Evidence brief: Beyond silos: Drivers and barriers to intersectoral collaboration in zoonotic disease surveillance and response in the Greater Accra Metropolitan Area, Ghana

Abstract

The One Health approach has gained global traction as a strategy to combat zoonotic diseases, which account for 60–75% of emerging infectious diseases. While effective surveillance requires intersectoral collaboration, challenges such as fragmented systems, resource constraints, and weak coordination hinder efforts, particularly in low- and middle-income countries like Ghana. This qualitative study explores the factors influencing collaboration in zoonotic disease surveillance and response at the operational level, providing insights to strengthen intersectoral collaboration and improve public health outcomes across human, animal and wildlife sectors. Using reflexive thematic analysis, we analyzed interviews with 66 professionals from the human, animal, and wildlife health sectors, all directly involved in zoonotic disease surveillance and response. The findings reveal individual factors (interpersonal relationships, personal initiative, motivations, professional hierarchy, shared interests) and structural factors (financial resources, workforce availability, the governance and organization of surveillance and response systems, institutional visibility, knowledge systems) that shape collaboration dynamics. Additionally, positive outcomes from past collaborations created reinforcing cycles that influenced future engagement. Participants shared expectations of improved efficiency, strengthened disease surveillance, and enhanced resource pooling from future collaboration. Despite the global push for intersectoral collaboration, operational-level challenges persist. While grounded in a Ghanaian context, the types of factors identified likely resonate across resource-limited settings, though their specific manifestations and relative importance may vary by context. These findings underscore the broader need for stronger governance, equitable partnerships, and realistic alignment of stakeholder expectations to foster sustainable One Health collaboration and enhance zoonotic disease surveillance globally.

Introduction

Zoonotic diseases account for 60−75% of emerging infectious diseases, posing a significant health threat [1–3]. Outbreaks of COVID-19, Highly Pathogenic Avian Influenza (HPAI), Ebola, and Marburg illustrate how rapidly these diseases can spread, disrupting economies, agriculture, and food production [4,5]. The risk of zoonotic disease transmission is particularly high in low- and middle-income countries (LMICs), where frequent human-animal interactions facilitate zoonotic spillover, while weak surveillance systems and limited public health infrastructure impede effective detection and response [6–8]. Over the past two decades, zoonotic diseases have caused approximately 30,000 human infections in sub-Saharan Africa [9]. Climate change is expected to exacerbate the spread of zoonotic diseases, altering their epidemiology, and increasing the severity of vector-borne, waterborne, foodborne, and airborne infections [10,11].

The One Health approach, which recognizes that human, animal, and environmental health are interconnected and require integrated actions, has gained global momentum as a strategy to combat zoonotic diseases [12–14]. Effective disease surveillance requires intersectoral collaboration; however, governance challenges, fragmented systems, resource constraints and poor communication often hinder these collaborative efforts [12–14]. In LMICs like Ghana, translating One Health principles into practical, sustained collaboration at the operational level remains a major challenge due to limited guidance and weak intersectoral coordination [13].