Critical Systematic Review of Zoonoses and Transboundary Animal Diseases' Prioritization in Africa

Abstract

Background: Disease prioritization aims to enhance resource use efficiency concerning human and animal health systems' preparedness and response to the most important problems for the optimization of beneficial outcomes. In sub-Sahara Africa (SSA), several prioritizations of zoonoses and transboundary animal diseases (TADs) have been implemented at different scales to characterize potential disease impacts. Method and principal findings: In this systematic review, we analyze the methodologies used, outcomes, and their relevance by discussing criteria required to align decision-makers' perceptions of impacts to those of other stakeholders for different prioritization in SSA. In general, the sectorial representativeness of stakeholders for processes implemented with the support of international partners showed slight differences with the absence of local stakeholders. Whatever the tool prioritized, zoonoses were similar in general because of the structured nature of those tools in assessing decision-makers' preferences through value trade-offs between criteria while ensuring transparency and reproducibility. However, by involving field practitioners and farmers, there were different outcomes with processes concerning only decision makers and experts who were more sensitive to infectious TADs, while the former raised parasitic disease constraints. In this context, multicriteria decision analysis-based zoonoses and TADs prioritizations involving a balanced participation of stakeholders might contribute to bridging these divergences, whatever the scale.

Conclusion and significance: Prioritization processes were important steps toward building and harmonizing technical laboratory and surveillance networks to coordinate projects to address priority zoonoses and TADs at the country and/or sub-regional level. Those processes should be enhanced.

Keywords: Africa; critical systematic review; prioritization; transboundary animal diseases; zoonoses.

Figure 1

Participation proportion of stakeholders involved in the prioritization processes of zoonotic diseases by the CDC One Health Zoonotic Disease Prioritization tool for 10 SSA countries (Burkina Faso, Cameroon, Cote d’Ivoire, Democratic Republic of Congo, Ethiopia, Kenya, Mali, Mozambique, Tanzania, and Uganda). X-axis shows the proportion of participation of each stakeholder type (Y-axis) in the included prioritization processes.

Figure 2

Participation proportion of stakeholders involved in the prioritization processes of zoonotic diseases by the OIE Phylum tool for 10 SSA countries (Burundi, Djibouti, Eritrea, Ethiopia, Kenya, Rwanda, South-Sudan, Sudan, Tanzania, Uganda). X-axis shows the proportion of participation of each stakeholder type (Y-axis) in the included prioritization processes.

Figure 3

Systematic search of papers and reports on zoonosis and transboundary animal disease (TADs) prioritization processes in Africa before February 2021. * OHZDP: One Health Zoonotic Disease Prioritization.