Mano River Health Security Alliance - MRHSA

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Regional professional organization established to unite public health professionals, epidemiologists, clinicians, health policy experts, community health workers, and allied health practitioners across the four Mano River Union (MRU) member states.

Which disease is most likely to trigger an outbreak in the Mano River Region in 2026?As public health professionals work...
08/06/2026

Which disease is most likely to trigger an outbreak in the Mano River Region in 2026?

As public health professionals working across Sierra Leone, Liberia, Guinea, and Côte d'Ivoire, this is a question we cannot afford to leave unanswered.

The Mano River Health Security Alliance (MRHSA) has developed an evidence-based outbreak risk outlook for 2026 — and the findings demand our collective attention.

Here's what the data tells us:

#1 — Cholera | Most Likely Outbreak
Driven by seasonal flooding, limited access to safe water, and poor sanitation in urban and peri-urban areas, cholera remains the highest-probability threat across the region. Recent activity in Côte d'Ivoire is a warning signal we must not ignore.

#2 — Lassa Fever | Persistent Endemic Threat
Lassa fever is not new — but it remains deadly and underestimated. Endemic in Guinea, Liberia, and Sierra Leone, it circulates year-round, with health facility transmission continuing to pose risks to frontline workers.

#3 — Mpox | Emerging Regional Risk
Following Sierra Leone's large outbreak in 2025–2026, mpox has become a major concern. Sustained human-to-human transmission, cross-border spread risks, and vaccine access gaps require urgent attention.

#4 — Ebola | Lower Probability, Highest Impact
With outbreaks still active in DRC and Uganda, EVD risk to our region — while currently lower — must never be treated casually. A single undetected introduction could be catastrophic.

The vulnerabilities driving these risks — cross-border population movement, overburdened health systems, WASH deficits, and surveillance gaps — are not new. But in 2026, we have more tools, more partnerships, and more collective will to act.

Strengthened surveillance. Community engagement. WASH improvement. Cross-border collaboration. These are not aspirations — they are necessities.

The Mano River region has survived its share of epidemics. Our job now is to make sure the next one never takes hold.

This analysis was developed by the Mano River Health Security Alliance. Data sourced from WHO Africa, Ministry of Health reports, and regional surveillance updates (2024–May 2026).

Population Services International Clinton Health Access Initiative Jhpiego Sierra Leone GIZ Sierra Leone and Liberia Mohamed Megga Kallon World Health Organization Sierra Leone

Using the most recent World Health Organization (WHO) International Health Regulations (IHR) State Party Self-Assessment...
06/06/2026

Using the most recent World Health Organization (WHO) International Health Regulations (IHR) State Party Self-Assessment Annual Reporting (SPAR) data available in 2025–2026, the outbreak preparedness levels of the four MANO RIVER UNION countries are as follows:

Rank Country Preparedness Score (%)

1 Côte d'Ivoire 78%
2 Sierra Leone 58%
3 Guinea 55%
4 Liberia 48%

These percentages represent the average score across the 15 IHR core capacities used by WHO to assess a country's ability to prevent, detect, and respond to infectious disease outbreaks and other public health emergencies.

Interpretation

1. Côte d'Ivoire – 78%

Strongest preparedness among the Mano River countries.

High scores in emergency management, human resources, risk communication, and zoonotic disease surveillance.

Above both the African regional average and the global average.

2. Sierra Leone – 58%

Significant progress since the Ebola outbreak era.

Strong surveillance systems (80%) and improved emergency preparedness structures.

WHO reported an increase from 55% in 2024 to 58% in 2025.

3. Guinea – 55%

Moderate preparedness.

Strong laboratory capacity (80%) and risk communication (80%).

Weaknesses remain in health service provision and points of entry.

4. Liberia – 48%

Lowest overall preparedness score among the four countries.

Relatively strong emergency management capacity but lower performance in surveillance, laboratory systems, and health service provision.

Key Takeaway

Among the Mano River Union countries, Côte d'Ivoire is currently the most prepared for infectious disease outbreaks, while Sierra Leone ranks second and leads the traditional Ebola-affected MRU countries (Sierra Leone, Liberia, and Guinea) in overall outbreak preparedness.

National Public Health Agency
GIZ Sierra Leone and Liberia Population Services International Clinton Health Access Initiative Jhpiego Sierra Leone Ministry of Health

Mano River Health Security Alliance - MRHSA is a regional professional organization established to unite public health p...
24/05/2026

Mano River Health Security Alliance - MRHSA is a regional professional organization established to unite public health professionals, epidemiologists, clinicians, health policy experts, community health workers, and allied health practitioners across the four Mano River Union (MRU) member states: Guinea, Liberia, Sierra Leone, and Côte d’Ivoire.

Population Services International Clinton Health Access Initiative Jhpiego Sierra Leone GIZ Sierra Leone and Liberia National Public Health Agency Ministry of Health World Health Organization Sierra Leone MANO RIVER UNION

The 2013–2016 West Africa Ebola outbreak remains one of the most devastating public health emergencies in modern history...
24/05/2026

The 2013–2016 West Africa Ebola outbreak remains one of the most devastating public health emergencies in modern history, with over 28,000 reported cases and more than 11,000 deaths across the region.

This infographic by the Mano River Health Security Alliance - MRHSA highlights the scale of the outbreak, the countries most affected, and the lessons that continue to shape regional health security and emergency preparedness today.

The outbreak exposed critical vulnerabilities in surveillance systems, healthcare infrastructure, and cross-border coordination — but it also demonstrated the power of regional collaboration, resilience, and community engagement.
Population Services International Jhpiego Sierra Leone GIZ Sierra Leone and Liberia Clinton Health Access Initiative

Prepared. Ready. Committed. The Mano River Health Security Alliance - MRHSA is boosting preparedness across our region ...
18/05/2026

Prepared. Ready. Committed. The Mano River Health Security Alliance - MRHSA is boosting preparedness across our region — surveillance, lab response, and risk communication — and we need partners and communities to join the effort. Get involved and share this message!

🌍 Welcome to the official page of the Mano River Health Security Alliance (MRHSA)!We are proud to unite Sierra ...
04/05/2026

🌍 Welcome to the official page of the Mano River Health Security Alliance (MRHSA)!

We are proud to unite Sierra Leone, Liberia, Guinea, and Côte d’Ivoire in advancing regional health security through collaboration, preparedness, disease surveillance, and resilient health systems.

This page will share updates, initiatives, partnerships, public health information, and our collective efforts to protect communities across the Mano River region.

Together, we are stronger. Together, we are safer.

One River. Four Nations. Securing Health Together.

GIZ Sierra Leone and Liberia World Health Organization Sierra Leone Ministry of Health Jhpiego Sierra Leone Clinton Health Access Initiative Population Services International National Public Health Agency

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125 Wilkinson Road
Freetown
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