Public Health Threats and Preparedness in West Africa

Introduction

In 2025, West Africa confronts a confluence of public health risks that highlight the region’s ongoing susceptibility to infectious disease outbreaks and the urgent need for increased readiness. While regional actors respond to an Ebola outbreak declared in the Democratic Republic of the Congo in early September, new and recurrent epidemics are taking place, such as recent clusters of cholera, resurgence of Lassa fever worries, and persistent mpox activity (apnews.com , Lassa Fever International Conference, 2025 , who.int). These incidents show how poor health systems, porous borders, and unequal surveillance and response capabilities can cause local illnesses to quickly spread to regional issues.

West African governments and global partners have increased their coordination regarding Lassa Fever, and in order to improve vaccine readiness and cross-border epidemic preparedness, policymakers and health professionals convened at the 2nd ECOWAS Lassa Fever International Conference in September 2025 in Abidjan (lassafeverinternationalconference.org).This depicts Lassa Fever as a regional security and economic issue. The initiative aligns with efforts to improve surveillance, rapid response, and stockpiling of medical countermeasures.

Major challenges in health persist despite a number of mobilization efforts, including limited domestic financing, gaps in surveillance, political instability, and misinformation affecting vaccination and public health. Recent cholera cases near Abidjan and the Ebola cluster in the Democratic Republic of Congo highlights the need for vigilance due to cross-border transmission (apnews.com , reuters.com).

The epidemiological picture (which diseases are active and where), the state of preparedness (regional coordination), the main barriers (health financing, insecurity, and misinformation), and the priorities of the international community and regional actors to lower risk are all examined in this article. The objective is simple: to demonstrate how investing in regional health is a necessary strategic priority for global health security.

Current Health Threats

Cholera
Cholera outbreaks are occurring in several West and Central African nations as of mid-2025. In Côte d’Ivoire (Vridi Akobrate region), there have been notable cases that have resulted in seven fatalities and roughly 45 confirmed cases (africanews.com , apnews.com). Togo, Niger, Liberia, and Benin are being watched, while Ghana has reported hundreds of instances (un.org). Around 80,000 children in 12 countries are at high risk, according to UNICEF, especially during the rainy season when conditions increase owing to flooding, relocation, and damage to water infrastructure (unicef.org). Poor sanitation, contaminated drinking water, climate change, displacement brought on by conflict, and a lack of vaccines are some of the contributing factors (apnews.com , unicef.org).

Lassa Fever

Between January and September 2025, Nigeria reported approximately 8,700 suspected Lassa fever cases, with about 849 confirmed cases and 162 deaths (afro.who.int). Liberia had 22 confirmed cases and 6 deaths, Sierra Leone recorded 9 confirmed cases and 5 deaths, while Guinea reported 2 confirmed cases, both fatal (myjoyonline.com). In total, there were around 7,343 suspected cases across these countries. Research is focusing on co-infection of Lassa fever with malaria and includes the ENABLE 1.5 program examining incidence and long-term effects like hearing loss (vanguardngr.com). The UNVEIL initiative, launched in August 2025, aims to accelerate Lassa fever vaccine development, with support from organizations such as CEPI and Wellcome, particularly for the University of Texas Medical Branch’s Galveston lab (myjoyonline.com).

Monkey Pox (Mpox)

In 24 African Union member nations, there were about 97,144 suspected mpox cases and 29,849 confirmed cases between January and mid-August 2025, with 593 fatalities. Over the past six weeks, the number of confirmed cases has decreased by 34.5%; however, new outbreaks are still occurring in places like Ghana, Cameroon, and The Gambia (vanguardngr.com). Children and people with impaired immune systems are among the vulnerable groups at risk, and health systems in many West African countries continue to face challenges, especially when it comes to diagnosis, isolation, and treatment (afro.who.int).

Regional preparedness and co-ordination efforts

To start with, West African institutions have prioritized Lassa fever and epidemic preparedness, highlighted by the 2nd ECOWAS Lassa Fever International Conference in September 2025 in Abidjan. This event gathered policymakers, scientists, and partners to synchronize efforts on vaccine readiness and diagnostics. A Ministerial Roundtable resulted in a communiqué that called for a regional vaccine strategy and regulatory alignment, representing a transition to formal ministerial commitments in the region (lfic2025.org, lassafeverinternationalconference.org)

The West African Health Organisation (WAHO)/ECOWAS leads regional coordination for public health preparedness, while Africa CDC offers technical guidance and resource mobilization. Recently assigned by AU leadership, Africa CDC is enhancing fundraising and coordinating responses to cholera and other outbreaks, emphasizing regional collaboration. These institutions facilitate collective procurement, unified protocols, and multi-country simulations, crucial for managing cross-border outbreaks (africacdc.org , wahooas.org) .

The Abidjan ministerial roundtable focused on vaccine readiness for Lassa fever by prioritizing regulatory alignment, creating national deployment plans, and establishing pooled financing mechanisms. Global partners support accelerated trials and manufacturing tailored to West African needs including Coalition for Epidemic Preparedness Innovations (CEPI) and International AIDS Vaccine Initiative (IAVI). This regional approach emphasizes the importance of readiness planning to ensure rapid and equitable vaccine distribution when a product is available, even if licensed vaccines are still months or years away (cepi.net, lassafeverinternationalconference.org).

Senegal and Global Fund-supported projects serve as examples of how nations are improving real-time detection capacities through Integrated Disease Surveillance and Response (IDSR) systems (exemplars.health). Attention is being given to investments in laboratory networks and quick access to diagnoses. While the World Bank and other donors promote genomic surveillance to discover variations and direct responses at a continental level, groups such as FIND (Foundation for Innovative New Diagnostics) and ASLM (African Society for Laboratory Medicine) are pushing for better diagnostics adoption and equal access (worldbank.org , cepi.net)

Training rapid-response teams, growing networks of community health workers, utilizing AI-enabled surveillance in Senegal, and using reliable local channels for risk communication are a few examples of the local innovations and community-level actors that are the focus of regional preparedness. The goal of these grassroots initiatives is to close any gaps in outbreak response and detection that may be missed by national ministries (exemplars.health , finddx.org , stories.theglobalfund.org ).

Key challenges and Implications

The ability of nations to respond to emergencies is severely hampered by persistent underfunding in public health preparation. In order to counteract declining external help, WHO and Africa CDC have highlighted the need for domestic and regional investment to address the shortage of flexible, predictable funding required for emergency operations and capacity building. These budgetary limitations have a negative impact on staff preparedness and stocks, which eventually compromises surveillance and quick response times during epidemics (afticacdc.org , who.int).

Due to the impacts of COVID-19 burnout and clinician exodus, West Africa is facing a severe shortage of qualified health personnel. By 2030, the WHO predicts that there will be a shortage of health workers worldwide, especially in low-income areas. The WHO and the Africa CDC have also noted growing workforce challenges throughout the continent. Clinical care is compromised, case investigations are impeded, and the ability to conduct routine services and vaccination programs during outbreaks is diminished due to the lack of available health workers (afro.who.int ; who.int).

Conflict and political instability in the Sahel and coastal West Africa are impeding humanitarian and health operations, restricting access for aid workers and causing significant displacement. This situation reallocates health resources towards emergency care and food assistance, resulting in gaps in surveillance that complicate vaccine and drug delivery. Outbreaks in these insecure settings create challenges for detection and control, disproportionately impacting vulnerable populations (reuters.com ; unchoa.org).

Global health agencies, notably WHO and Africa CDC, highlight that inadequate surveillance systems in West Africa pose a significant threat to global biosecurity, especially with rapid air travel and trade, pathogens can swiftly spread from rural areas in Guinea or Sierra Leone to major international cities (africacdc.org). This ongoing underinvestment in health systems in West Africa is a concern that transcends regional boundaries, as it heightens the risk of pandemics and jeopardizes international health security frameworks like the International Health Regulations and the proposed Pandemic Accord (Eneh et al., 2025).

Conflict-linked outbreaks in the Sahel region, exacerbated health pressures, are driving population displacement towards coastal states and Europe. Reports from UN OCHA and IOM indicate record internal displacements alongside disease outbreaks, which both fuel and result from these movements. Such health crises in fragile contexts not only strain local systems but also burden international humanitarian operations, highlighting that health insecurity intertwined with migration and conflict has significant geopolitical implications that affect global migration patterns, humanitarian funding, and border policies (unocha.org).

West Africa’s health emergencies significantly affect global commodity markets, particularly in bauxite, gold, cocoa, and energy exports. The 2025 cholera outbreak in Abidjan, made worse by political instability and floods, raises concerns about supply chain reliability, especially for the region’s largest port. Increased health issues could lead to higher insurance costs, shipping delays, and investor risk premiums, ultimately influencing global commodity prices and regional trade. Strengthening public health capacity is thus essential for economic resilience and safeguarding supply chains linked to global manufacturing and energy.

Conclusion

Lassa fever, cholera, and monkey pox are just a few of the serious public health risks that West Africa faces. It shows the connection between regional health security and international stability. As a continuous global priority, sustained investment in surveillance, and robust health systems are necessary. Although political commitment has been strengthened by regional cooperation through WAHO, Africa CDC, and ECOWAS, this progress would not be sustained in the absence of steady finance, and better laboratories. In order to strengthen defenses against pandemics, future efforts should concentrate on converting political promises into long-term initiatives including boosting local manufacturing, merging regional health systems into global governance, and integrating climate adaptation into health planning.

References

80000 children at high risk of cholera as outbreaks spread across 12 countries in West and Central Africa.unicef.org.https://www.unicef.org/press-releases/80000-children-high-risk-cholera-outbreaks-spread-across-12-countries-west-and

Africa CDC reports sharp drop in mpox cases, warns of cholera spread. vanguardngr.com. https://www.vanguardngr.com/2025/08/africa-cdc-reports-sharp-drop-in-mpox-cases-warns-of-cholera-spread/

Benue State, WHO expands Lassa Fever response with community-level outreach campaigns. afro.who.int. October 8, 2025. https://www.afro.who.int/countries/nigeria/news

Decision of the Committee of Heads of State and Government of Africa CDC Extraordinary Session on the Margins of UNGA 80. africacdc.org. https://africacdc.org/news-item/decision-of-the-committee-of-heads-of-state-and-government-of-africa-cdc/

Ebola virus disease – Democratic Republic of the Congo. who.int. https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON580

Eneh, S. C., Anokwuru, C. C., Onukansi, F. O., Obi, C. G., Ikhuoria, O. V., Dauda, Z. U., … & Udoewah, S. A. (2025). Implementation of integrated disease surveillance and response systems in West Africa: lessons learned and future directions. BMJ Health & Care Informatics, 32(1), e101346.

Financing and implementation of the Programme budget 2024–2025. https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_19-en.pdf