Infectious disease outbreaks remain a challenge in the West African region, driven in part by significant cross-border migration. The area has experienced persistent outbreaks of diseases that have become endemic, like malaria. Lassa fever and Ebola virus disease (EVD). Its diverse geography and interlinked economies foster close ties between countries; however, this also creates favourable conditions for infectious diseases to spread rapidly across the borders. This emphasises the need to strengthen the region's research infrastructure, boost clinical capacity, and improve coordinated responses to health emergencies. Therefore, effective research preparedness is essential to safeguard West Africa's health security.
In light of these challenges, the Africa Centres for Disease Control and Prevention (Africa CDC), the West Africa Health Organization (WAHO), the MRC Unit The Gambia (MRCG) at the London School of Hygiene & Tropical Medicine, and the International Vaccine Institute (IVI), with funding from the Coalition of Epidemic Preparedness Innovations (CEPI), convened a stakeholder consultative workshop titled "Ecosystem Engagement Workshop."
Building on the findings from the first consultative Ecosystem Engagement Workshop, which took place in Dakar in June 2024, key stakeholders reconvened in Accra from 30 October to 1 November 2024 to deepen the discussions on strengthening research capacity, regulatory alignment, and cross-country collaboration in the region. The workshop brought together over 120 public health experts, researchers, and representatives from all 15 West African nations. They collectively mapped regional research preparedness gaps and developed actionable strategies to enhance the region's research preparedness capabilities.
Laying the foundation
The Advancing Research Capacity in West Africa (ARC-WA) programme seeks to develop a stakeholder engagement plan and a strategy for emergency evidence-generation readiness in West Africa. This will be achieved through stakeholder mapping and assessments of West African countries' existing capacities and infrastructure. The programme will identify gaps and provide a roadmap for sustainable engagement, as well as help to build a strengthened clinical research ecosystem that can be quickly mobilised in the event of public health emergencies.
The first consultative Ecosystem Engagement workshop, held in Dakar in June 2024, marked a foundational step in assessing the region's research preparedness landscape. Over 50 researchers, including public health professionals and representatives from nine West African countries, participated, and the workshop focused on identifying strengths and gaps in clinical research capacity, governance, and stakeholder engagement.
Discussions identified three areas for advancing research preparedness in the region, including foundational elements for evidence generation, such as ensuring political commitment from national governments, ensuring strong oversight by national coordinating committees, and establishing agile clinical research systems. In addition, there was a push to strengthen cross-country evidence generation and sustainable stakeholder engagements at both national and regional levels. Leveraging existing platforms for regular communication between stakeholders and national and regional coordinating structures is important to achieve the goal of strengthening the research ecosystem.
Solutions for a resilient research ecosystem in West Africa
The recently concluded workshop in Accra built on the outcomes of the first workshop in Dakar, with a focus on developing tailored solutions to address previously identified gaps. The discussions also acknowledged the region's existing strengths, including a robust national coordination structure for outbreak response, and the presence of active research institutions like MRCG and Institute Pasteur, which contribute to clinical trials and vaccine research during inter-epidemic periods. These strengths provided a foundation for formulating actionable solutions to enhance research preparedness. The workshop featured presentations, breakout sessions, and plenary discussions, providing participants with the opportunity to explore targeted strategies for strengthening research preparedness.
The consultative sessions identified six major gaps in research preparedness, including:
1. Limited prioritisation of national research agendas
2. Inadequate regional/national coordination
3. Insufficient clinical research capacity
4. Weak regulatory and ethics systems
5. Limited in-country, cross-country, and cross-border collaboration for clinical research
6. Insufficient resources for research preparedness activities
Based on the identified gaps, solutions that align with the Africa CDC and WAHO's objectives of strengthening regional health security and preparedness were outlined:
1. Prioritising research preparedness in national agendas: Although there is ongoing research across the region, a key gap highlighted during the workshop was the limited prioritisation of research agendas in national development plans within the region, including in existing health security frameworks across the region, a challenge partly driven by insufficient political will.
While Africa CDC has developed a risk ranking and prioritisation tool for epidemic-prone diseases, it has yet to be fully adopted by member states. To address this, national agendas need to be developed and prioritised across the region and integrated into national systems. The national research agenda should be developed through participatory processes involving all relevant stakeholders. Serving as blueprints for advancing research preparedness, the national agendas must be accompanied by continuous oversight, evaluation, and advocacy.
2. Strengthening coordination mechanisms: Despite several coordination structures being developed in the region, gaps remain in research preparedness coordination at both regional and national levels. While significant clinical research activities are taking place in research institutes across countries, there is very limited coordination between these centres.
Although the Africa CDC has begun mapping and documenting research activities within the region, and WAHO has developed a regional research agenda for the region, there is a need to build on these efforts. This would require conducting a comprehensive mapping of activities and capacities to better harness the region's resources and ensure improved synergy and cohesion, particularly as West African countries face very similar infectious disease outbreaks.
It was recommended that National Coordination Committees, supported by dedicated research Technical Working Groups (TWGs), be established. In addition to the creation of a Regional Coordination Committee with national representation to help improve alignment across countries and facilitate cross-border research coordination.
3. Expanding clinical research capacity: While the West African region has no shortage of qualified doctoral-level researchers, there remains a gap in the specific skills required for quality clinical research. Advanced research facilities exist in countries like Senegal (Institut Pasteur Dakar) and Nigeria (Nigeria Institute of Medical Research); however, clinical research expertise is still limited in the region. The hub-and-spoke model was proposed as a means to efficiently allocate resources and expertise. Hubs would serve as focal points for training and technical support, while spokes would focus on community engagement, local data collection, and reporting. Practical steps to operationalise this model were suggested, including the use of assessment tools to evaluate existing clinical research sites and the development of criteria for categorising and allocating sites. This approach aims to efficiently distribute resources and expertise across the region, thereby strengthening the overall capacity for clinical research.
4. Enhancing regulatory and ethics systems: Regulatory frameworks in the region are advanced, with countries like Nigeria and Ghana attaining Maturity Level 3 in 2020 and 2022 respectively. However, participants, highlighted the importance of harmonising regulatory frameworks to expedite research approvals, as well as bridging gaps that persist in ethics. To support countries with less-developed regulatory systems, collaborative programmes with more experienced countries and the use of WHO's Global Benchmarking Tool for regulatory assessment were recommended.
5. Increasing in-country, cross-country, and cross-border collaboration for clinical research: Research activities in the region often operate in silos, with limited collaboration between centres and countries. To maximise impact, sharing knowledge and resources within and across borders is essential. Mapping and connecting research institutions and laboratories working on similar diseases is essential for fostering collaborations, integrating existing surveillance platforms, and supporting real-time data sharing and coordinated response to health challenges. In addition, establishing exchange programmes between hubs and spokes can provide opportunities for language immersion, helping to bridge communication gaps and reduce language barriers.
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6. Ensuring sustainable funding models for research preparedness: Funding for research activities is currently limited and often driven by donor interests rather than aligning with national priorities. This makes it challenging to shape the research agenda and tailor it to the specific needs of countries and communities, highlighting the importance of political will. To address this issue, advocacy activities demonstrating the significance of research preparedness were recommended. This encourages funders to allocate resources to specifically strengthen research preparedness. Increased focus on sustainable financing model is critical to building a resilient research ecosystem.l cross-cutting gap that was also highlighted was the limited translation of research findings into policy and practice, which is essential for evidence-based responses to health threats. To address this, there is a need to bridge this gap by strengthening communication, public involvement and community engagement capacities within the research community. This will ensure that evidence is not only understood but also applied in shaping health policies and practices.
A Path Forward for West Africa
The consultative workshops represent a step in building a resilient, collaborative research ecosystem in West Africa. By establishing a regional stakeholder engagement framework for research preparedness, these workshops identified gaps in capabilities and coordination, laying a solid foundation for a sustainable and collaborative response to infectious disease outbreaks across the region. The next steps from this workshop include the development of tailored engagement plans based on identified solutions and recommendations. These plans will serve as a strategic framework for guiding funding and initiatives to strengthen research preparedness in the region.
