The World Health Organization (WHO) Response Preparedness (RePrep) workshop on preparedness for response to zoonotic outbreaks was held in Addis Ababa from 23-26 May 2023. The workshop is part of the RePrep programme that the WHO developed to support countries in developing a joint, intersectoral framework for zoonotic disease outbreak response. The workshop in Addis Ababa was among the first implementations of this programme globally and the first in Africa.

This pilot of the RePrep to Zoonotic Disease Outbreaks Operational Tool and the Workforce Development Operational Tool (WFD OT) was organised by WHO upon request from the Ethiopia National One Health Steering Committee (NOHSC) represented by Dr Feyesa Regassa from the Ethiopian Public Health Institute (EPHI). Facilitators included WHO HQ representatives, Lisa Sheuermann leading on the RePrep pilot and Ong-orn Aim Prasarnphanich leading on the WFD-OT pilot, WHO Afro representatives included Dr Tieble Traore, Dr Dilys Morgan and Triantafyllia Efthymiou, WHO Ethiopia representatives included Dr Patrick Abok and Dr Mohammed Abdikadir, and Dr Kiki Oluwarore represented the WHO office in Nigeria. UKHSA IHR-SP as a valued partner was represented by Lukeki Kaindama, as a facilitator, and Dr Baye Wassie who provided technical contributions in the group work and plenary discussions.

The aim of the workshop was to support countries to develop or amend their zoonotic disease outbreak response framework by working through a fictitious outbreak scenario. This framework will ensure that all partners have a good understanding of their role, the contribution of the other parties and proposes a structure for joint management of zoonotic outbreaks. The goal is for a joint framework for coordinated response to zoonotic disease outbreaks to be developed that facilitates a collaborative, joint approach with a clear distribution of roles, responsibilities, and operations. The workshop was attended by 48 participants from the Ministry of Public Health (MoH), the Ministry of Agriculture (MoA), the Ministry of Environment (MoE), the NOHSC, the Ethiopian Public Health Institute (EPHI), the Animal Health Institute (AHI), the Ethiopian Wildlife Conservation Authority (EWCA), the Environmental Protection Authority (EPA) with representatives from the central, and regional level attending the three-day discussions. Representatives of the Ethiopian Disaster Risk Management Commission, Federal Police Commission, as well as Jimma and Addis Ababa Universities were also present.

The programme contributes to the following outcomes:

· A better understanding of expertise and capacities existing in other sectors and opportunities and benefit to pool and synergize between sectors

· New/strengthened interpersonal relationships to facilitate collaboration between sectors (behavior change)

· An operational approach ensuring multisectoral coordination in preparedness and response to zoonotic disease outbreaks, with some experienced references to existing WHO guidance

· Strengthened professional competence in coordinating the response to zoonotic outbreaks

The RePrep workshop began with an overview of current outbreak response plans from the health and animal sector followed by a presentation from the NOHSC providing an overview of zoonotic outbreaks, current response and surveillance structures and current challenges to outbreak response. The next session involved participants defining current response activities to three priority zoonoses (Rift Valley Fever, Rabies and Anthrax). Participants then rated the activities to determine strengths and weaknesses of the current response. Following these two sessions, the fictitious

outbreak scenario was introduced and covered the next five sessions. Session seven brought all the data from the three days together as a draft zoonotic disease outbreak response framework with participants agreeing the overall structure and main points of the framework. Participants then discussed where a zoonotic disease outbreak response framework would best sit within their national structure. Based on the format of the “Multisectoral Zoonotic Disease Outbreak Investigation Guideline”, Ethiopia will develop a stand-alone guidance on joint zoonotic disease outbreak response. The draft framework document produced from this workshop will be reviewed, developed, and finalised by the NOHSC.

While countries recognize the benefits of taking a multisectoral, OH approach to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases and other health threats at the human-animal-environment interface, many countries still meet difficulties in operationalizing multisectoral coordination, communication, and collaboration, and have limited or inadequate human resources available or accessible. Therefore, the final part of this workshop was a condensed version of the pilot of the WFD Operational Tool where an evidence-based approach was used to plan for and mobilize a multisectoral, OH workforce for effective zoonotic disease preparedness and response. The workforce functions and occupations required for effective zoonotic disease preparedness and response, were mapped out (including human resource/ staffing needs and competency-based education and training strategies for current and future workers) to identify areas for workforce strengthening and development.