# An analysis of One Health timeliness metrics across multisectoral public health emergencies in Uganda

## TL;DR

The study examines how quickly Uganda detects and responds to disease outbreaks using a One Health approach, finding that known diseases and viral hemorrhagic fevers are addressed faster due to prior experience and preparedness.

## Contribution

The study identifies factors influencing outbreak timeliness in Uganda using a One Health framework, emphasizing the role of prior experience and perceived threat.

## Key findings

- Outbreaks with prior experience or viral hemorrhagic fevers show improved detection and response times.
- Diagnostic and contextual factors, including One Health collaborations, influence timeliness.
- Enhanced coordination across sectors could prevent future pandemics by improving outbreak control.

## Abstract

Timeliness metrics offer countries a framework by which to assess and optimize speed in outbreak detection and response times. This study analyses the One Health timeliness metrics for multisectoral public health emergencies in Uganda to identify and explore factors influencing outbreak performance.

We compiled a database of outbreak events in Uganda occurring between 2018-2022 and involving the human, animal, plant, and environmental sectors. Outbreak milestone dates were extracted from reports to calculate timeliness metrics, which were analyzed using proportional hazards regression models. Concurrently, we conducted Key Informant Interviews to explore factors affecting detection and response timeliness.

Integrated analyses of timeliness metrics from 81 outbreaks and expert interviews reveal that the greatest predictors of improved timeliness are frequent past experience with similar disease outbreaks and whether an outbreak is a viral hemorrhagic fever due to heightened perceived threat and pre-existing preparedness measures. Other factors, including diagnostic and laboratory considerations and contextual influences, such as One Health collaborations, are also described as relevant to timeliness.

To complement positive timeliness trends in Uganda, disease-agnostic investments in outbreak preparedness and response efforts will facilitate the ability of health systems to rapidly detect and respond to all outbreaks, irrespective of the pathogen.

Fieldhouse et al. assess outbreak timeliness during health events in Uganda occurring between 2018-2022 and involving human, animal, plant, and environmental sectors. Detection and response times are strongest for diseases Uganda has previous experience with and for outbreaks of viral hemorrhagic fevers due to heighted perceived threat.

Rapid detection and response to disease outbreaks helps prevent their spread into larger, more harmful epidemics or pandemics. This study evaluates how quickly teams in Uganda detect and address disease outbreaks using a “One Health” approach, which integrates the health of humans, animals, plants, and the environment. By analyzing key dates of outbreaks between 2018 and 2022 and interviewing response experts, we compare detection and response times across different outbreak types. Findings reveal that while teams respond quickly to known diseases, novel diseases that the health system is unfamiliar with take longer to detect and address. Enhanced coordination between animal, human, and environmental health sectors could help prevent future pandemics by ensuring all outbreaks, regardless of type, are identified and controlled before widespread disease transmission occurs.