Strengths and challenges of the One Health approach in the response to zoonotic epidemics in CAR

Strengths and challenges of the One Health approach in the response to zoonotic epidemics in CAR | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Strengths and challenges of the One Health approach in the response to zoonotic epidemics in CAR Kalthan Ernest, Mbaikoua Marie Noelle, Bambou Bernard, Vopamade-Passi Roger, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6887391/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Each year, the WHO African Region experiences over 100 health emergencies, representing approximately 70% of the global total. Notably, more than 75% of emerging infectious diseases in humans are of zoonotic origin, underscoring the critical need for integrated approaches to disease prevention and control. The "One Health" approach—recognized as a cornerstone of global health security—seeks to enhance the world's capacity to prevent, detect, and respond to infectious disease threats by fostering collaboration across human, animal, and environmental health sectors. In the Central African Republic (CAR), incremental progress has been made in operationalizing the One Health framework. Key advancements include: Capacity-building initiatives aimed at improving understanding and operational uptake of the One Health concept across relevant sectors; Multisectoral and multidisciplinary coordination mechanisms for the surveillance of epidemic-prone diseases and public health emergency response, led respectively by the Directorate of Epidemiological Surveillance and the Public Health Emergency Operations Center (COUSP); Risk communication and information-sharing, notably through the publication of a monthly One Health bulletin that reports on surveillance, preparedness, and response activities related to public health emergencies. This bulletin is disseminated via multisectoral digital platforms such as WhatsApp groups. Despite these achievements, critical gaps remain in areas such as sustainable capacity building, institutional governance, and strategic planning. Strengthening these components is essential to fully operationalize the One Health approach and enhance national health security in the Central African Republic (CAR). One Health coordination training investigation response zoonosis CAR Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Episodes of disease transmission from animals or the environment to humans are becoming increasingly frequent [ 1 , 2 ]. The principal drivers of zoonotic spillover include ecosystem disruption—often resulting from deforestation due to agricultural expansion, logging, mining, and oil extraction—as well as changes in farming and food production systems and the intensification of wildlife trade [ 3 ]. These environmental pressures significantly increase opportunities for pathogens to cross species barriers, thereby facilitating the emergence of new epidemics. Moreover, they are among the leading causes of biodiversity loss worldwide [ 4 ]. The One Health concept is founded on the recognition of the complex and interdependent relationships between humans, animals, and ecosystems situated within the broader political, economic, and social systems in which they coexist [ 2 ]. On May 30 2018, the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (WOAH), and the World Health Organization (WHO) signed a Memorandum of Understanding (MoU) to enhance their coordinated efforts in addressing health threats at the human–animal–environment interface, with particular emphasis on the prevention and control of antimicrobial resistance (AMR) [ 5 ]. The One Health approach has now received formal endorsement from multiple United Nations agencies, the European Commission, the World Bank, academic institutions, non-governmental organizations (NGOs), and other international stakeholders [ 6 ]. Approximately 60% of emerging infectious diseases (EIDs) reported globally originate from animals— both wild and domesticated. Over the past three decades, more than 30 novel human pathogens have been identified, of which an estimated 75% are of zoonotic origin [ 7 , 8 ]. The One Health concept is defined as a "collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—to achieve optimal health and well-being outcomes while recognizing the interconnection between people, animals, plants, and their shared environment" (One Health Commission, 2019) [ 9 ]. Although the One Health concept has been widely recognized for over a decade, its operationalization remains limited, and systematic evaluation of its impact is largely absent [ 10 ]. In the CAR, the One Health approach is still primarily known within academic and technical circles in specific disciplines. This raises several critical questions: To what extent is the One Health strategy being implemented in practice? What has been its concrete contribution to the management of public health emergencies? What operational, institutional, or contextual challenges are limiting its complete application? This analysis seeks to explore these questions and provide insights into the current status, achievements, and obstacles to the effective implementation of One Health in CAR. Historical reminder of "One Health" in CAR The legal and institutional foundations for the One Health approach in the Central African Republic (CAR) were first established through Decree No. 28 of April 2 2009, which appointed members to the Committee for Epidemiological Surveillance, Preparedness and Response to Epidemics and Other Public Health Emergencies. This decree laid the groundwork for multisectoral coordination in line with One Health principles. It was followed by the issuance of a decree establishing an inter-ministerial unit dedicated to the prevention and control of zoonotic diseases, further reinforcing this collaborative framework. In 2019, the government enacted a decree defining the structure and operational procedures of the Public Health Emergency Operations Center (COUSP), explicitly aligned with the One Health approach. With financial support from the Bill & Melinda Gates Foundation, a dedicated COUSP facility was constructed and completed in 2023. In 2022, CAR adopted an interministerial order to establish the One Health platform for human, animal, and environmental health laboratories, fostering cross-sectoral collaboration in laboratory surveillance. In the same year, Interministerial Order No. 245/MSP/MESA/MEDD/MEFCP, dated August 23 2022, was issued to define the list of priority zoonotic diseases in the country. Further operationalization occurred in 2023 with the launch of a multisectoral frontline field epidemiology training program involving key One Health ministries. This initiative was developed with technical support from the U.S. Centers for Disease Control and Prevention (CDC) and AFENET (African Field Epidemiology Network) with funding from World Bank (Fig. 1 ). During the same year, an interministerial order establishing a national "One Health" platform for the surveillance of priority diseases in the Central African Republic was signed by the Ministers of Health, Livestock, Environment, and Water, Forests, Hunting, and Fishing. This platform formalizes multisectoral collaboration for disease surveillance and response. In alignment with the WHO's flagship initiatives on emergency preparedness and response, managers from ministries responsible for human, animal, and environmental health, as well as other relevant sectors, received capacity-building training to reinforce national response readiness. As a result, an AVoCH-SURGE (African Volunteer Health Corps - Emergency Response Surge Capacity) team has been established and can be rapidly mobilized in response to public health emergencies. Additionally, with funding from the World Bank through the REDISSE IV project, the country developed its national surveillance plans for priority zoonotic diseases in 2024, applying the principles of the One Health approach to ensure integrated, cross-sectoral preparedness. Operationalization of "One health" in CAR Capacity building on "One Health" The implementation of the One Health approach in the Central African Republic (CAR) has been closely associated with efforts to strengthen national capacities. Over recent years, several Central African professionals across sectors—including academia, livestock, agriculture, water and forestry, public Health, and laboratory sciences—have been trained abroad on One Health principles. A recurring recommendation from these returning professionals has been the formal establishment of a national One Health platform to institutionalize multisectoral coordination. Notably, the Cheikh Anta Diop University of Dakar, in collaboration with the University of Montpellier, has organized an academic programme leading to an International University Diploma (IUD) focused on emerging infections through the One Health lens. Professionals from CAR, representing both human and animal health sectors, participated in the 2022 and 2023 cohorts of this programme. Domestically, a number of multisectoral training initiatives have been undertaken. One such initiative involved the adaptation of the third edition of the SMIR (Integrated Disease Surveillance and Response) guide, ensuring the inclusion of all relevant components of the International Health Regulations (IHR)—namely, the animal, environmental, and human health sectors. This inclusive approach continued with tiered training programs, conducted in collaboration with One Health stakeholders and tailored to the health system pyramid. Training was also extended to technical staff from the ministries of livestock, water and forests, and the environment, reinforcing cross-sectoral readiness and collaboration. In addition, the World Health Organization (WHO) supported the training of 70 officials from seven ministerial departments to form a national rapid response team, capable of being deployed promptly in the event of an outbreak alert. These various capacity-building initiatives have contributed significantly to enhancing intersectoral understanding of the One Health approach and have facilitated its gradual implementation across key institutions and sectors. One Health Collaboration and Coordination There are several levels of coordination and multisectoral collaboration in CAR. It is overseen by the Prime Minister for Food Security, the Ministry of Health for surveillance and response, and the Ministry of Agriculture for the implementation of the CODEX Alimentarius. In the field of zoonotic surveillance, a weekly meeting is held at the Epidemiological Surveillance Directorate. It brings together professionals from multisectoral (animal, environmental, and human health) and multidisciplinary (epidemiologists, public health physicians, biologists, veterinarians, entomologists, and humanitarian) backgrounds. The epidemiological situation of the country is exposed and discussed. The data are complete and validated, with recommendations for improvement (Fig. 2 ). Regarding the response to epidemics, coordination is conducted at the level of the Public Health Emergency Operations Centre (COUSP). Once again, the COUSP brings together "One Health" actors to coordinate the response. Depending on the type of emergency (zoonosis, arbovirus, or natural disaster), a specific incident manager is appointed. Meetings are held closely at the beginning and then spaced out until the end of the incident. Decisions are made to activate or deactivate the COUSP. Investigation and Response Effective investigation of zoonotic diseases and arboviral outbreaks increasingly requires strong multisectoral and multidisciplinary collaboration. The composition of investigation teams is tailored based on the nature of the outbreak. For zoonotic events, the inclusion of a veterinarian is essential to assess animal-human transmission dynamics. In the case of arboviruses, the presence of an entomologist is critical for vector identification and control strategies. In all scenarios, the roles of the epidemiologist and environmental health expert are cross-cutting, providing essential insights across investigation types. This collaborative structure has been successfully applied in the Central African Republic (CAR) during investigations of multiple epidemics, including Mpox, rabies, and yellow fever (Fig. 3 ), demonstrating the operational value of the One Health approach in outbreak settings. In emergency contexts, human resources for outbreak response are often structured around investigation teams. Since 2023, the Central African Republic has increasingly relied on the deployment of the SURGE team (Fig. 3 ) as the core operational unit for public health response. While the availability of trained human resources has improved, the mobilization of financial resources remains a significant constraint. During each health crisis, the deployment of investigation and response teams is frequently delayed or hindered by resource mobilization bottlenecks, leading to operational setbacks and unnecessary stress on teams. The absence of readily accessible, dedicated emergency response funds continues to pose a critical barrier to timely action. Communication on the One Health approach The One Health focal point within the Ministry of Water, Forests, Hunting, and Fisheries has established a multisectoral WhatsApp platform dedicated to the exchange of information. This platform includes representatives from the ministries of Health, livestock, environment, municipal authorities, and other relevant sectors. It serves as an informal yet effective space for sharing information related to epidemiological surveillance and cross-sectoral collaboration. In parallel, other coordination mechanisms—such as the International Health Regulations (IHR) coordination unit, the Methods and Strategy Committee for Public Health Emergency Response, the SURGE team, and Technical Working Groups (TWGs) on Antimicrobial Resistance (AMR) and Event-Based Surveillance (EBS)—have also established WhatsApp groups to facilitate timely communication across sectors. Collectively, these platforms play a key role in enhancing the real-time flow of information relevant to epidemic surveillance and response. Moreover, since 2022, the One Health surveillance team has produced a monthly epidemiological bulletin (Fig. 4 ). This publication documents surveillance, preparedness, and response activities related to zoonotic diseases. It is disseminated electronically to government officials, national institutions, and development partners, and is also shared across the multisectoral platforms mentioned above to ensure broad access and situational awareness. Challenges and Issues of "One Health" To ensure effective coordination of the One Health approach, the establishment of a national One Health platform is essential to align and consolidate local and sectoral initiatives. However, the Central African Republic (CAR) remains behind in fully operationalizing such a coordinating body at the national level. Despite growing awareness, the One Health approach is still poorly institutionalized at decentralized and community levels, limiting its impact in areas where zoonotic and environmental health risks are most pronounced. Moreover, there is currently limited support and insufficient guidance from the global One Health coordination mechanisms, which affects national efforts to contextualize and sustain the approach. Notably, CAR lacks a national strategic or operational plan for One Health, resulting in fragmented implementation efforts. Critically, the execution of One Health-related activities in the country is almost entirely dependent on external funding, raising concerns about sustainability and national ownership. Conclusion The WHO African Region reports approximately 100 public health events each year. The subregion encompassing the Congo and Lake Chad basins is particularly vulnerable, as it serves as a hotspot for emerging and re-emerging infectious diseases. In this context, the One Health approach offers a sustainable and integrated framework to strengthen preparedness and response to epidemics and other health emergencies. In the Central African Republic (CAR), considerable progress has been made under the One Health agenda—particularly in the areas of coordination, communication, investigation, and outbreak response. Despite these notable achievements, significant gaps remain in terms of capacity-building, institutional governance, and strategic planning. Addressing these limitations will be essential to fully institutionalize the One Health approach and enhance the country's ability to respond to future health threats. Declarations Conflicts of interest The authors state that they have no conflicts of interest Statement of funding None Acknowledgements The authors thank Dr. Ionela Gouandjika and Dr. Marie-Roseline Darnycka Bélizairefor reviewing the article. Clinical trial number : not applicable. Ethics, Consent to Participate, and Consent to Publish declarations : not applicable Authors' contribution N° Name and surname Name initial Authors' contribution 1 Kalthan Ernest KE Manuscript writing 2 Mbaikoua Marie Noelle MMN Proofreading the manuscript 3 Mapouka Achille MA Proofreading the manuscript 4 Takpando Le Grand Davy Romeo TGRD Proofreading the manuscript 5 Mbailao Raphael MR Proofreading the manuscript 6 Kakema Hebo Cathy KHC Proofreading the manuscript 7 Moyen Méthode Jean MMJ Proofreading the manuscript 8 Bambou Bernard BB Data collection 9 Vopamade Roger VR Data collection 10 Pamatika Christian Maucler PMC Data collection 11 Pathe-Erepe Glwadys PEG Data collection 12 Lango Yaya Ernest LYE Data collection Mbaikoua Marie Noelle, Mapouka Achille, Takpando Le Grand Davy Romeo, Mbailao Raphael, Kakema Hebo Cathy, and Moyen Méthode Jean collected the data. Kalthan Ernest wrote the manuscript. Bambou Bernard, Vopamade Roger, Pamatika Christian Maucler, Pathe-Erepe Glwadys and Lango Yaya Ernest proofread the document. References Karesh WB, Dobson A, Lloyd-Smith JO, Lubroth J, Dixon MA, Bennett M et al. Ecology of zoonoses: natural and unnatural histories. Lancet 2012;380:1936–1945. Machalaba Catherine, Virginia Porter, William B. Karesh. Menaces pandémiques émergentes. Réduire le Risque Pandémique, Promouvoir la Santé. [Internet]. [cited 2024 November 21]. Available from: file:///C:/Users/esnes/Desktop/ONE%20HEALTH/Catherine%20MaChalaba. pdf. Loh EH, Olival KJ, Zambrana-Torellio C, Bogich TL, Johnson CK, Mazet JAK et al. (2015). Targeting transmission pathways for emerging zoonotic disease surveillance and control. Vector Borne and Zoonotic Diseases ; doi: 10.1089/vbz.2013.1563. OMS. Une seule santé [Internet]. [cited 2024 November 21]. Available from: https://www.who.int/fr/news-room/fact-sheets/detail/ one-health. Memorandum of understanding. Regarding cooperation to combat health risks at the animal-human-ecosystems interface in the context of the "one health" approach and including antimicrobial resistance [Internet]. [cited 2024 November 21]. Available from: file:///C:/Users/esnes/AppData/Local/Microsoft /Windows/INetCache/IE/J2VBPVIL/MoU_Tripartite_Signature_May_30_2018[1].pdf. Ministère des Affaires Étrangères et Européennes. Direction générale de la mondialisation, du développement et des partenariats. Position française sur le concept « One Heath/Une seule santé » : pour une approche intégrée de la santé face à la mondialisation des risques sanitaires, Août 2011 [Internet]. [cited 2024 November 21]. Available from: http://www.diplomatie.gouv.fr/fr/IMG/pdf/ Rapport_One_Health.pdf. World Health Organization and Convention on Biological Diversity. (2015). Connecting global priorities: biodiversity and human Health, a state of knowledge review. Geneva, Switzerland and Montréal: WHO and SCBD [Internet]. [cited 2024 November 21]. Available from: http://apps.who.int/iris/bitstream/10665/174012/1/9789241508537_eng.pdf. Gashaw Adane Erkyihun, and Meseret Bekele Alemayehu. One Health Approach for the Control of Zoonotic Diseases. Zoonoses ; DOI 10.15212/ZOONOSES-2022-0037. Moustapha Moncher Nsangou, Pierre Ongolo-Zogo. Etat des lieux de l’approche « One health » dans les pays de la CEMAC [Internet]. [cited 2024 November 21]. Available from: file:///C:/Users/esnes/Desktop/ONE%20 HEALTH/Moustapha%20Moncher%20Nsangou.pdf. Stéphanie Duhamel. One Health - Une seule santé, évaluation d’une approche intégrée en santé, Rapport technique n°64 avril 2021 [Internet]. [cited 2024 November 21]. Available from: https://issuu.com/objectif-developpement/docs/rt64vf_one_health_evaluation_approche_integree_san. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6887391","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":476542350,"identity":"522e5634-5d01-4800-a257-904bdf5f1f65","order_by":0,"name":"Kalthan 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2","display":"","copyAsset":false,"role":"figure","size":104390,"visible":true,"origin":"","legend":"\u003cp\u003eReport\u003cstrong\u003e \u003c/strong\u003eof the One Health Surveillance Coordination Meeting\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-6887391/v1/50d8ed25ce8d4e68c5eb61fc.png"},{"id":85478695,"identity":"93afd7bc-b0a6-4575-9fb3-a5a5b604bac4","added_by":"auto","created_at":"2025-06-26 10:34:00","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":485032,"visible":true,"origin":"","legend":"\u003cp\u003eOne Health Investigation of Confirmed Cases of Disease by Health District.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-6887391/v1/f15a2c337476e1e20029bfd4.png"},{"id":85478301,"identity":"e0a312ea-24b9-4d69-8364-f22eb4581b65","added_by":"auto","created_at":"2025-06-26 10:26:00","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":833870,"visible":true,"origin":"","legend":"\u003cp\u003eOne Health epidemiological bulletin published\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-6887391/v1/2f023239a5c554b9a733e32c.png"},{"id":86235366,"identity":"cc4dfb4c-a10b-47b9-b246-e0b50c46b61a","added_by":"auto","created_at":"2025-07-08 09:32:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2299682,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6887391/v1/acdd8186-edca-4897-b9ed-278d952e1ef9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Strengths and challenges of the One Health approach in the response to zoonotic epidemics in CAR","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEpisodes of disease transmission from animals or the environment to humans are becoming increasingly frequent [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The principal drivers of zoonotic spillover include ecosystem disruption\u0026mdash;often resulting from deforestation due to agricultural expansion, logging, mining, and oil extraction\u0026mdash;as well as changes in farming and food production systems and the intensification of wildlife trade [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These environmental pressures significantly increase opportunities for pathogens to cross species barriers, thereby facilitating the emergence of new epidemics. Moreover, they are among the leading causes of biodiversity loss worldwide [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe \u003cb\u003eOne Health\u003c/b\u003e concept is founded on the recognition of the complex and interdependent relationships between humans, animals, and ecosystems situated within the broader political, economic, and social systems in which they coexist [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOn May 30 2018, the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (WOAH), and the World Health Organization (WHO) signed a Memorandum of Understanding (MoU) to enhance their coordinated efforts in addressing health threats at the human\u0026ndash;animal\u0026ndash;environment interface, with particular emphasis on the prevention and control of antimicrobial resistance (AMR) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe One Health approach has now received formal endorsement from multiple United Nations agencies, the European Commission, the World Bank, academic institutions, non-governmental organizations (NGOs), and other international stakeholders [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eApproximately 60% of emerging infectious diseases (EIDs) reported globally originate from animals\u0026mdash; both wild and domesticated. Over the past three decades, more than 30 novel human pathogens have been identified, of which an estimated 75% are of zoonotic origin [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe One Health concept is defined as a \"collaborative, multisectoral, and transdisciplinary approach\u0026mdash;working at the local, regional, national, and global levels\u0026mdash;to achieve optimal health and well-being outcomes while recognizing the interconnection between people, animals, plants, and their shared environment\" (One Health Commission, 2019) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough the One Health concept has been widely recognized for over a decade, its operationalization remains limited, and systematic evaluation of its impact is largely absent [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the CAR, the One Health approach is still primarily known within academic and technical circles in specific disciplines. This raises several critical questions: To what extent is the One Health strategy being implemented in practice? What has been its concrete contribution to the management of public health emergencies? What operational, institutional, or contextual challenges are limiting its complete application?\u003c/p\u003e \u003cp\u003eThis analysis seeks to explore these questions and provide insights into the current status, achievements, and obstacles to the effective implementation of One Health in CAR.\u003c/p\u003e"},{"header":"Historical reminder of \"One Health\" in CAR","content":"\u003cp\u003eThe legal and institutional foundations for the One Health approach in the Central African Republic (CAR) were first established through Decree No. 28 of April 2 2009, which appointed members to the Committee for Epidemiological Surveillance, Preparedness and Response to Epidemics and Other Public Health Emergencies. This decree laid the groundwork for multisectoral coordination in line with One Health principles. It was followed by the issuance of a decree establishing an inter-ministerial unit dedicated to the prevention and control of zoonotic diseases, further reinforcing this collaborative framework.\u003c/p\u003e \u003cp\u003eIn 2019, the government enacted a decree defining the structure and operational procedures of the Public Health Emergency Operations Center (COUSP), explicitly aligned with the One Health approach. With financial support from the Bill \u0026amp; Melinda Gates Foundation, a dedicated COUSP facility was constructed and completed in 2023.\u003c/p\u003e \u003cp\u003eIn 2022, CAR adopted an interministerial order to establish the One Health platform for human, animal, and environmental health laboratories, fostering cross-sectoral collaboration in laboratory surveillance. In the same year, Interministerial Order No. 245/MSP/MESA/MEDD/MEFCP, dated August 23 2022, was issued to define the list of priority zoonotic diseases in the country.\u003c/p\u003e \u003cp\u003eFurther operationalization occurred in 2023 with the launch of a multisectoral frontline field epidemiology training program involving key One Health ministries. This initiative was developed with technical support from the U.S. Centers for Disease Control and Prevention (CDC) and AFENET (African Field Epidemiology Network) with funding from World Bank (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eDuring the same year, an interministerial order establishing a national \"One Health\" platform for the surveillance of priority diseases in the Central African Republic was signed by the Ministers of Health, Livestock, Environment, and Water, Forests, Hunting, and Fishing. This platform formalizes multisectoral collaboration for disease surveillance and response.\u003c/p\u003e \u003cp\u003eIn alignment with the WHO's flagship initiatives on emergency preparedness and response, managers from ministries responsible for human, animal, and environmental health, as well as other relevant sectors, received capacity-building training to reinforce national response readiness. As a result, an AVoCH-SURGE (African Volunteer Health Corps - Emergency Response Surge Capacity) team has been established and can be rapidly mobilized in response to public health emergencies.\u003c/p\u003e \u003cp\u003eAdditionally, with funding from the World Bank through the REDISSE IV project, the country developed its national surveillance plans for priority zoonotic diseases in 2024, applying the principles of the One Health approach to ensure integrated, cross-sectoral preparedness.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Operationalization of \"One health\" in CAR","content":"\u003ch2\u003eCapacity building on \"One Health\"\u003c/h2\u003e\u003cp\u003eThe implementation of the One Health approach in the Central African Republic (CAR) has been closely associated with efforts to strengthen national capacities. Over recent years, several Central African professionals across sectors—including academia, livestock, agriculture, water and forestry, public Health, and laboratory sciences—have been trained abroad on One Health principles. A recurring recommendation from these returning professionals has been the formal establishment of a national One Health platform to institutionalize multisectoral coordination.\u003c/p\u003e\u003cp\u003eNotably, the Cheikh Anta Diop University of Dakar, in collaboration with the University of Montpellier, has organized an academic programme leading to an International University Diploma (IUD) focused on emerging infections through the One Health lens. Professionals from CAR, representing both human and animal health sectors, participated in the 2022 and 2023 cohorts of this programme.\u003c/p\u003e\u003cp\u003eDomestically, a number of multisectoral training initiatives have been undertaken. One such initiative involved the adaptation of the third edition of the SMIR (Integrated Disease Surveillance and Response) guide, ensuring the inclusion of all relevant components of the International Health Regulations (IHR)—namely, the animal, environmental, and human health sectors. This inclusive approach continued with tiered training programs, conducted in collaboration with One Health stakeholders and tailored to the health system pyramid. Training was also extended to technical staff from the ministries of livestock, water and forests, and the environment, reinforcing cross-sectoral readiness and collaboration.\u003c/p\u003e\u003cp\u003eIn addition, the World Health Organization (WHO) supported the training of 70 officials from seven ministerial departments to form a national rapid response team, capable of being deployed promptly in the event of an outbreak alert.\u003c/p\u003e\u003cp\u003eThese various capacity-building initiatives have contributed significantly to enhancing intersectoral understanding of the One Health approach and have facilitated its gradual implementation across key institutions and sectors.\u003c/p\u003e"},{"header":"One Health Collaboration and Coordination","content":"\u003cp\u003eThere are several levels of coordination and multisectoral collaboration in CAR. It is overseen by the Prime Minister for Food Security, the Ministry of Health for surveillance and response, and the Ministry of Agriculture for the implementation of the CODEX Alimentarius.\u003c/p\u003e \u003cp\u003eIn the field of zoonotic surveillance, a weekly meeting is held at the Epidemiological Surveillance Directorate. It brings together professionals from multisectoral (animal, environmental, and human health) and multidisciplinary (epidemiologists, public health physicians, biologists, veterinarians, entomologists, and humanitarian) backgrounds. The epidemiological situation of the country is exposed and discussed. The data are complete and validated, with recommendations for improvement (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eRegarding the response to epidemics, coordination is conducted at the level of the Public Health Emergency Operations Centre (COUSP). Once again, the COUSP brings together \"One Health\" actors to coordinate the response. Depending on the type of emergency (zoonosis, arbovirus, or natural disaster), a specific incident manager is appointed. Meetings are held closely at the beginning and then spaced out until the end of the incident. Decisions are made to activate or deactivate the COUSP.\u003c/p\u003e"},{"header":"Investigation and Response","content":"\u003cp\u003eEffective investigation of zoonotic diseases and arboviral outbreaks increasingly requires strong multisectoral and multidisciplinary collaboration. The composition of investigation teams is tailored based on the nature of the outbreak. For zoonotic events, the inclusion of a veterinarian is essential to assess animal-human transmission dynamics. In the case of arboviruses, the presence of an entomologist is critical for vector identification and control strategies.\u003c/p\u003e \u003cp\u003eIn all scenarios, the roles of the epidemiologist and environmental health expert are cross-cutting, providing essential insights across investigation types.\u003c/p\u003e \u003cp\u003eThis collaborative structure has been successfully applied in the Central African Republic (CAR) during investigations of multiple epidemics, including Mpox, rabies, and yellow fever (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e), demonstrating the operational value of the One Health approach in outbreak settings.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eIn emergency contexts, human resources for outbreak response are often structured around investigation teams. Since 2023, the Central African Republic has increasingly relied on the deployment of the SURGE team (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) as the core operational unit for public health response.\u003c/p\u003e \u003cp\u003eWhile the availability of trained human resources has improved, the mobilization of financial resources remains a significant constraint. During each health crisis, the deployment of investigation and response teams is frequently delayed or hindered by resource mobilization bottlenecks, leading to operational setbacks and unnecessary stress on teams. The absence of readily accessible, dedicated emergency response funds continues to pose a critical barrier to timely action.\u003c/p\u003e"},{"header":"Communication on the One Health approach","content":"\u003cp\u003eThe One Health focal point within the Ministry of Water, Forests, Hunting, and Fisheries has established a multisectoral WhatsApp platform dedicated to the exchange of information. This platform includes representatives from the ministries of Health, livestock, environment, municipal authorities, and other relevant sectors. It serves as an informal yet effective space for sharing information related to epidemiological surveillance and cross-sectoral collaboration.\u003c/p\u003e \u003cp\u003eIn parallel, other coordination mechanisms—such as the International Health Regulations (IHR) coordination unit, the Methods and Strategy Committee for Public Health Emergency Response, the SURGE team, and Technical Working Groups (TWGs) on Antimicrobial Resistance (AMR) and Event-Based Surveillance (EBS)—have also established WhatsApp groups to facilitate timely communication across sectors. Collectively, these platforms play a key role in enhancing the real-time flow of information relevant to epidemic surveillance and response.\u003c/p\u003e \u003cp\u003eMoreover, since 2022, the One Health surveillance team has produced a monthly epidemiological bulletin (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). This publication documents surveillance, preparedness, and response activities related to zoonotic diseases. It is disseminated electronically to government officials, national institutions, and development partners, and is also shared across the multisectoral platforms mentioned above to ensure broad access and situational awareness.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e "},{"header":"Challenges and Issues of \"One Health\"","content":"\u003cp\u003eTo ensure effective coordination of the One Health approach, the establishment of a national One Health platform is essential to align and consolidate local and sectoral initiatives. However, the Central African Republic (CAR) remains behind in fully operationalizing such a coordinating body at the national level.\u003c/p\u003e\u003cp\u003eDespite growing awareness, the One Health approach is still poorly institutionalized at decentralized and community levels, limiting its impact in areas where zoonotic and environmental health risks are most pronounced.\u003c/p\u003e\u003cp\u003eMoreover, there is currently limited support and insufficient guidance from the global One Health coordination mechanisms, which affects national efforts to contextualize and sustain the approach. Notably, CAR lacks a national strategic or operational plan for One Health, resulting in fragmented implementation efforts.\u003c/p\u003e\u003cp\u003eCritically, the execution of One Health-related activities in the country is almost entirely dependent on external funding, raising concerns about sustainability and national ownership.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe WHO African Region reports approximately 100 public health events each year. The subregion encompassing the Congo and Lake Chad basins is particularly vulnerable, as it serves as a hotspot for emerging and re-emerging infectious diseases.\u003c/p\u003e \u003cp\u003eIn this context, the One Health approach offers a sustainable and integrated framework to strengthen preparedness and response to epidemics and other health emergencies. In the Central African Republic (CAR), considerable progress has been made under the One Health agenda\u0026mdash;particularly in the areas of coordination, communication, investigation, and outbreak response.\u003c/p\u003e \u003cp\u003eDespite these notable achievements, significant gaps remain in terms of capacity-building, institutional governance, and strategic planning. Addressing these limitations will be essential to fully institutionalize the One Health approach and enhance the country's ability to respond to future health threats.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors state that they have no conflicts of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatement of funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank Dr. Ionela Gouandjika and Dr.\u0026nbsp;Marie-Roseline Darnycka Bélizairefor reviewing the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e: not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics, Consent to Participate, and Consent to Publish declarations\u003c/strong\u003e: not applicable\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAuthors' contribution\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN°\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eName and surname\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eName initial\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAuthors' contribution\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eKalthan Ernest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eKE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eManuscript writing\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMbaikoua Marie Noelle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMMN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProofreading the manuscript\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMapouka Achille\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProofreading the manuscript\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTakpando Le Grand Davy Romeo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTGRD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProofreading the manuscript\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMbailao Raphael\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProofreading the manuscript\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eKakema Hebo Cathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eKHC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProofreading the manuscript\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMoyen Méthode Jean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMMJ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProofreading the manuscript\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBambou Bernard\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eData collection\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVopamade Roger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eData collection\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePamatika Christian Maucler\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePMC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eData collection\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePathe-Erepe Glwadys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePEG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eData collection\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLango Yaya Ernest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLYE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eData collection\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMbaikoua Marie Noelle, Mapouka Achille, Takpando Le Grand Davy Romeo, Mbailao Raphael, Kakema Hebo Cathy, and Moyen Méthode Jean collected the data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKalthan Ernest wrote the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBambou Bernard, Vopamade Roger, Pamatika Christian Maucler, Pathe-Erepe Glwadys and Lango Yaya Ernest proofread the document.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKaresh WB, Dobson A, Lloyd-Smith JO, Lubroth J, Dixon MA, Bennett M et al. Ecology of zoonoses: natural and unnatural histories. Lancet 2012;380:1936\u0026ndash;1945.\u003c/li\u003e\n\u003cli\u003eMachalaba Catherine, Virginia Porter, William B. Karesh. Menaces pand\u0026eacute;miques \u0026eacute;mergentes. R\u0026eacute;duire le Risque Pand\u0026eacute;mique, Promouvoir la Sant\u0026eacute;. [Internet]. [cited 2024 November 21]. Available from: file:///C:/Users/esnes/Desktop/ONE%20HEALTH/Catherine%20MaChalaba. pdf.\u003c/li\u003e\n\u003cli\u003eLoh EH, Olival KJ, Zambrana-Torellio C, Bogich TL, Johnson CK, Mazet JAK et al. (2015). Targeting transmission pathways for emerging zoonotic disease surveillance and control. Vector Borne and Zoonotic Diseases ; doi: 10.1089/vbz.2013.1563.\u003c/li\u003e\n\u003cli\u003eOMS. Une seule sant\u0026eacute; [Internet]. [cited 2024 November 21]. Available from: https://www.who.int/fr/news-room/fact-sheets/detail/ one-health. \u003c/li\u003e\n\u003cli\u003eMemorandum of understanding. Regarding cooperation to combat health risks at the animal-human-ecosystems interface in the context of the \u0026quot;one health\u0026quot; approach and including antimicrobial resistance [Internet]. [cited 2024 November 21]. Available from: file:///C:/Users/esnes/AppData/Local/Microsoft /Windows/INetCache/IE/J2VBPVIL/MoU_Tripartite_Signature_May_30_2018[1].pdf. \u003c/li\u003e\n\u003cli\u003eMinist\u0026egrave;re des Affaires \u0026Eacute;trang\u0026egrave;res et Europ\u0026eacute;ennes. Direction g\u0026eacute;n\u0026eacute;rale de la mondialisation, du d\u0026eacute;veloppement et des partenariats. Position fran\u0026ccedil;aise sur le concept \u0026laquo; One Heath/Une seule sant\u0026eacute; \u0026raquo; : pour une approche int\u0026eacute;gr\u0026eacute;e de la sant\u0026eacute; face \u0026agrave; la mondialisation des risques sanitaires, Ao\u0026ucirc;t 2011 [Internet]. [cited 2024 November 21]. Available from: http://www.diplomatie.gouv.fr/fr/IMG/pdf/ Rapport_One_Health.pdf.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization and Convention on Biological Diversity. (2015). Connecting global priorities: biodiversity and human Health, a state of knowledge review. Geneva, Switzerland and Montr\u0026eacute;al: WHO and SCBD [Internet]. [cited 2024 November 21]. Available from: http://apps.who.int/iris/bitstream/10665/174012/1/9789241508537_eng.pdf. \u003c/li\u003e\n\u003cli\u003eGashaw Adane Erkyihun, and Meseret Bekele Alemayehu. One Health Approach for the Control of Zoonotic Diseases. Zoonoses ; DOI 10.15212/ZOONOSES-2022-0037.\u003c/li\u003e\n\u003cli\u003eMoustapha Moncher Nsangou, Pierre Ongolo-Zogo. Etat des lieux de l\u0026rsquo;approche \u0026laquo; One health \u0026raquo; dans les pays de la CEMAC [Internet]. [cited 2024 November 21]. Available from: file:///C:/Users/esnes/Desktop/ONE%20 HEALTH/Moustapha%20Moncher%20Nsangou.pdf. \u003c/li\u003e\n\u003cli\u003eSt\u0026eacute;phanie Duhamel. One Health - Une seule sant\u0026eacute;, \u0026eacute;valuation d\u0026rsquo;une approche int\u0026eacute;gr\u0026eacute;e en sant\u0026eacute;, Rapport technique n\u0026deg;64 avril 2021 [Internet]. [cited 2024 November 21]. Available from: https://issuu.com/objectif-developpement/docs/rt64vf_one_health_evaluation_approche_integree_san. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"One Health, coordination, training, investigation, response, zoonosis, CAR","lastPublishedDoi":"10.21203/rs.3.rs-6887391/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6887391/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eEach year, the WHO African Region experiences over 100 health emergencies, representing approximately 70% of the global total. Notably, more than 75% of emerging infectious diseases in humans are of zoonotic origin, underscoring the critical need for integrated approaches to disease prevention and control.\u003c/p\u003e \u003cp\u003eThe \"One Health\" approach\u0026mdash;recognized as a cornerstone of global health security\u0026mdash;seeks to enhance the world's capacity to prevent, detect, and respond to infectious disease threats by fostering collaboration across human, animal, and environmental health sectors.\u003c/p\u003e \u003cp\u003eIn the Central African Republic (CAR), incremental progress has been made in operationalizing the One Health framework. Key advancements include:\u003c/p\u003e \u003cp\u003eCapacity-building initiatives aimed at improving understanding and operational uptake of the One Health concept across relevant sectors;\u003c/p\u003e \u003cp\u003eMultisectoral and multidisciplinary coordination mechanisms for the surveillance of epidemic-prone diseases and public health emergency response, led respectively by the Directorate of Epidemiological Surveillance and the Public Health Emergency Operations Center (COUSP);\u003c/p\u003e \u003cp\u003eRisk communication and information-sharing, notably through the publication of a monthly One Health bulletin that reports on surveillance, preparedness, and response activities related to public health emergencies. This bulletin is disseminated via multisectoral digital platforms such as WhatsApp groups.\u003c/p\u003e \u003cp\u003eDespite these achievements, critical gaps remain in areas such as sustainable capacity building, institutional governance, and strategic planning. Strengthening these components is essential to fully operationalize the One Health approach and enhance national health security in the Central African Republic (CAR).\u003c/p\u003e","manuscriptTitle":"Strengths and challenges of the One Health approach in the response to zoonotic epidemics in CAR","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-26 10:25:55","doi":"10.21203/rs.3.rs-6887391/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"93d71444-79ca-4baf-899c-402ffcc0cea8","owner":[],"postedDate":"June 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-21T09:23:41+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-26 10:25:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6887391","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6887391","identity":"rs-6887391","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}