to agreed objectives and mutual benefit for the stakeholders involved. The decisions are made jointly, and roles are not only respected but are also backed by legal and moral rights. The World Health Organization (WHO) has been and continues to be the foremost promoter as well as the host for many of the global and regional partnerships in health. A typological classification would include technical assistance partnerships supporting service access and provision of services including drugs, partnerships focusing on research and development, advocacy and resource mobilisation and financing partnerships mainly to provide funds for definite disease programmes. Partnerships in health have brought and continue to bring multiple benefits to the countries. But they also engender several challenges, including the duplication of effort and waste, high transaction costs (usually to government), issues of accountability and consequent lack of alignment with country priorities. As partnerships become increasingly significant in the twenty-first century, better coordination, particularly in terms of donor harmonisation with national priorities, would be needed. It is not ambitious to attempt the elusive ideal where all parties will benefit from one other with a give and take between all stakeholders. Partnerships in health could well herald a new dawn for health development in the South-East Asia Region.

Introduction Lassa fever, a viral haemorrhagic disease endemic to West Africa, demands strong crossborder surveillance and timely data sharing to support effective control efforts. The West African Health Organization (WAHO), through its Regional Centre for Surveillance and Disease Control (RCSDC), coordinates disease intelligence via a regional data portal. This study examines how well national surveillance data aligns with what is reported to the WAHO portal. Methods We analysed Lassa fever data submitted to the WAHO (https://data.wahooas.org/outbreaks), portal from January 2023 to December 2024, focusing on suspected and confirmed cases and deaths. National Situation Reports (SitReps) from Nigeria, Ghana, and Liberia were reviewed, and descriptive statistics (frequencies and proportions) were used to assess concordance between the national and regional figures using Stata Version 18. Results Between January 2023 and December 2024, national SitReps from Nigeria, Ghana, and Liberia reported 19,947 suspected cases, 2,783 confirmed cases, and 497 deaths. In contrast, the WAHO portal recorded only 253 suspected cases, 57 confirmed, and 30 deaths. Nigeria’s reports showed 9,155 suspected cases, 1,270 confirmed, and 227 deaths in 2023, and 10,098 suspected, 1,309 confirmed, and 214 deaths in 2024, none of which was reflected on the portal. Ghana’s 2023 data recorded 30 suspected, 27 confirmed cases, and 1 death, but the portal reported only 14 suspected/confirmed cases and 1 death. Liberia’s 2024 SitReps reported 225 suspected, 39 confirmed, and 11 deaths, while the portal showed 90 suspected, 11 confirmed, and 13 deaths suggesting overreporting of deaths. Conclusion There is a significant gap in data concordance between national SitReps and regional reporting on the WAHO portal. Underreporting and inconsistencies undermine efforts to conduct timely regional risk assessments and coordinated responses. Strengthening data harmonization and coordination processes as well as improving real-time reporting mechanisms are essential for regional epidemic preparedness and response.

International collaboration in the first wave of hybrid courts followed a consistent pattern: the international partner in each instance was the United Nations (UN). The second wave of hybrid courts evinces a significant change in this configuration. For the first time, two of the three new hybrid courts have been structured as partnerships with regional organizations, the African Union (AU) and the European Union (EU). An additional proposed hybrid tribunal for South Sudan is also being developed as a regional partnership with the AU. From the perspective of the history of hybrid courts, this marks an abrupt change. However, this regional engagement in hybrid tribunals is an expression of a long-term trend towards the development of regional commitments to transitional justice and international criminal law (ICL). The EU and the AU, as well as other regional organizations, have supported various transitional justice endeavours. This chapter assesses the trend towards regional commitments to transitional justice and ICL and the theoretical arguments for regional transitional justice institutions. It then evaluates the engagement of regional actors in the Kosovo Specialist Chambers and Special Prosecutor’s Office (KSC), the Extraordinary African Chambers in the Courts of Senegal (EAC), and the proposed Hybrid Court for South Sudan (HCSS) in light of these trends and arguments.

BackgroundThe Economic Commission of the West African States (ECOWAS), through her specialised health Institution, the West African Health Organization (WAHO) is supporting Members States to improve health outcomes in West Africa. There is a global recognition that evidence-based health policies are vital towards achieving continued improvement in health outcomes. The need to have a tool that will provide systematic guide on the use of evidence in policymaking necessitated the production of the evidence-based policy-making (EBPM) Guidance.MethodsGoogle search was performed to identify existing guidance on EBPM. Lessons were drawn from the review of identified guidance documents. Consultation, interaction and interviews were held with policymakers from the 15 West African countries during WAHO organized regional meetings in Senegal, Nigeria, and Burkina Faso. The purpose was to elicit their views on the strategies to promote the use of evidence in policymaking to be included in the EBPM Guidance. A regional Guidance Validation Meeting for West African policymakers was thereafter convened by WAHO to review findings from review of existing guidance documents and validate the EBPM Guidance.ResultsOut of the 250 publications screened, six publications fulfilled the study inclusion criteria and were reviewed. Among the important issues highlighted include: what evidence informed decision-making is; different types of research methods, designs and approaches, and how to judge the quality of research. The identified main target end users of the EBPM Guidance are policy/decision makers in the West African sub-region, at local, sub-national, national and regional levels. Among the key recommendations included in the EBPM Guidance include: properly defining/refining policy problem; reviewing contextual issues; initiating policy priority setting; considering political acceptability of policy; commissioning research; use of rapid response services, use of policy advisory/technical/steering committees; and use of policy briefs and policy dialogue.ConclusionThe EBPM Guidance is one of the emerging tools that can enhance the understanding of evidence to policy process. The strategies to facilitate the use of evidence in policymaking outlined in the Guidance, can be adapted to local context, and incorporated validated approaches that can be used to promote evidence-to-policy-to-practice process in West Africa.

This article investigates how practitioners in the West African Health Organization (WAHO) obtain and exercise autonomous political agency in the development of regional health policy. While many process-driven accounts of African agency focus on the freedom and ability of African governments and regional organisations to act and not be acted upon, the article finds that it is necessary look within these agents to examine how they are constituted and the processes in which they acquire the capacity to be agents in their external interactions. This article shows that practitioners in WAHO rely on three institutional strategies that constitute them as agents within the organisation: networking with extra-regional partners; the inclusion of civil society in regional social policy; and the development of intra-organisational linkages to create insulation from political control. Through these strategic interactions, WAHO practitioners constitute themselves as agents within the organisation as well as autonomous agents in the broader global health theatre.

Antimicrobial resistance poses a significant challenge to public health globally, leading to increased morbidity and mortality. AMR surveillance involves the systematic collection, analysis, and interpretation of data on the occurrence and distribution of AMR in humans, animals, and the environment for action. The West African Health Organization, part of the Economic Community of West African States (ECOWAS), is committed to addressing AMR in the region. This paper examines the status of AMR surveillance in ECOWAS countries using available WHO data from the TrACSS survey and GLASS enrollments. The analysis reveals that while progress has been made, significant challenges remain. Twelve of the fifteen ECOWAS countries are enrolled in GLASS, and ten have developed national action plans (NAPs) for AMR. However, there is a need to ensure all countries fully implement their NAPs, continue reporting to GLASS, and use the data for evidence-based actions and decision making. Surveillance systems for AMR and antimicrobial consumption/use vary across countries with some demonstrating limited capacity. All countries, except Cabo Verde, reported having a reference laboratory for AMR testing. Strengthening laboratory capabilities, data management and use, and multisectoral coordination are crucial for effective AMR surveillance and response. Based on the findings and the regional context, it is essential to prioritize capacity building, data utilization, and the adoption of standardized guidelines for AMR surveillance. Collaboration among ECOWAS countries, the WAHO, and international partners is essential to address AMR comprehensively. Ensuring a consistent supply of essential antimicrobial medications and reagents is vital.

At its International Centres Week in October 2000 (ICW2000), the Consultative Group on International Agricultural Research (CGIAR) adopted a new Vision and Strategy. This paper is about Plank 4 of the CGIAR's Vision and Strategy which calls for the adoption, in collaboration with national and regional partners, of a regional approach to research planning, priority setting and implementation. Given the poverty and impact focus of international public goods research, both national agricultural research systems (NARS) and the CGIAR have advantages in pursuing a regional approach as a component of their respective activities. For the NARS in the region, this means seeking advantages at the regional level that they could not derive solely from a national-level approach. For the CGIAR, this means seeking complementary gains that it could not achieve exclusively through a global or ecoregional approach. These mutual advantages open the door for partnerships in regional research between NARS and their regional organizations, and the CGIAR. The paper highlights the advantages as well as risks and limitations of a regional approach to research. Since ICW2000, all regional and sub-regional organizations and CGIAR Centres have taken action to facilitate consultation processes that could eventually lead to the establishment of a regional approach to research for the CGIAR and NARS. The paper notes some emerging lessons, and takes a forward look.