Côte d’Ivoire: Score Justification Summary

1.1.1a National plan for AMR priority pathogens

Score: 100

Côte d'Ivoire has a national AMR plan for the surveillance, detection, and reporting of priority AMR pathogens. In 2021, Côte d'Ivoire published the Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025. PAN-RAM includes six strategic objectives with attached sub-objectives and goals: Strengthening the organizational framework for the fight against antimicrobial resistance (p. 38), improve awareness and understanding of antimicrobial resistance through effective communication, education, and training (p. 40); strengthen knowledge and evidence through surveillance and research (p. 42); reduce the incidence of infection through effective sanitation, hygiene, and infection prevention measures (p. 45); optimize the use of antimicrobial agents in human and animal health (p. 47); and promote sustainable investment based on country needs and sustainable research and development (p. 52). ¹ Specific Objective 3.1: “Develop a national multisectoral AMR surveillance system”, covers surveillance, detection and reporting, with action steps (“3.1.1.1 Revitalizing the coordination of multisectoral surveillance of AMR in laboratories,” “3.1.2.1 Strengthen laboratory surveillance of AMR in human health, animal health, the environment, agri-food, water, and forests,” “3.1.2.2 Integrate laboratory surveillance of AMR into environmental health,” and “3.1.2.3 Establish an AMR surveillance network for agri-food safety.”) (pp. 42-43). ²

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

There is evidence that Côte d'Ivoire tests for priority AMR pathogens but not all 7+1. According to the Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, Côte d’Ivoire has a national laboratory system. ³ Section P4.2. Surveillance of AMR reports that “Diagnostic capabilities are available in all sectors and are reinforced by molecular biology and genomics platforms (whole genome sequencing) at the Pasteur Institute of Côte d'Ivoire (IPCI)” and “A network of public and private laboratories participating in AMR surveillance is being established” (p. 17). ⁴ The 2021 Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report includes a summary of information concerning Côte d’Ivoire and confirms that there are 23 laboratories performing antimicrobial susceptibility testing (and all with external quality assurance) (p. 79) but does not specify which tests are avaliable. ⁵ The Catalogue of Current Medical Analyses (Catalogues des Analyses Médicales) of the Pasteur Institute of Côte d'Ivoire confirms that some tests are available for common AMR diseases but does not off which specific tests are avaliable. ⁶

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is insufficient evidence that Côte d’Ivoire conducts environmental detection or surveillance activities for antimicrobial residues or AMR organisms. According to the Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, Côte d’Ivoire does not conduct or publish environmental surveillance data on AMR pathogens (and should do so) (p. 17). ⁷ The 2021 Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report includes a summary of information concerning Côte d’Ivoire and does not contain evidence of environmental detection or surveillance activities, with all the noted surveillance sites being healthcare related (p. 79). ⁸ The 2021 Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 includes a Situational Analysis and Evaluation of AMR capacity in Côte d’Ivoire (conducted in 2021) that notes that while there is capacity to carry out environmental surveillance through the CIAPOL microbiology laboratory (p. 24), there was “no surveillance of antimicrobial residues in effluents and the environment (p. 25). Further, the PAN-RAM’s sub-objective “3.1.2.1 Strengthen laboratory surveillance of AMR in human health, animal health, the environment, agri-food, water, and forests” (p. 43), but does not contain specific evidence of ongoing surveillance and establishing such a surveillance system is not included in any of the sub-activities for the objective, on pages 81-84. ⁹ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁰, the Ministry of Environment and Sustainable Development ¹¹, the Ministry of Water and Forests ¹² and the Institut Pasteur de Côte d'Ivoire ¹³ do not contain evidence of environmental detection or surveillance activities relating to AMR.

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 0

There is insufficient evidence of national legislation or regulation in place requiring prescriptions for antibiotic use for humans in Côte d’Ivoire. According to the Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that “Structures capable of regulating the rational use of antimicrobial agents (sub-directorate of pharmacy and veterinary medicines, the national order of veterinarians of Côte d'Ivoire) have been put in place” (p.18) but that Côte d’Ivoire needs to take significant steps around anti-biotic use in humans, incluing “Policies and regulations on pharmacovigilance must be developed,” and “Procedures for stock management and procurement must be developed” (p. 19). ¹⁴ The 2021 Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 includes a Situational Analysis and Evaluation of AMR capacity in Côte d’Ivoire (conducted in 2021) that notes that “The country has regulations governing the importation and marketing of medicines for human health, as well as a code of ethics and a guideline for the dispensing of medicines for the human and animal health sectors” (p. 20) but does not state the prescriptions are required for all antibiotics used for humans. ¹⁵ Article 8 of the Statutes and Codes of Medical Ethics of the National Order of Doctors of the Republic Of Côte d'Ivoire states “The practitioner is free to prescribe as he or she wishes, but must take into account his or her duty of moral assistance and limit his or her prescriptions and actions to what is necessary for the quality, safety, and effectiveness of care. He or she must charge fees proportional to the care provided,” but they do not specify that antibiotic require a prescription. ¹⁶

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 0

There is insufficient evidence of national legislation or regulation in place requiring prescriptions for antibiotic use for animals in Côte d'Ivoire. According to the Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that “Policies and regulations on pharmacovigilance must be developed,” “Data on the distribution of veterinary drugs by veterinary pharmacies must be updated, and monitoring strengthened,” “Data on veterinary products distributed (veterinary pharmacies) and used (veterinary clinics) must be collected,” and “Guidelines on the prudent use of antimicrobials for veterinary use must be issued” (p. 19). ¹⁷ The 2021 Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 includes a Situational Analysis and Evaluation of AMR capacity in Côte d’Ivoire (conducted in 2021) that notes that “the animal health system in Côte d'Ivoire needs specific regulations on AMR. Decrees implementing this code must be adopted for the use of antimicrobials in animal health and for the fight against AMR” (p. 21). ¹⁸

1.2.1a Laws/plans on zoonotic disease

Score: 0

There is insufficient evidence that Côte d’Ivoire has national legislation, plans, or equivalent strategy documents for zoonotic disease prioritization, detection and reporting. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, includes in its reccomended priorty actions for zoonosis, that Côte d’Ivoire “Update the list of priority zoonoses” (which were created in 2017), “Develop and apply procedures for managing and exchanging information on zoonotic diseases between different sectors” and “Establish standard operating procedures for multisectoral response (defining the roles of different actors: logistical coordination, resource mobilization) and conduct after-action reviews (AARs)” (p. 21); the JEE also notes that “Comprehensive plans to combat highly pathogenic avian influenza (HPAI) and rabies have been developed” but does not contain evidence of a strategy covering all zoonotic diseases (p. 21). ¹⁹ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁰, the Ministry of Environment and Sustainable Development ²¹, the Ministry of Water and Forests ²² and the Institut Pasteur de Côte d'Ivoire ²³ do not contain evidence of national legislation, plans, or equivalent strategy documents for zoonotic disease prioritzation, detection and reporting.

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 0

There is insufficient evidence that Côte d’Ivoire has national legislation, plans, or equivalent strategy documents which include measures for risk identification and reduction for zoonotic disease spillover events from animals to humans. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, includes in its reccomended priorty actions for zoonosis, that Côte d’Ivoire “Update the list of priority zoonoses” (which were created in 2017), “Develop and apply procedures for managing and exchanging information on zoonotic diseases between different sectors” and “Establish standard operating procedures for multisectoral response (defining the roles of different actors: logistical coordination, resource mobilization) and conduct after-action reviews (AARs)” (p. 21); the JEE also notes that “Comprehensive plans to combat highly pathogenic avian influenza (HPAI) and rabies have been developed” but does not contain evidence of a strategy covering all zoonotic diseases (p. 21). ²⁴ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁵, the Ministry of Environment and Sustainable Development ²⁶, the Ministry of Water and Forests ²⁷ and the Institut Pasteur de Côte d'Ivoire ²⁸ do not contain evidence of national legislation, plans, or equivalent strategy documents for zoonotic disease prioritzation, detection and reporting.

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 0

There is insufficient evidence that Côte d’Ivoire has national legislation, plans, or equivalent strategy documents that account for the surveillance and control of multiple zoonotic pathogens of public health concern. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, includes in its recommended priority actions for zoonosis, that Côte d’Ivoire “Update the list of priority zoonoses” (which were created in 2017), “Develop and apply procedures for managing and exchanging information on zoonotic diseases between different sectors” and “Establish standard operating procedures for multisectoral response (defining the roles of different actors: logistical coordination, resource mobilization) and conduct after-action reviews (AARs)” (p. 21); the JEE also notes that “Comprehensive plans to combat highly pathogenic avian influenza (HPAI) and rabies have been developed” and “Integrated surveillance plans for the priority zoonoses of Lassa fever, Rift Valley fever, brucellosis, and tuberculosis have been developed” but does not contain evidence of a strategy covering all zoonotic diseases (p. 21). ²⁹ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁰, the Ministry of Environment and Sustainable Development ³¹, the Ministry of Water and Forests ³² and the Institut Pasteur de Côte d'Ivoire ³³ do not contain evidence of national legislation, plans, or equivalent strategy documents for zoonotic disease prioritzation, detection and reporting.

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 100

Côte d’Ivoire has a department, agency, or similar unit functioning as a multi-sectoral co-ordinating mechanism dedicated to zoonotic disease that functions across ministries. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that “The One Health Platform and the Technical Working Group (TWG) on Animal Health have been established and are recognized by all sectors as the framework for multisectoral coordination of zoonosis management” (p. 21). ³⁴

1.2.1e Presence of One Health strategic plan

Score: 0

Côte d'Ivoire has a One Health platform but there is no evidence of a One Health strategic plan. ³⁵³⁶

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 100

There is evidence of a national mechanism for owners of livestock to conduct and report on disease surveillance, but not to a central government agency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the zoonosis section that “Integrated surveillance plans for priority zoonoses of Lassa, Valley fever, Rift, brucellosis and tuberculosis have been developed” (p. 20). ³⁷ According to the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, animal health surveillance is conducted at the district level, where surveillance data is collected by livestock station officers, who then report to district officers, who finally pass that information to the Ministry of Animal and Fisheries Resources (ministère des Ressources animales et halieutiques) MIRAH (p. 5); the PANSS reports that rinderpest, African swine fever, contagious bovine pleuropneumonia, peste des petits ruminants, foot-and-mouth disease, Newcastle disease, rabies, anthrax, and tuberculosis are the targets of surviellance (p.5). ³⁸

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

Côte d'Ivoire's data privacy regulations may apply to safeguard the confidentiality of information about owners generated through surveillance activities for animals, but there is no available public evidence that the law specifically applies to information generated through surveillance. Côte d'Ivoire's data privacy regulations—Law No. 2013-450 of June 19, 2013 on Protection of Personal Data and Decree No. 2015-79 of February 4, 2015 (Authorization Procedure for Personal Data Processing)—protect all forms of personal information collected from any type of media. While there is no explicit mention of protection for information generated through animal disease surveillance activities, such data would fall under the category of "personal data" if it contains identifying information about an individual. Personal data, which is defined as any information relating to an identified or identifiable individual, is protected under Law No. 2013-450 of June 19, 2013 and Decree No. 2015-79 of February 4, 2015. However, the data protection regulations do not explicitly address surveillance or property protections. Law No. 2013-450 does cover "the processing of personal data with a pattern of public interest, particularly for historical, statistical or scientific purposes." ³⁹⁴⁰ Côte d'Ivoire's Telecommunications and ICT Regulatory Authority (Autorité de Régulation des Télécommunications/TIC de Côte d'Ivoire (ARTCI)) oversees the implementation of data protection regulation. and ARTCI conducts ongoing seminars and training on data protection regulation. However, there is no mention of data protection related to information generated through surveillance activities for animals for owners in these seminars and training sessions ⁴¹⁴².

1.2.2c Wildlife zoonotic disease surveillance

Score: 100

Côte d’Ivoire conducts surveillance of zoonotic disease in wildlife (e.g., wild animals, insects, other disease vectors), poultry and livestock. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the zoonosis section that “Integrated surveillance plans for priority zoonoses of Lassa, Valley fever, Rift, brucellosis and tuberculosis have been developed” (p. 20). ⁴³ Further, the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, reports that animal health surveillance is conducted at the district level and that rinderpest, African swine fever, contagious bovine pleuropneumonia, peste des petits ruminants, foot-and-mouth disease, Newcastle disease, rabies, anthrax, and tuberculosis are the targets of surveillance (p. 5); figure 3 (p. 5) shows that surviellance is conducted on farms, in abattoirs, in markets as well as at points of entry, but it does not specify which animals are targeted, only the diseases. ⁴⁴ The JEE reports “The country has a surveillance system using electronic devices capable of detecting alert thresholds in human and animal health” (p. Viii) but the diseases prioritized for surveillance have not been updated since 2017 (p. 20). ⁴⁵ The 2016 JEE confirms that zoontic surviellance is ongoing, noting that “Côte d’Ivoire has bodies responsible for zoonotic disease surveillance (the Ministry of Animal Resources and Fisheries, the Ministry of Water and Forests and the Ministry of Health and Public Hygiene), each of which carries out surveillance activities independently” (p. 15) and that the country has had a “Surveillance system for animal diseases (including zoonotic diseases) since 2001, for human health and wildlife” (p. 15). ⁴⁶ Section 3.2.2, Pathogens detected in wildlife 2025, of a 2025 research paper in the journal One Health documents which pathogens and virus have been detected in wildelife in Côte d’Ivoire since 2025. ⁴⁷ No evidence of an updated list of prioritized diseases is available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁸, the Ministry of Environment and Sustainable Development ⁴⁹, the Ministry of Water and Forests ⁵⁰ or the Institut Pasteur de Côte d'Ivoire ⁵¹.

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the World Organisation for Animal Health (WOAH). The World Organization for Animal Health includes a list of Animal Disease Notification Focal Points on its website, who are responsible for transmitting information concerning notifiable diseases for inclusion in the WAHIS database; Cote d’Ivoire has an Animal Disease Notification Focal Point, the Deputy Director of Regulation And Zoosanitary Information in the Directorate of Veterinary Services and Animal Welfare. ⁵²

1.2.4a Number of veterinarians per 100,000 people

Score: 4.29

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 2.91

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is insufficient evidence that Côte d’Ivoire has national legislation, plans, or equivalent strategy documents for zoonotic disease prioritization, detection and reporting, including working with the private sector. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, includes in its reccomended priorty actions for zoonosis, that Côte d’Ivoire “Update the list of priority zoonoses” (which were created in 2017), “Develop and apply procedures for managing and exchanging information on zoonotic diseases between different sectors” and “Establish standard operating procedures for multisectoral response (defining the roles of different actors: logistical coordination, resource mobilization) and conduct after-action reviews (AARs)” (p. 21); the JEE also notes that “Comprehensive plans to combat highly pathogenic avian influenza (HPAI) and rabies have been developed” but does not contain evidence of a strategy covering all zoonotic diseases (p. 21); none of the information indicated plans or policies for working with the private sector. ⁵³ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵⁴, the Ministry of Environment and Sustainable Development ⁵⁵, the Ministry of Water and Forests ⁵⁶ and the Institut Pasteur de Côte d'Ivoire ⁵⁷ do not contain evidence of national legislation, plans, or equivalent strategy documents for zoonotic disease prioritzation, detection and reporting, including private sector participation. However, according to the WHO, Côte d’Ivoire does have a focal point for animal disease notification with WOAH. ⁵⁸

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is no evidence that Côte d’Ivoire has in place a record, updated within the past five years, of the facilities in which especially dangerous pathogens and toxins are stored or processed, but that it does not include details on inventories and inventory management systems of those facilities. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that “there is no system for updating the inventory and actively monitoring dangerous biological agents at the national level” (p. 25). ⁵⁹ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain evidence of plans to produce a public record of the facilities in which especially dangerous pathogens are stored or processed. ⁶⁰ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁶¹, the Ministry of Environment and Sustainable Development ⁶², the Ministry of Water and Forests ⁶³ and the Institut Pasteur de Côte d'Ivoire ⁶⁴ do not contain evidence of a record of the facilities in which especially dangerous pathogens and toxins are stored or processed. Côte d'Ivoire has submitted Confidence Building Measures under the Biological Weapons Convention since 2022; the 2025 report is public and reports that both the Institut Pasteur de Côte d'Ivoire and the National Laboratory of Public Health (LNSP) are designated BLS4 or equivalent and handle “bacteria and viruses”; no further information is provided (p. 3-5). ⁶⁵ In addition, there is no legislation or regulation listed in the VERTIC BWC legislation database regarding the storage or processing of dangerous pathogens and toxins. ⁶⁶

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 50

There is evidence that Côte d’Ivoire has legislation and/or regulations related to biosecurity, but insufficient evidence that it outlines specific requirements such as physical containment, operation practices, failure reporting systems, and/or cybersecurity of facilities in which especially dangerous pathogens and toxins are stored or processed. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d’Ivoire “has legislation regulating biological safety and security activities within the various laboratory levels, already taking into account the P4 level” (p. 25). ⁶⁷ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, contains the objective that “By 2019, national regulations for biological safety and security concerning the use, storage, disposal, and safe and secure containment of pathogens in laboratories are developed in the human, animal, agricultural, and environmental fields” (p. 33). ⁶⁸ The United Nations Institute for Disarmament Research (UNIDIR) reports that Côte d’Ivoire has laws covering biosecurity: “Article 10 of Law No. 2022-792 provides a list of biological agents and toxins that pose a severe risk to public health and safety and national security. Côte d’Ivoire has a specific legal framework governing the licensing, registration and inspections of individuals and facilities working with biological agents and toxins.” ⁶⁹ That law, Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), covers requirements for handling such pathogens, with Article 16 requiring prompt notification of the national authorites of any theft, accident, loss or release of controlled substances or toxins; however, the law does not specifically discuss specific requirements such as physical containment, operation practices, failure reporting systems, and/or cybersecurity of facilities. ⁷⁰ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁷¹, the Ministry of Environment and Sustainable Development ⁷², the Ministry of Water and Forests ⁷³ and the Institut Pasteur de Côte d'Ivoire ⁷⁴ do not contain further information about legislation and/or regulations related to biosecurity. Côte d'Ivoire has submitted Confidence Building Measures under the Biological Weapons Convention since 2022; the 2025 report is public but does not contain information about specific laws or regulations covering laboratories. ⁷⁵ In addition, there is no legislation or regulation listed in the VERTIC BWC legislation database regarding the storage or processing of dangerous pathogens and toxins. ⁷⁶

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 100

There is evidence of an established agency responsible for the enforcement of biosecurity legislation and regulations in Côte d’Ivoire. Article 3 of Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), establishes an agency for overseeing and enforcing biosafety and biosecurity laws: “A National Authority is hereby established to implement the Convention at the national level. The National Authority shall have legal personality and financial autonomy. The powers, organization, and operation of the National Authority shall be determined by decree issued by the Council of Ministers.” ⁷⁷ However, there is insufficient evidence of such a designation on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁷⁸, the Ministry of Environment and Sustainable Development ⁷⁹, the Ministry of Water and Forests ⁸⁰ and the Institut Pasteur de Côte d'Ivoire ⁸¹.

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is insufficient public evidence that Côte d'Ivoire has taken action to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, ⁸² and the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS do not contain evidence or discussion of consolidating inventories of especially dangerous pathogens and toxins. ⁸³ The United Nations Institute for Disarmament Research (UNIDIR) also does not contain evidence of such actions. ⁸⁴ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁸⁵, the Ministry of Environment and Sustainable Development ⁸⁶, the Ministry of Water and Forests ⁸⁷ and the Institut Pasteur de Côte d'Ivoire ⁸⁸ do not contain evidence of a record of the facilities in which especially dangerous pathogens and toxins are stored or processed. Côte d'Ivoire has submitted Confidence Building Measures under the Biological Weapons Convention since 2022; the 2025 report is public but it does not discuss plans to consolidate inventories of dangerous pathogens and toxins. ⁸⁹ In addition, there is no legislation or regulation listed in the VERTIC BWC legislation database regarding the storage or processing of dangerous pathogens and toxins. ⁹⁰

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 100

Côte d'Ivoire has public evidence of in-country capacity to conduct Polymerase Chain Reaction (PCR)-based diagnostic testing for Ebola that precludes culturing a live pathogen. An academic publication from 2017 indicates that the Pasteur Institute of Côte d'Ivoire has the capacity to conduct PCR-based diagnostic testing that precludes culturing a live pathogen; the Institute participated in an international study that conducted PCR-based diagnostic test for Ebola from inactivated ebolavirus samples. ⁹¹ The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Biological safety and security” section that “Diagnostic methods that do not require prior culture of dangerous agents (TDR, PCR, etc.) are used.” (p. 26). ⁹² The Catalogue of Current Medical Analyses (Catalogues des Analyses Médicales) of the Pasteur Institute of Côte d'Ivoire reports that PCR testing for Hepatitis E (HEV) is available and has been in use since 2009. ⁹³

1.3.2a Biosecurity training using a standardised, required approach

Score: 33.33

There is evidence that Côte d'Ivoire requires biosecurity training but there is only evidence of biosecurity and biosafety training being provided on an ad hoc basis. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d’Ivoire “In addition to various training courses for staff in the human, animal, and environmental sectors, standard operating procedures, biosafety, and biosecurity manuals are developed and updated within the country's reference laboratories, such as the Pasteur Institute of Côte d'Ivoire (IPCI) and the National Laboratory for Agricultural Development Support (LANADA). There are no plans for training laboratory staff in biosafety and biosecurity at the national level” (p. 25). ⁹⁴ Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), covers regulations for handling especially dangerous pathogens and toxins, does not specifically contain requriements for staff training or recertification. ⁹⁵ Information on training for personnel working with such toxins and pathogens is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁹⁶, the Ministry of Environment and Sustainable Development ⁹⁷, the Ministry of Water and Forests ⁹⁸ and the Institut Pasteur de Côte d'Ivoire ⁹⁹.

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is insufficient evidence that regulations or licensing conditions in Côte d'Ivoire specify that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are subject to the following checks: drug testing, background checks, and psychological or mental fitness checks. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not contain evidence that any of these checks are required for security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential. ¹⁰⁰ The United Nations Institute for Disarmament Research (UNIDIR) reports that Côte d’Ivoire does not require background checks for personnel working with especially dangerous pathogens or toxins. ¹⁰¹ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, discusses improving laboratory capacity and capability but does not discuss requiring personnel to undergo drug testing, background checks, and psychological or mental fitness checks. ¹⁰² Information on requirements for personnel working with such toxins and pathogens is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁰³, the Ministry of Environment and Sustainable Development ¹⁰⁴, the Ministry of Water and Forests ¹⁰⁵ and the Institut Pasteur de Côte d'Ivoire ¹⁰⁶.

1.3.4a National transport regulations for Category A and B infectious substances

Score: 0

There is evidence that Côte d’Ivoire has national regulations on the safe and secure transport of infectious substances (specifically including Categories A and B), although these are not publicly available. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Biological safety and security” section that “National regulations for the transport of infectious substances (categories A and B) are implemented.” (p. 26). However, those regulations are not publically avaliable, including on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁰⁷, the Ministry of Environment and Sustainable Development ¹⁰⁸, the Ministry of Water and Forests ¹⁰⁹, the National Civil Protection Agency (ONPC) ¹¹⁰ and the National Institute of Public Hygiene (INHP) ¹¹¹.

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 100

There is evidence that Côte d’Ivoire has legislation and/or regulations in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d’Ivoire “has legislation regulating biological safety and security activities within the various laboratory levels, already taking into account the P4 level” (p. 25). ¹¹² The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, contains the objective that “By 2019, national regulations for biological safety and security concerning the use, storage, disposal, and safe and secure containment of pathogens in laboratories are developed in the human, animal, agricultural, and environmental fields” (p. 33). ¹¹³ The United Nations Institute for Disarmament Research (UNIDIR) reports that Côte d’Ivoire has laws covering biosafety and biosecurity: “Article 10 of Law No. 2022-792 provides a list of biological agents and toxins that pose a severe risk to public health and safety and national security. Côte d’Ivoire has a specific legal framework governing the licensing, registration and inspections of individuals and facilities working with biological agents and toxins.” ¹¹⁴ That law, Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), covers requirements for handling the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential in Article 14, stating “The transfer, trade, and brokering of controlled biological agents and toxins, as well as controlled equipment and technologies, are subject to prior authorization and declaration. Authorization is granted only if the State of destination or the consignee provides, at the request of the National Authority, an end-use certificate and a non-re-export certificate”. ¹¹⁵

1.4.1a Biosafety laws/regulations

Score: 100

There is evidence that Côte d’Ivoire has legislation and/or regulations related to biosafety. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d’Ivoire “has legislation regulating biological safety and security activities within the various laboratory levels, already taking into account the P4 level” (p. 25). ¹¹⁶ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, contains the objective that “By 2019, national regulations for biological safety and security concerning the use, storage, disposal, and safe and secure containment of pathogens in laboratories are developed in the human, animal, agricultural, and environmental fields” (p. 33). ¹¹⁷ The United Nations Institute for Disarmament Research (UNIDIR) reports that Côte d’Ivoire has laws covering biosafety and biosecurity: “Article 10 of Law No. 2022-792 provides a list of biological agents and toxins that pose a severe risk to public health and safety and national security. Côte d’Ivoire has a specific legal framework governing the licensing, registration and inspections of individuals and facilities working with biological agents and toxins.” ¹¹⁸ That law, Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), covers requirements for handling such pathogens, with Article 16 requiring prompt notification of the national authorites of any theft, accident, loss or release of controlled substances or toxins. ¹¹⁹

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is evidence of a law requiring the establishment of an agency responsible for the enforcement of biosafety legislation and regulations in Côte d’Ivoire but insufficient evidence of a specific agency in practice. Article 3 of Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), establishes an agency for overseeing and enforcing biosafety and biosecurity laws: “A National Authority is hereby established to implement the Convention at the national level. The National Authority shall have legal personality and financial autonomy. The powers, organization, and operation of the National Authority shall be determined by decree issued by the Council of Ministers.” ¹²⁰ However, there is insufficient evidence of such a designation on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹²¹, the Ministry of Environment and Sustainable Development ¹²², the Ministry of Water and Forests ¹²³ and the Institut Pasteur de Côte d'Ivoire ¹²⁴.

1.4.2a Biosafety training using a standardised, required approach

Score: 33.33

There is evidence that Côte d'Ivoire requires biosafety training but there is only evidence of biosecurity and biosafety training being provided on an ad hoc basis. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d’Ivoire “In addition to various training courses for staff in the human, animal, and environmental sectors, standard operating procedures, biosafety, and biosecurity manuals are developed and updated within the country's reference laboratories, such as the Pasteur Institute of Côte d'Ivoire (IPCI) and the National Laboratory for Agricultural Development Support (LANADA). There are no plans for training laboratory staff in biosafety and biosecurity at the national level” (p. 25). ¹²⁵ Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), covers regulations for handling especially dangerous pathogens and toxins, does not specifically contain requriements for staff training or recertification. ¹²⁶ Information on training for personnel working with such toxins and pathogens is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹²⁷, the Ministry of Environment and Sustainable Development ¹²⁸, the Ministry of Water and Forests ¹²⁹ and the Institut Pasteur de Côte d'Ivoire ¹³⁰.

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is insufficient evidence that Côte d’Ivoire has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. Article 3 of Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction) establishes an agency for overseeing and enforcing biosafety and biosecurity law but it does not specifically charge the agency with overseeing especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research outside the scope of the biological weapons convention. ¹³¹ There is no further evidence of such an assessment on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹³², the Ministry of Environment and Sustainable Development ¹³³, the Ministry of Water and Forests ¹³⁴ and the Institut Pasteur de Côte d'Ivoire ¹³⁵.

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is insufficient evidence that Côte d'Ivoire has legislation and/or regulation requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d’Ivoire “has legislation regulating biological safety and security activities within the various laboratory levels, already taking into account the P4 level” (p. 25). ¹³⁶ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not specifically discuss oversight or research on such pathogens or toxins. ¹³⁷ The United Nations Institute for Disarmament Research (UNIDIR) reports that Côte d’Ivoire has laws covering biosecurity: “Article 10 of Law No. 2022-792 provides a list of biological agents and toxins that pose a severe risk to public health and safety and national security. Côte d’Ivoire has a specific legal framework governing the licensing, registration and inspections of individuals and facilities working with biological agents and toxins.” ¹³⁸ That law, Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), does not specifically discuss requirements or authority to oversee research relating to such pathogens or toxins. ¹³⁹ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁴⁰, the Ministry of Environment and Sustainable Development ¹⁴¹, the Ministry of Water and Forests ¹⁴² and the Institut Pasteur de Côte d'Ivoire ¹⁴³ do not contain further information about legislation and/or regulations concerning oversight of research on such pathogens or toxins. Côte d'Ivoire has submitted Confidence Building Measures under the Biological Weapons Convention since 2022; the 2025 report is public but does not contain information about specific laws or regulations covering laboratories. ¹⁴⁴ In addition, there is no legislation or regulation listed in the VERTIC BWC legislation database regarding oversight of research on dangerous pathogens and toxins. ¹⁴⁵

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is insufficeint evidence that Côte d'Ivoire has an agency responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. According to Article 3 of Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction), the National Authority is established to oversee such reserach and enforce the Biological Weapons Convention. ¹⁴⁶ However, the specific responsiblities of that agency with regard to oversight of research concerning dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research is not publically avaliable, including on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁴⁷, the Ministry of Environment and Sustainable Development ¹⁴⁸, the Ministry of Water and Forests ¹⁴⁹ and the Institut Pasteur de Côte d'Ivoire ¹⁵⁰. Côte d'Ivoire has submitted Confidence Building Measures under the Biological Weapons Convention since 2022; the 2025 report is public but does not contain information about specific laws or regulations covering laboratories. ¹⁵¹ In addition, there is no legislation or regulation listed in the VERTIC BWC legislation database regarding oversight of research on dangerous pathogens and toxins. ¹⁵²

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is insufficient evidence that Côte d'Ivoire legislation and/or regulation requires the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before it is sold. Neither the Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, ¹⁵³ nor the Biological Weapons Convention National Implementation Measures Database of the United Nations Institute for Disarmament Research (UNIDIR) ¹⁵⁴ contains evidence of such screenings. Article 14 of Law No. 2022-792 of October 13, 2022 relating to the application of the Convention of April 10, 1972 on the prohibition of the development, manufacture and stockpiling of bacteriological weapons (biological) or toxins and on their destruction (Loi No. 2022-792 du 13 Octobre 2022 relative a l'application de la Convention du 10 Avril 1972 sur l'interdiction de la mise au point, de la fabrication et du stockage des armes bacteriologiques (biologiques) ou a toxines et sur leur destruction) sets export requirements for export of restricted compounds and toxins and does not include such a requirement. ¹⁵⁵ The websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁵⁶, the Ministry of Environment and Sustainable Development ¹⁵⁷, the Ministry of Water and Forests ¹⁵⁸ and the Institut Pasteur de Côte d'Ivoire ¹⁵⁹ do not contain further information about legislation and/or regulations related to screening of synthesized DNA. Côte d'Ivoire has submitted Confidence Building Measures under the Biological Weapons Convention since 2022; the 2025 report is public but does not contain information about specific laws or regulations related to screening of synthesized DNA. ¹⁶⁰ In addition, there is no legislation or regulation listed in the VERTIC BWC legislation database regarding the screening of synthesized DNA.

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 0

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 0

There is insufficient evidence that official foot-and-mouth disease (FMD) vaccination figures for livestock are publicly available through the WOAH database for Côte d'Ivoire. The WAHIS database, maintained by the World Organization for Animal Health (WOAH) does not contain vaccination figures for FMD in Côte d'Ivoire; the WAHIS dashboard indicates that the country has "official vaccination" listed as a control measure, but that the vaccination figures are not publicly available for livestock ¹⁶¹

1.6.1c Equitablenature of national immunization strategy/plan

Score: 0

There is evidence that Côte d’Ivoire has a national immunization strategy but it is not publicly available, so it cannot be reviewed for plans to ensure equitable distribution or strategies to overcome socioeconomic inequalities, geography, cultural/linguistic differences and/or gender barriers to vaccination. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d'Ivoire has a national immunization strategy for 2022-2025 (p. 28). ¹⁶² A 2022 Facebook post from the Expanded Program on Immunization Coordination Department (DCPEV) in Côte d’Ivoire, part of the Ministry of Health, Public Hygiene and Universal Health Coverage, confirms the plan’s existence and reports that the National Immunization Strategy (Stratégie Nationale de Vaccination) (SNV) 2022-2025 will serve as the basis for coordinating with GAVI, but does not link to the SNV itself. ¹⁶³ GAVI does not include the plan on its website. ¹⁶⁴ The plan is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁶⁵, the Ministry of Environment and Sustainable Development ¹⁶⁶, the Ministry of Water and Forests ¹⁶⁷ and the Institut Pasteur de Côte d'Ivoire do not link to or publish the National Immunization Strategy (Stratégie Nationale de Vaccination) (SNV) 2022-2025.

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 0

There is evidence that Côte d’Ivoire has a national immunization strategy but it is not publicly available, so it cannot be reviewed for measures to address vaccine hesitancy and build public trust in vaccines. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d'Ivoire has a national immunization strategy for 2022-2025 (p. 28). ¹⁶⁸ A 2022 Facebook post from the Expanded Program on Immunization Coordination Department (DCPEV) in Côte d’Ivoire, part of the Ministry of Health, Public Hygiene and Universal Health Coverage, confirms the plan’s existence and reports that the National Immunization Strategy (Stratégie Nationale de Vaccination) (SNV) 2022-2025 will serve as the basis for coordinating with GAVI, but does not link to the SNV itself. ¹⁶⁹ GAVI does not include the plan on its website. ¹⁷⁰ The plan is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁷¹, the Ministry of Environment and Sustainable Development ¹⁷², the Ministry of Water and Forests ¹⁷³ and the Institut Pasteur de Côte d'Ivoire do not link to or publish the National Immunization Strategy (Stratégie Nationale de Vaccination) (SNV) 2022-2025.

1.6.1e National advisory group for immunization strategy/plan

Score: 100

Côte d'Ivoire has a national advisory group that provides technical guidance and advice on the immunization strategy/plan. Ministrial Decree No. 226 MSHP/CAB of December 16, 2009, establishing the creation, organization, powers, and functioning of the National Committee of Independent Experts on Vaccination and Vaccines of Côte d'Ivoire (CNEIV-CI) established the “National Committee of Independent Experts on Vaccination and Vaccines of Côte d'Ivoire (Comité National d'Experts Indépendants pour la Vaccination et les vaccins de la Côte d'Ivoire) — CNEIV-CI” in 2009. ¹⁷⁴ According to Article 4 of the decree, the CNEIV-CI’s missions are “to advise the Minister of Health on the choice of optimal strategies for controlling vaccine-preventable diseases; to advise the Minister of Health on the data and information to be collected for decision-making in the field of immunization and vaccines; to inform the Minister of Health on the latest scientific developments in the field of immunization and vaccines; [and] to establish partnerships with other national or international committees of independent experts for vaccination and vaccines”. ¹⁷⁵

1.6.1f Presence of an immunization programme for influenza

Score: 100

There is evidence that Côte d'Ivoire has an immunization programme for influenza. Côte d'Ivoire has self reported to the WHO that they do have a formal influenza program in the public sector ¹⁷⁶.

According to the Official Government Portal of Côte d'Ivoire, Côte d'Ivoire launched a seasonal influenza vaccination campaign in 2021 ¹⁷⁷; however, that website does not include information or evidence of seasonal influenza vaccination campaigns after that date. ¹⁷⁸ Cote d’Ivoire’s vaccination strategy, the National Immunization Strategy (Stratégie Nationale de Vaccination) (SNV) 2022-2025, is not publically avaliable: a 2022 Facebook post from the Expanded Program on Immunization Coordination Department (DCPEV) in Côte d’Ivoire, part of the Ministry of Health, Public Hygiene and Universal Health Coverage, confirms the plan’s existence and reports that the National Immunization Strategy (Stratégie Nationale de Vaccination) (SNV) 2022-2025 will serve as the basis for coordinating with GAVI, but does not link to the SNV itself. ¹⁷⁹ GAVI does not include the plan on its website. ¹⁸⁰ The plan is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁸¹, the Ministry of Environment and Sustainable Development ¹⁸², the Ministry of Water and Forests ¹⁸³ and the Institut Pasteur de Côte d'Ivoire ¹⁸⁴ do not link to or publish the National Immunization Strategy (Stratégie Nationale de Vaccination) (SNV) 2022-2025.

1.7.1a Strategy/plan for resilience of health system

Score: 100

Côte d'Ivoire has a strategy to develop a health system that is resiliant to the challenges that climate change and changing seasonal weather patterns pose, that includes the threat of infectious diseases. The 2021 “National Health Sector Adaptation Plan to Climate Change (PNASS) 2021-2025,” produced by the Ministry of Health, Public Hygiene and Universal Health Coverage, includes 7 “Strategic Orientations”: “Risk and capacity assessment; Strengthening health system capacity; Decision-making tools for effective management of public health risks related to climate change; Health system response to climate change-related disasters; Research; Monitoring and evaluation; [and] Coordination and resource mobilization” (p. 13). ¹⁸⁵ The plan includes the specific objectives: “Improve early warning and rapid response systems; Strengthen the capacities of national actors; Test interventions aimed at reducing health risks specific to the environment and climate change; [and] Disseminate positive experiences in this field” (p. 14) as well as the strategic objectives: “Assess risks and capacities; Strengthen health system capacities; Develop decision-making tools for the effective management of public health risks related to climate change; Strengthen the health system's response to climate change-related disasters; Develop and promote research; Conduct monitoring and evaluation; [and] Strengthen coordination and mobilize resources” (p. 14). The plan has a budget of 8,475,000,000 FCFA (16,950,000 USD) (p. 14). ¹⁸⁶

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 100

There is evidence that Côte d’Ivoire has a national laboratory system with the capacity to conduct diagnostic tests for at least 5 of the 10 WHO-defined core tests. The Pasteur Institute of Côte d'Ivoire is able to conduct five WHO-defined core tests: virus culture for poliovirus (polio); serology for HIV; microscopy for mycobacterium tuberculosis (tuberculosis/TB); rapid diagnostic testing for plasmodium spp. (malaria); and influenza PCR testing according to its website. ¹⁸⁷ The Pasteur Institute of Côte d'Ivoire is a national public institution and is under the supervision of the Ministry of Higher Education and Scientific Research, according to its website. ¹⁸⁸

2.1.1b Plan to conduct testing during a public health emergency

Score: 0

There is insufficient evidence of a national plan, strategy or similar document for conducting testing during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d'Ivoire does not have an active emergency response plan and strongly recommends in the “Disaster preparedness” section that “A national multi-risk and multi-sectoral plan must be developed” (p. 42). ¹⁸⁹ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address conducting testing during a public health emergency (or public health emergencies at all). ¹⁹⁰ There is insufficient evidence of a plan or similar document for conducting testing during a public health emergency on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ¹⁹¹, the Ministry of Environment and Sustainable Development ¹⁹², the Ministry of Water and Forests ¹⁹³ and the Institut Pasteur de Côte d'Ivoire ¹⁹⁴.

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 100

Côte d'Ivoire has a national laboratory that serves as a reference facility which is accredited. The Institut Pasteur de Côte d'Ivoire is a national public institution and is under the supervision of the Ministry of Higher Education and Scientific Research, according to its website; it servers as a national reference laboratory. ¹⁹⁵ A press release from July 2025 confirms that the Institut Pasteur de Côte d'Ivoire has ISO 15189:2015 certification, along with 6 other laboratories in the country. ¹⁹⁶ A 2017 interview with the director of the Institut Pasteur de Côte d'Ivoire confirmed that it is a reference laboratory for Côte d'Ivoire: “At regional level we are the reference laboratory for several pathologies such as polio, influenza or gonococcus”. ¹⁹⁷ The website of West African Accreditation System (WAAS) confirms that the e Institut Pasteur de Côte d'Ivoire has a currently-valid ISO 15289 certification. ¹⁹⁸

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

There is evidence that there is a national laboratory that serves as a reference facility which is subject to external quality assurance review. The Institut Pasteur de Côte d'Ivoire is a national public institution and is under the supervision of the Ministry of Higher Education and Scientific Research, according to its website; it serves as a national reference laboratory. ¹⁹⁹ The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “National Laboratory System” section that “Laboratories in the human and animal health sectors participate in internal quality control and external quality assessments (EQA)” (p. 32). ²⁰⁰ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, contains the objective "Establish the multisectoral institutional framework for the national External Quality Assessment program” (p. 21). ²⁰¹ The Institut Pasteur de Côte d'Ivoire has ISO 15189:2015 certification, which requires ongoing participation in EQA. ^202203204

2.2.1a Nationwide specimen transport system

Score: 0

There is insufficient evidence of a nationwide specimen transport system in Côte d’Ivoire. The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, contains the objective that “By 2019, the plan for the safe transport of materials posing a risk of infection to human, animal, agricultural, and environmental health will be developed and implemented” (p. 33). ²⁰⁵ The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d'Ivoire has agreements in place to transport specimens but no nationwide specimen transport system: “Regarding the transport of samples, agreements are signed with the Post Office and a manual for the secure transport of biological samples was revised in 2023 on behalf of the MESRS-IPCI. However, the post office does not cover all districts, does not operate on weekends or public holidays, which impacts the quality and compliance of some samples.” Further, “There is no national guide for the secure transport of samples” (p. 31). ²⁰⁶ The Institut Pasteur de Côte d’Ivoire reports that in 2023, a workshop was held at the institute “set up a multi-sectoral Technical Working Group (TWG) for the safe transport of materials at health risk” but does not provide evidence that a specimin transport system was created. ²⁰⁷ There is no further information about a specimen transport system on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁰⁸, the Ministry of Environment and Sustainable Development ²⁰⁹, or the Ministry of Water and Forests ²¹⁰

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

There is insufficient evidence of a plan in place to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d'Ivoire does not have an active emergency response plan and strongly recommends that “A national multi-risk and multi-sectoral plan must be developed” (p. 42). ²¹¹ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address conducting testing during a public health emergency (or public health emergencies at all). ²¹² There is insufficient evidence of a plan or similar document for scaling-up testing during a public health emergency on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²¹³, the Ministry of Environment and Sustainable Development ²¹⁴, the Ministry of Water and Forests ²¹⁵ and the Institut Pasteur de Côte d'Ivoire ²¹⁶.

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

There is evidence that Cote d’Ivoire is conducting ongoing event-based and indicator-based surveillance and analysis for notifiable and novel infectious diseases but no evidence that the data are being analyzed on a daily basis. While there limited evidence of indicator-based surveillance, it is inferred through the SIMR guide and and the JEE documents. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that “The country has developed a SIMR guide for event-based multi-sectoral surveillance” and “The country has a surveillance system that uses electronic devices capable of detecting alert thresholds in human and animal health” (p. Viii). ²¹⁷ The 2023 JEE also confirms that Cote d’Ivoire has a functioning Public Health Emergency Operations Centre (COUSP) (p. 42). ²¹⁸ A 2023 article from the WHO Africa Region reports on a workshop designed to train experts to recognize and record vaccine-preventable diseases, with almost 250 having undergone training, showing that the surveillance system is functioning in practice. ²¹⁹ There is no further information on ongoing event-based and indicator-based surveillance on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²²⁰, the Ministry of Environment and Sustainable Development ²²¹, the Ministry of Water and Forests ²²², the Ministry of Interior and Security ²²³ or the Institut Pasteur de Côte d'Ivoire ²²⁴.

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the WHO within the set timeline in Côte d’Ivoire. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that “The national RSI focal point (PFN RSI) was formally designated by ministerial decree” (p. 9). ²²⁵ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, reports that an IHR focal point has been named and housed within the National Institute of Public Health (INHP) (p. 12); however, the PANSS does not offer concrete information about the functioning of the IHR focal point. ²²⁶

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

There is evidence that Côte d’Ivoire operates an electronic reporting surveillance system at both the national and sub-national levels. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that “The country has developed a SIMR guide for event-based multi-sectoral surveillance” and “The country has a surveillance system that uses electronic devices capable of detecting alert thresholds in human and animal health” (p. Viii). ²²⁷ The 2023 JEE also confirms that Cote d’Ivoire has a functioning Public Health Emergency Operations Centre (COUSP) (p. 42). ²²⁸ A 2023 article from the WHO Africa Region reports on a workshop designed to train experts to recognize and record vaccine-preventable diseases, with almost 250 having undergone training, showing that the surveillance system is functioning in practice. ²²⁹ According to a 2025 fact sheet published by the US CDC, the CDC “helped train 459 community health workers in event-based surveillance and community-based disease surveillance” in 2013 (p. 2). ²³⁰ According to the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, reports that “Disease surveillance based on indicators in Côte d'Ivoire is carried out through the implementation of integrated disease surveillance and response (SIMR)” and provides a table with the priorities of SIMR (p. 3). The PANSS further confirms the electronic reporting component of the system by noting that “The country has a functional electronic notification system to facilitate real-time reporting of notifiable diseases through the provision of information collection tools, smartphones in all districts and health regions, the use of District Health Information Software (DHIS2) trackers, and the Advanced Mobile Data Messaging and Visualization (MAGPI) website” (p. 4). ²³¹

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 0

There is insufficient evidence that Côte d’Ivoire uses an electronic reporting surveillance system to collect ongoing or real-time laboratory data. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, recommends in the “National Laboratory System” section that the country “Establish a national system for transferring laboratory data and results” (p. 34) which indicates that electronic systems are not thoroughly integrated and real-time data is not being collected. ²³² Section 7.2 of the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS includes objectives and goals related to establishing a real-time surveillance system but such a system was not yet available. ²³³ Further information about collecting real-time or ongoing laboratory data was not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²³⁴, the Ministry of Environment and Sustainable Development ²³⁵, the Ministry of Water and Forests ²³⁶, the National Civil Protection Agency (ONPC) ²³⁷ and the National Institute of Public Hygiene (INHP) ²³⁸.

2.3.3a National wastewater surveillance programme or initiative

Score: 50

There is evidence of some wastewater and environmental surveillance (WES) activity within the country. The WHO and GPEI Q4 2025 Polio ES Bulletin lists the country as having 24 ES sites as of Q4 in 2025, although it is unclear whether these are at the national level and are ongoing.²³⁹

Moreover, there is also evidence that the country is making progress towards being able to conduct robust ES. In 2025, the country established a new facility, located at Institut Pasteur of Cote d’Ivoire, will help speed up turnaround time of analyses of environmental surveillance and Acute Flaccid Paralysis (AFP) samples, leading to more effective public health interventions. The aim is that by 2026, Côte d’Ivoire will become one of the countries in the African Region with full laboratory capacity for Poliovirus detection. WHO, with support from the Gates Foundation and in collaboration with the Global Polio Eradication Initiative, led the refurbishment of the laboratory. This included providing modern equipment, upgrading information systems, and training staff to use the latest technologies. In addition, WHO worked with national authorities to optimize environmental surveillance sites, ensuring that the samples collected from sewage and wastewater better reflect where the virus may be circulating, so that outbreaks can be detected and stopped more quickly. ²⁴⁰

Between 2019 and 2020, poliovirus was isolated in a sewage sample before (or in the absence of) a confirmed AFP case in Afghanistan, Cameroon, Chad, Côte d'Ivoire, Egypt, Ghana, Iran, Kenya, Liberia, Senegal (all cVDPV2), Philippines (cVDPV1), and Malaysia (cVDPV1 and cVDPV2). ²⁴¹ This suggests that ES has been conducted in the country in the past, however it is unclear whether it is ongoing or at a national level.

2.4.1a Common usage of electronic health records

Score: 50

There is insufficient evidence that electronic health records are commonly in use in Côte d’Ivoire but evidence that they are in use. In 2023, the Ministry of Health, Public Hygiene and Universal Health Coverage launched an app, “SANTE CIV”, that includes an Electronic Health Record. ²⁴² The 2021 National Health Development Plan 2021-2025 mentions that electronic health records and other electronic infrastructure will be important for improving care in the future (p. 90), but the plan does not include any evidence of active plans or strategies to develop and implement them. ²⁴³ In August of 2024, the head of the Directorate of Information Technology and Digital Health (DISD) gave a presentation of the concept of an EHR in Côte d’Ivoire that had been in development since 2021 but the presentation did not discuss if the records are in widespread use, only that they were being developed. ²⁴⁴ A November 2024 project conducted by the DISD worked to bring updated infrastructure to rural sectors to support an EHR but also noted that considerable work still needed to be done. ²⁴⁵ An 24 September 2025 press release from DISD announced that a major agreement had been reached to bring EHR records to several large hospitals, but a timeline for their deployment was not presented. ²⁴⁶ The specific plan covering the development and deployment of an EHR in Côte d’Ivoire is not available on the websites of the DISD ²⁴⁷ or the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁴⁸. Côte d’Ivoire is in the process of developing and implementing an EHR but it has not yet entered into common use.

2.4.1b Public health system access to individual electronic health records

Score: 0

There is insufficient evidence that the national public health system has access to electronic health records of individuals in Côte d’Ivoire. In 2023, the Ministry of Health, Public Hygiene and Universal Health Coverage launched an app, “SANTE CIV”, that includes an Electronic Health Record; however, it does not include information concerning access by the public health system. ²⁴⁹ The 2021 National Health Development Plan 2021-2025 mentions that electronic health records and other electronic infrastructure will be important for improving care in the future (p. 90), but the plan does not include any evidence of active plans or strategies to develop and implement them or plans to ensure the public health system has access to those records. ²⁵⁰ The specific plan covering the development and deployment of an EHR in Côte d’Ivoire is not available on the websites of the DISD ²⁵¹ or the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁵²; neither website contains information about whether the national public health system has access to electronic health records of individuals in Côte d’Ivoire.

2.4.1c Existence of data standards for health record data comparability

Score: 0

There is insufficient evidence that there are data standards in Cote d’Ivoire to ensure data conpatability. In 2023, the Ministry of Health, Public Hygiene and Universal Health Coverage launched an app, “SANTE CIV”, that includes an Electronic Health Record; however, it does not include information concerning a data standard. ²⁵³ The 2021 National Health Development Plan 2021-2025 mentions that electronic health records and other electronic infrastructure will be important for improving care in the future (p. 90), but the plan does not include any evidence of active plans or strategies to develop and implement them or information concerning a data standard. ²⁵⁴ The specific plan covering the development and deployment of an EHR in Côte d’Ivoire is not available on the websites of the DISD ²⁵⁵ or the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁵⁶; neither website contains information concerning a data standard in Côte d’Ivoire.

2.4.2a Data sharing mechanisms

Score: 100

There is evidence of established mechanisms at the relevant ministries responsible for animal, human, and wildlife surveillance to share data in Côte d’Ivoire. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Zoonosis” section that “The One Health Platform and the Animal Health Technical Working Group (TWG) have been established and are recognized by all sectors as a multi-sectoral coordination framework for zoonotic disease management” and that “Integrated surveillance plans for priority zoonoses of Lassa, Valley fever, Rift, brucellosis and tuberculosis have been developed” (p. 20); however, the JEE notes that “The exchange of information between different sectors must be formalized” (p. 21). ²⁵⁷

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 100

Cote d’Ivoire makes de-identified health surveillance data on infectious diseases publicly available via reports on government websites. The Public Health Bulletin – Côte d’Ivoire (Bulletin de Santé Publique – Côte d’Ivoire — BSP-CI) is “a government communication tool for the dissemination of up-to-date, objective, reliable, useful, accurate and authoritative public health information to improve population health” and is part of the National Institute of Public Health (INSP) according to its website. ²⁵⁸ The BSP-CI published regular bulletins that cover health surveillance; the most recent publication is the “Côte d'Ivoire Public Health Bulletin, Volume 03 Number 02, June 2025 (Bulletin de santé publique de Côte d’Ivoire, Volume 03 Numéro 02, Juin 2025)”, which includes data on yellow fever, dengue, meningitis, cholera, MAPI, Avian Flu, TNN, Guinea Worm, PFA, Measles, Influenza, and mpox (pp. 36-37 ). ²⁵⁹

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

There is evidence that Côte d'Ivoire has regulations that explicitly safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities. Côte d'Ivoire's data privacy regulations–Law No. 2013-45 of June 19, 2013 on Protection of Personal Data and Decree No. 2015-79 of February 4, 2015 on the Authorization Procedure for Personal Data Processing–protect all personal information of any form and collected from any type of media. ²⁶⁰²⁶¹ According to the definitions section in Chapter 1 of Law No. 2013-45, personal health information falls under the category of "sensitive data." Sensitive data is defined as any information of a personal nature regarding opinion and activities related to religion, philosophy, politics, unions; sex or race; health; social measures; prosecution; and criminal or administrative sanctions. ²⁶² Thus, the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities is covered under Côte d'Ivoire's data privacy laws.

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 100

Côte d'Ivoire’s data protection legislation explicitly protects the confidentiality of identifiable halth information, including from cyber attacks.. Côte d'Ivoire's data privacy regulations–Law No. 2013-45 of June 19, 2013 on Protection of Personal Data and Decree No. 2015-79 of February 4, 2015 on the Authorization Procedure for Personal Data Processing–protect all personal information of any form and collected from any type of media. ²⁶³²⁶⁴ According to the definitions section in Chapter 1 of Law No. 2013-45, personal health information falls under the category of "sensitive data." Sensitive data is defined as any information of a personal nature regarding opinion and activities related to religion, philosophy, politics, unions; sex or race; health; social measures; prosecution; and criminal or administrative sanctions. ²⁶⁵ Articles 39, 40 and 41 of the data protection law cover the obligations of companies and organizations processing data, including that it be kept confidential (Art. 39), every precaution be taken to prevent sensitive data from being damaged, distorted or accessed by unauthorized individuals or entities (Art. 40) and data facilities and transfers be protected from unauthorized access (Art. 41). ²⁶⁶

2.4.5a Cooperative commitments or agreements within regions

Score: 0

There is no publicly available evidence that the government of Côte d'Ivoire has made a commitment via public statements, legislation and/or a cooperative agreement to share surveillance data with other countries on one or more than one disease during public health emergencies. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not report on a commitment via public statements, legislation and/or a cooperative agreement to share surveillance data with other countries. ²⁶⁷ Neither the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ²⁶⁸ nor the Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 include objectives related to sharing surveillance data with other countries. The National Health Development Plan (Plan National de Developpement Sanitaire) 2021-2025 does not include evidence of such a plan. ²⁶⁹ The is no evidence of a plan or committment to share surveillance data with other countries on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁷⁰, the Ministry of Environment and Sustainable Development ²⁷¹, the Ministry of Water and Forests ²⁷², the National Civil Protection Agency (ONPC) ²⁷³ and the National Institute of Public Hygiene (INHP) ²⁷⁴.

However, Côte d'Ivoire is part of three major regional surveillance networks: the West and Central Africa Veterinary Laboratory Network for Avian Influenza and other Transboundary Diseases (RESOLAB), the Regional Network of National Epidemiosurveillance Systems for HPAI and Other Priority Animal Diseases in West Africa (RESEPI), and the West Africa Network for Infectious Disease Surveillance (WANIDS). WANIDS aims to enhance the capacity of its 15 member countries to collect and share health information; member countries participate in a regional platform that regularly collects and shares health information. ²⁷⁵²⁷⁶ RESOLAB and RESEPI bring together the animal health experts in the region in order to prepare and implement regional control strategies for major animal diseases, including Avian Influenza, Foot-and-Mouth Disease, Peste des Petits Ruminants (also known as 'goat plague') and rabies. There is no evidence that either network requires that members share surveillance data, although data sharing is encouraged in the RESOLAB sub-networks focused on specific diseases. ²⁷⁷²⁷⁸ Côte d'Ivoire will also be taking part in the West Africa Regional Disease Surveillance Systems Enhancement (REDISSE) project, funded by the World Bank, which has building regional inter-sectoral capacities for enhanced collaborative disease surveillance as an objective. It is expected to be operational by January of 2023. However, there is no evidence of an explicit requirement that member countries share surveillance data during public health emergencies. ²⁷⁹²⁸⁰

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 0

There is insufficient evidence that the national government supports sub-national systems to prepare for future public health emergencies. There is insufficient evidence that Côte d'Ivoire has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ²⁸¹ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ²⁸² There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁸³, the Ministry of Environment and Sustainable Development ²⁸⁴, the Ministry of Water and Forests ²⁸⁵ and the National Civil Protection Agency (ONPC) ²⁸⁶.

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

There is insufficient evidence that Côte d'Ivoire has a plan to provide wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support and medical attention. There is insufficient evidence that Côte d'Ivoire has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ²⁸⁷ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ²⁸⁸ There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁸⁹, the Ministry of Environment and Sustainable Development ²⁹⁰, the Ministry of Water and Forests ²⁹¹ and the National Civil Protection Agency (ONPC) ²⁹².

2.5.2a Strategy for tracing and quarantining international travelers

Score: 0

There is insufficient evidence of a joint plan between the public health system and border control authorities to identify suspected and potential cases in international travelers and trace and quarantine their contacts in the event of a public health emergency in Côte d’Ivoire. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Points of Entry and Border Health” section that Côte d’Ivoire has a public health security plan in place at the countries main airport, but only in limited capacity at other official points of entry (and not at all for many unofficial points of entry) (p. 55). ²⁹³

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

Côte d'Ivoire has an applied epidemiology training program in the country but there is insufficient evidence that the government sends citizens to other countries for training. A 2024 report from the US CDC confirms that Côte d'Ivoire has all three levels of the Field Epidemiology Training Program (FETP) available in the country: “Through FETP, CDC strengthens capacity at district, regional and national levels to detect, prevent, and respond to illnesses with epidemic potential. Cote d’Ivoire has all three levels of FETP training: frontline, intermediate, and advanced. Graduates work at all government levels in the human, animal, and environmental health sectors throughout Côte d'Ivoire, and that “more than 520 public health workers graduated from FETP program since 2016”. ²⁹⁴ Facebook posts from the African Field Epidemiology Network confirm that FETP trainings are ongoing, with a December 2024 post celebrating the 15th graduation ceremony of the Côte d’Ivoire Field Epidemiology Training Program (FETP) in Abidjan ²⁹⁵ and an August 2025 post discussing the final workshop for another FETP cohort in Côte d’Ivoire ²⁹⁶. There is insufficient evidence on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ²⁹⁷, the Ministry of Environment and Sustainable Development ²⁹⁸, the Ministry of Water and Forests ²⁹⁹, the Ministry of Interior and Security ³⁰⁰ or the Institut Pasteur de Côte d'Ivoire ³⁰¹.

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

There is evidence that Côte d'Ivoire has a specific animal health field epidemiology training program, ISAVET. According to documents from the Food and Agriculture Organization of the United Nations ³⁰² and the World Organization of Animal Health (WOAH) ³⁰³, the In-Service Applied Veterinary Epidemiology Training (ISAVET) program has been available in Côte d'Ivoire since 2019, with 22 trainees, 4 trainers and 3 mentors as of 2022. ³⁰⁴

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 100

Côte d'Ivoire has at least 1 trained field epidemiologist per 200,000 people. According to the US CDC, at least 520 public health workers from Côte d'Ivoire have graduated from the Field Epidemiology Training Program (FETP) since 2016. ³⁰⁵ With a population of 31.93 million in 2024, Côte d'Ivoire has 1 trained field epidemiologist per 61,404 people.

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 33.33

There is insufficient evidence that Côte d'Ivoire has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential but there is evidence that it has a disease-specific one. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³⁰⁶ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³⁰⁷ There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁰⁸, the Ministry of Environment and Sustainable Development ³⁰⁹, the Ministry of Water and Forests ³¹⁰ and the National Civil Protection Agency (ONPC) ³¹¹. Côte d'Ivoire developed a response plan for Covid-19 in 2020 that includes measures as social distancing, hand hygiene, cancellation of mass gatherings, and the closure of schools, as well as a communication plan; however, that plan is disease-specific. ³¹²

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is insufficient evidence that Côte d'Ivoire has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential; therefore, such a plan cannot have been updated in the last 3 years. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³¹³ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³¹⁴ There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³¹⁵, the Ministry of Environment and Sustainable Development ³¹⁶, the Ministry of Water and Forests ³¹⁷ and the National Civil Protection Agency (ONPC) ³¹⁸.

3.1.1c One health principles by covering multiple threat types

Score: 0

There is insufficient evidence that Côte d'Ivoire has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential; therefore, such a plan cannot follow one health principles by covering multiple threat types. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³¹⁹ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³²⁰ There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³²¹, the Ministry of Environment and Sustainable Development ³²², the Ministry of Water and Forests ³²³ and the National Civil Protection Agency (ONPC) ³²⁴.

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 0

There is insufficient evidence that Côte d'Ivoire has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential; therefore, there is no evidence that such a plan could consider the impact of health equity or include mechanisms for identifying and considering the needs of vulnerable populations. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³²⁵ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³²⁶ There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³²⁷, the Ministry of Environment and Sustainable Development ³²⁸, the Ministry of Water and Forests ³²⁹ and the National Civil Protection Agency (ONPC) ³³⁰.

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 0

There is insufficient evidence that Côte d'Ivoire has a specific mechanism(s) for engaging with the private sector to assist with outbreak emergency preparedness and response. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³³¹ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³³² There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³³³, the Ministry of Environment and Sustainable Development ³³⁴, the Ministry of Water and Forests ³³⁵ and the National Civil Protection Agency (ONPC) ³³⁶. A 2024 article from Prevention Web suggests that such mechanisms are under development but have not yet been formalized. ³³⁷

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 50

There is insufficient evidence that Côte d'Ivoire has an overarching policy, plan and/or guidelines in place to implement non-pharmaceutical interventions (NPIs) during an epidemic or pandemic; however, it does have a disease-specific one. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency”(p. 41). ³³⁸ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³³⁹ There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁴⁰, the Ministry of Environment and Sustainable Development ³⁴¹, the Ministry of Water and Forests ³⁴² and the National Civil Protection Agency (ONPC) ³⁴³. Côte d'Ivoire developed a response plan for Covid-19 in 202o that includes some NPIs such as social distancing, hand hygiene, cancellation of mass gatherings, the closure of schools, and a prohibition on consuming bush meat; however, that plan is disease-specific. ³⁴⁴

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 0

There is insufficient evidence that Côte d’Ivoire has either activated its national emergency response plan for an infectious disease outbreak in the past year or completed a national-level biological threat-focused exercise (either with WHO or separately) in the past year. Neither the World Health Organization (WHO) ³⁴⁵ nor the WHO Regional Office for Africa ³⁴⁶ reports that Côte d’Ivoire has either activated its national emergency response plan or completed a national-level biological threat-focused exercise in the past year. There is no evidence of that Côte d’Ivoire has either activated its national emergency response plan or completed a national-level biological threat-focused exercise in the past year on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁴⁷, the Ministry of Environment and Sustainable Development ³⁴⁸, the Ministry of Water and Forests ³⁴⁹, the National Civil Protection Agency (ONPC) ³⁵⁰ and the National Institute of Public Hygiene (INHP) ³⁵¹.

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 0

There is no evidence that Côte d'Ivoire has identified a list of gaps and best practices in response (either through an infectious disease response, after action review or a biological-threat focused exercise) and developed a plan to improve response capabilities; however, that plan has not been published. A December 2023 article from the WHO reports that Côte d'Ivoire is using the results of the Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023 to develop a new National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, similar to the 2018 PANSS developed after the first JEE in 2016. ³⁵² However, that plan is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁵³, the Ministry of Environment and Sustainable Development ³⁵⁴, the Ministry of Water and Forests ³⁵⁵, the National Institute of Public Hygiene (INHP) and the National Civil Protection Agency (ONPC) ³⁵⁶.

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is insufficient evidence that Côte d’Ivoire has undergone a national-level biological threat-focused exercise that has included private sector representatives in the past year. Neither the World Health Organization (WHO) ³⁵⁷ nor the WHO Regional Office for Africa ³⁵⁸ reports that Côte d’Ivoire has undergone a national-level biological threat-focused exercise in the past year. There is no evidence of that Côte d’Ivoire has undergone a national-level biological threat-focused exercise in the past year on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁵⁹, the Ministry of Environment and Sustainable Development ³⁶⁰, the Ministry of Water and Forests ³⁶¹, the National Civil Protection Agency (ONPC) ³⁶² and the National Institute of Public Hygiene (INHP) ³⁶³.

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

Côte d'Ivoire has an Emergency Operations Center (EOC) in place. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire has a functioning EOC (in French, Centre des Opérations d’urgence de Santé Publique — COUSP), with “a concept of operations (CONOPS) and contingency plans” as well as six functional regional COUSPs (p. 42). Further, the COUSP carries out simulation exercises at least twice per year (p. 42). ³⁶⁴ The website of the National Institute of Public Hygiene (INHP) covers the core mission and activities of the COUSP, which include “Continuously monitoring public health events; Coordinating investigations in times of health crises; Coordinating response activities; [and] Collaborating in the management of health crises at the sub-regional and international levels”. ³⁶⁵ The INHP’s website does not include an operational plan or strategy for the COUSP. ³⁶⁶

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 100

Côte d'Ivoire has an Emergency Operations Center (EOC) in place and it conducts drills at least once per year. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire has a functioning EOC (in French, Centre des Opérations d’urgence de Santé Publique — COUSP), with “a concept of operations (CONOPS) and contingency plans” as well as six functional regional COUSPs (p. 42). Further, the COUSP carries out simulation exercises at least twice per year (p. 42). ³⁶⁷ The website of the National Institute of Public Hygiene (INHP) covers the core mission and activities of the COUSP but it does not state that the COUSP is required to conduct yearly drills. ³⁶⁸ The INHP’s website does not include an operational plan or strategy for the COUSP. ³⁶⁹

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is insufficient evidence that Côte d’Ivoire’s EOC has conducted a coordinated emergency response or emergency response exercise activated within 120 minutes of the identification of the public health emergency/scenario within the last year. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire has a functioning EOC (in French, Centre des Opérations d’urgence de Santé Publique — COUSP), it carries out simulation exercises at least twice per year (p. 42), but does not confirm that it can/must be activated within 120 minutes. ³⁷⁰ The website of the National Institute of Public Hygiene (INHP) covers the core mission and activities of the COUSP but it does not state that the COUSP is required to conduct yearly drills or be activated within 120 minutes. ³⁷¹ The INHP’s website does not include an operational plan or strategy for the COUSP. ³⁷² The regulation that created the COUSP, Decree No. 2019-292 of April 3, 2019 Concerning the Creation, Powers, Organization, and Operation Of The Public Health Emergency Operations Center, also does not specify a response time. ³⁷³ The is no evidence that the COUSP has been active within the last year on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁷⁴, the Ministry of Environment and Sustainable Development ³⁷⁵, the Ministry of Water and Forests ³⁷⁶, the National Civil Protection Agency (ONPC) ³⁷⁷ and the National Institute of Public Hygiene (INHP) ³⁷⁸.

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is insufficient evidence that public health, animal health, the private sector and national security authorities have carried out an exercise to respond to a potential deliberate biological event (i.e., bioterrorism attack) or that there are publicly available standard operating procedures, guidelines, memorandums of understanding (MOUs), or other agreements between the public health, animal health, the private sector and security authorities to respond to a potential deliberate biological event. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not report on plans or exercises concerning a potential deliberate biological event. ³⁷⁹ Neither the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ³⁸⁰ nor the Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 includes an objective related to on plans or exercises concerning a potential deliberate biological event. The National Health Development Plan (Plan National de Developpement Sanitaire) 2021-2025 does not include evidence of plans or exercises concerning a potential deliberate biological event. ³⁸¹ The is no evidence of plans or exercises concerning a potential deliberate biological event on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁸², the Ministry of Environment and Sustainable Development ³⁸³, the Ministry of Water and Forests ³⁸⁴, the National Civil Protection Agency (ONPC) ³⁸⁵ and the National Institute of Public Hygiene (INHP) ³⁸⁶.

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 0

There is insufficient evidence that Côte d’Ivoire has a risk communication plan that is specifically intended for use during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³⁸⁷ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³⁸⁸ There is insufficient evidence of a separate risk communication plan for public health emergency or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁸⁹, the Ministry of Environment and Sustainable Development ³⁹⁰, the Ministry of Water and Forests ³⁹¹ and the National Civil Protection Agency (ONPC) ³⁹².

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 0

There is insufficient evidence that Côte d’Ivoire has a risk communication plan that is specifically intended for use during a public health emergency or onther documents that outline how messages will reach populations and sectors with different communications needs (eg different languages, location within the country, media reach, vulnerable groups and hard-to-reach groups). The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³⁹³ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ³⁹⁴ There is insufficient evidence of a separate risk communication plan for public health emergency or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ³⁹⁵, the Ministry of Environment and Sustainable Development ³⁹⁶, the Ministry of Water and Forests ³⁹⁷ and the National Civil Protection Agency (ONPC) ³⁹⁸.

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 0

There is insufficient evidence that Côte d’Ivoire has a risk communication plan that is specifically intended for use during a public health emergency; therefore, there is no evidence that there is a specific position within the government to serve as the primary spokesperson to the public during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ³⁹⁹ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ⁴⁰⁰ There is insufficient evidence of a separate risk communication plan for public health emergency or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁰¹, the Ministry of Environment and Sustainable Development ⁴⁰², the Ministry of Water and Forests ⁴⁰³ and the National Civil Protection Agency (ONPC) ⁴⁰⁴.

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is evidence that, in the past year, the public health system in Cote d’Ivoire has actively shared messages via online media platforms (e.g. social media, website) to inform the public about ongoing public health concerns and/or dispel rumors, misinformation or disinformation. The Ministry of Health has a strong presence on Facebook and frequently posts information about local health initiatives as well as information about public health concerns and to dispel misinformation. ⁴⁰⁵ For example, a 30 September post announced the results of a free viral hepatitis screening in two coastal cities ⁴⁰⁶, and a 25 September post covered the key signs of Nephroblastoma (kidney cancer in children) ⁴⁰⁷.

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

No examples of senior leaders (president or ministers) of Côte d’Ivoire sharing misinformation or disinformation on infectious diseases in the past two years could be identified. No examples of such misinformation or disinformation on infectious diseases could be identified on the websites of the Presidency of the Republic of Côte d'Ivoire ⁴⁰⁸, the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁰⁹, the Ministry of Environment and Sustainable Development ⁴¹⁰, the Ministry of Water and Forests ⁴¹¹, the National Civil Protection Agency (ONPC) ⁴¹² the National Institute of Public Hygiene (INHP) ⁴¹³ and the Ministry of Interior and Security ⁴¹⁴.

3.6.1a Percentage of households with Internet

Score: 74.44

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 93.02

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 80

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 45.83

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is no evidence that Côte d’Ivoire has implemented restrictions on export/import of non-medical goods due to an infectious disease outbreak in the past year. There is no evidence of such restrictions on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴¹⁵, the Ministry of Environment and Sustainable Development ⁴¹⁶, the Ministry of Water and Forests ⁴¹⁷, the National Civil Protection Agency (ONPC) ⁴¹⁸ the National Institute of Public Hygiene (INHP) ⁴¹⁹ and the Ministry of Interior and Security ⁴²⁰.

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no evidence that Côte d’Ivoire has implemented restrictions on the export/import of non-medical goods due to an infectious disease outbreak in the past year. There is no evidence of such restrictions on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴²¹, the Ministry of Environment and Sustainable Development ⁴²², the Ministry of Water and Forests ⁴²³, the National Civil Protection Agency (ONPC) ⁴²⁴ the National Institute of Public Hygiene (INHP) ⁴²⁵ and the Ministry of Interior and Security ⁴²⁶.

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no evidence that Côte d’Ivoire has implemented inbound or outbound travel restrictions due to an infectious disease outbreak in the past year. There is no evidence of such restrictions on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴²⁷, the Ministry of Environment and Sustainable Development ⁴²⁸, the Ministry of Water and Forests ⁴²⁹, the National Civil Protection Agency (ONPC) ⁴³⁰ the National Institute of Public Hygiene (INHP) ⁴³¹ and the Ministry of Interior and Security ⁴³².

3.7.2b Risk-based approach to international travel-related measures

Score: 0

There is insufficient evidence that Côte d’Ivoire uses a risk-based approach to international travel-related measures. There is insufficient evidence that Côte d'Ivoire has an overarching national public health emergency response plan in place which addresses international travel-related measures. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41). ⁴³³ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ⁴³⁴ A 2025 journal article indicates that Côte d'Ivoire has capacity at POE's to implement risk-based measures but does not confirm they are in place: "Routine services such as medical assistance, equipment availability, and trained personnel for inspection are adequately present at all PoEs. Moreover, PoEs display readiness for PHEIC, with the availability of emergency contingency plans, facilities for isolating or quarantining sick travelers, and trained personnel in personal protective equipment (PPE) use." ⁴³⁵ There is insufficient evidence of an overarching national public health emergency response plan or similar document on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴³⁶, the Ministry of Environment and Sustainable Development ⁴³⁷, the Ministry of Water and Forests ⁴³⁸ and the National Civil Protection Agency (ONPC) ⁴³⁹.

4.1.1a Doctors per 100,000 people

Score: 1.95

4.1.1b Nurses and midwives per 100,000 people

Score: 9.64

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 0

There is insufficient evidence that Côte d’Ivoire has a health workforce strategy in place (which has been updated in the past five years) to identify fields where there is an insufficient workforce and strategies to address these shortcomings. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Human Resources” section that the country should “Assess the health workforce needs for the implementation of the IHR across all sectors” (p. 39). [1] The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to developing a health workforce strategy. [2] ] The is no evidence of a health workforce strategy on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage [3], the Ministry of Environment and Sustainable Development [4], the Ministry of Water and Forests [5], the National Civil Protection Agency (ONPC) [6] and the National Institute of Public Hygiene (INHP) [7].

4.1.1d Health system capacity for essential health services

Score: 0

There is insufficient evidence that there is sufficient capacity within the health system of Côte d’Ivoire to deliver essential health services.

The Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities gives the country a score of 1 for this measure. The JEE says that core weaknesses include the lack of a national plan for monitoring healthcare-associated infections to guide antimicrobial prevention policies must be implemented and limited technical capacity of medical biology laboratories in healthcare facilities must be strengthened.⁴⁴⁰

According to the Global Health Observatory of the WHO, Côte d’Ivoire scored 43 out of 100 on the “Coverage of essential health services (SDG 3.8.1)” indicator in 2021, which indicates a lack of capacity in the health system as a whole. ⁴⁴¹

4.1.1e Essential health services continuity plan for public health emergencies

Score: 0

There is insufficient evidence of a plan to ensure continuity of essential health services during a public health emergency in Côte d’Ivoire. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Provision of Health Services” section that Côte d’Ivoire should develop health service continuity plans (p. 47). [1] The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to developing a health service continuity plan. [2] ] The is no evidence of a plan to ensure continuity of essential health services on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage [3], the Ministry of Environment and Sustainable Development [4], the Ministry of Water and Forests [5], the National Civil Protection Agency (ONPC) [6] and the National Institute of Public Hygiene (INHP) [7].

4.1.2a Hospital beds per 100,000 people

Score: 5.75

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 0

There is insufficient evidence that Côte d’Ivoire has the capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit and/or patient isolation room/unit located within the country. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not report on isolation capacity within the country. ⁴⁴² Both the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ⁴⁴³ and the Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 include an objective related to developing isolation capacity at university hospitals (p. 111 of the PANSS; p. 20 of the PAN-RAM) but do not contain evidence of implementation. The National Health Development Plan (Plan National de Developpement Sanitaire) 2021-2025 does not include evidence of plans to increase isolation capacity. ⁴⁴⁴ The is no evidence of a the capacity to isolate patients with highly communicable diseases on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁴⁵, the Ministry of Environment and Sustainable Development ⁴⁴⁶, the Ministry of Water and Forests ⁴⁴⁷, the National Civil Protection Agency (ONPC) ⁴⁴⁸ and the National Institute of Public Hygiene (INHP) ⁴⁴⁹.

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 0

There is insufficient evidence that Côte d’Ivoire has demonstrated capacity to expand isolation capacity or has developed, updated or tested a plan to expand isolation capacity in response to an infectious disease outbreak in the past two years. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not report on isolation capacity within the country. ⁴⁵⁰ Both the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ⁴⁵¹ and the Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 include an objective related to developing isolation capacity at university hospitals (p. 111 of the PANSS; p. 20 of the PAN-RAM) but do not contain evidence of implementation. The National Health Development Plan (Plan National de Developpement Sanitaire) 2021-2025 does not include evidence of plans to increase isolation capacity. ⁴⁵² The is no evidence of a the capacity to isolate patients with highly communicable diseases on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁵³, the Ministry of Environment and Sustainable Development ⁴⁵⁴, the Ministry of Water and Forests ⁴⁵⁵, the National Civil Protection Agency (ONPC) ⁴⁵⁶ and the National Institute of Public Hygiene (INHP) ⁴⁵⁷.

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 50

There is evidence that Côte d’Ivoire has a national procurement protocol or contract framework in place which can be utilized by the Ministries of Health and Agriculture for the acquisition of laboratory supplies. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of health emergencies” section that “There are emergency supply chain management and procurement procedures in place in Côte d'Ivoire” (p. 43). ⁴⁵⁸ The 2018 “Procedures Manual for the Integrated Logistics Management System for Health Products in Côte D'ivoire (Manuel De Procedures Du Systeme Integre De Gestion Logistique Des Produits De Sante En Côte D’ivoire )” covers the acquisition of laboratory supplies (p. 15). ⁴⁵⁹

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 0

There is insufficient evidence that Côte d'Ivoire has a stockpile of medical supplies for national use during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not contain evidence that Côte d’Ivoire has an emergency stockpile of medical supplies. [1] The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to developing an emergency stockpile of medical supplies. [2] ] The is no evidence of an emergency stockpile of medical supplies on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage [3], the Ministry of Environment and Sustainable Development [4], the Ministry of Water and Forests [5], the National Civil Protection Agency (ONPC) [6] and the National Institute of Public Hygiene (INHP) [7].

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

There is insufficient evidence that Côte d'Ivoire has a stockpile of laboratory supplies for national use during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not contain evidence that Côte d’Ivoire has an emergency stockpile of laboratory supplies. ⁴⁶⁰ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to developing an emergency stockpile of medical supplies. ⁴⁶¹ The is no evidence of an emergency stockpile of laboratory supplies on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁶², the Ministry of Environment and Sustainable Development ⁴⁶³, the Ministry of Water and Forests ⁴⁶⁴, the National Civil Protection Agency (ONPC) ⁴⁶⁵ and the National Institute of Public Hygiene (INHP) ⁴⁶⁶.

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is insufficient evidence that Côte d'Ivoire has a stockpile of medical or laboratory supplies for national use during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not contain evidence that Côte d’Ivoire has an emergency stockpile of medical or laboratory supplies. ⁴⁶⁷ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to developing an emergency stockpile of medical supplies. ⁴⁶⁸ The is no evidence of an emergency stockpile of medical or laboratory supplies on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁶⁹, the Ministry of Environment and Sustainable Development ⁴⁷⁰, the Ministry of Water and Forests ⁴⁷¹, the National Civil Protection Agency (ONPC) ⁴⁷² and the National Institute of Public Hygiene (INHP) ⁴⁷³.

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 0

There is insufficient evidence that Côte d'Ivoire has a plan/agreement to leverage public and/or private sector domestic manufacturing capacity to produce or procure medical supplies or to expedite medical supplies through points of entry during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, documents that Côte d’Ivoire has does not have plans to leverage private sector manufacturing or procurement: “A national preference strategy should be put in place to increase production capacities for antibiotics, vaccines, laboratory equipment/supplies or others” and “Conventions or agreements must be signed between Côte d'Ivoire and suppliers for the supply of medical countermeasures in the event of a public health emergency” (p. 43). ⁴⁷⁴ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to leveraging public and/or private sector domestic manufacturing capacity to produce or procure medical supplies or to expedite medical supplies through points of entry during a public health emergency. ⁴⁷⁵ The is no evidence of a plan to leverage public and/or private sector domestic manufacturing capacity to produce or procure medical supplies or to expedite medical supplies through points of entry during a public health emergency on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁷⁶, the Ministry of Environment and Sustainable Development ⁴⁷⁷, the Ministry of Water and Forests ⁴⁷⁸, the National Civil Protection Agency (ONPC) ⁴⁷⁹ and the National Institute of Public Hygiene (INHP) ⁴⁸⁰.

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 0

There is insufficient evidence that Côte d'Ivoire has a plan/agreement to leverage public and/or private sector domestic manufacturing capacity to produce or procure laboratory supplies or to expedite laboratory supplies through points of entry during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, documents that Côte d’Ivoire has does not have plans to leverage private sector manufacturing or procurement: “A national preference strategy should be put in place to increase production capacities for antibiotics, vaccines, laboratory equipment/supplies or others” and “Conventions or agreements must be signed between Côte d'Ivoire and suppliers for the supply of medical countermeasures in the event of a public health emergency” (p. 43). ⁴⁸¹ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to leveraging public and/or private sector domestic manufacturing capacity to produce or procure laboratory supplies or to expedite laboratory supplies through points of entry during a public health emergency. ⁴⁸² The is no evidence of a plan to leverage public and/or private sector domestic manufacturing capacity to produce or procure laboratory supplies or to expedite laboratory supplies through points of entry during a public health emergency on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁸³, the Ministry of Environment and Sustainable Development ⁴⁸⁴, the Ministry of Water and Forests ⁴⁸⁵, the National Civil Protection Agency (ONPC) ⁴⁸⁶ and the National Institute of Public Hygiene (INHP) ⁴⁸⁷.

4.2.3c Mechanism emergency logistics and supply chain management

Score: 100

There is evidence that Côte d’Ivoire has a system or mechanism for national and subnational levels for emergency logistics and supply chain management and that it covers specific considerations, but not that it is updated regularly or that it covers both the public and private sector. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that “There are emergency supply chain management and procurement procedures in place in Côte d'Ivoire” and “There is a framework for meeting and carrying out simulation exercises at the logistics level (exercise book)” (p. 43). ⁴⁸⁸ The 2018 “Procedures Manual for the Integrated Logistics Management System for Health Products in Côte D'ivoire (Manuel De Procedures Du Systeme Integre De Gestion Logistique Des Produits De Sante En Côte D’ivoire )” covers “1) NPSP_ Recoverable medicines (NPSP_REC), 2) NPSP _Targeted free medicines, 3) NPSP _Service products and consumables, 4) PNLP (National Malaria Control Program): Antimalarials, Reagents and consumables, 5) PNLS (National AIDS Control Program): ARVs, TRC, Biochemistry, CD4, Hematology) 6) PNLT (National Tuberculosis Control Program): Anti-tuberculosis drugs, reagents, and consumables; 7) PNSME (National Mother and Child Health Program): Contraceptive products and mother and child products; 8) PNN (National Nutrition Program): Therapeutic foods, medicines, and anthropometric equipment; 9) PNSBD (National Oral Health Program): Oral health medicines; 10) PNLUB (National Program to Combat Buruli Ulcer)11) PNLMM (National Program for the Control of Metabolic Diseases), (integrated into form NPSP_REC); 12) PNLMNT (National Program for the Control of Non-Communicable Diseases); 13) PNSM (National Mental Health Program) (integrated into form NPSP_REC); 14) PNLCa (National Cancer Control Program) (form NPSP_REC); 15) PNLMTN-CP (National Program for the Control of Neglected Tropical Diseases with Preventive Chemoprophylaxis); 16) PNSSU-SAJ (National Program for School and University Health and Adolescent and Youth Health); 17) PNLHV (National Program for the Fight against Viral Hepatitis)” as well as “Vaccines EPI (Expanded Program on Immunization); Outside EPI (vaccines recoverable from INHP); Blood products and strategic inputs; Medical consumables; Serology reagent; Immunology reagents; Labile blood products; Hemodialysis products; Hemodialysis reagents; [and] Laboratory reagents” (pp. 14-15). ⁴⁸⁹ The plan includes cold chain management of vaccines; however, the system has not been updated since 2018. ⁴⁹⁰

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 0

There is insufficient evidence that Côte d'Ivoire has a plan, program, or guidelines in place for dispensing medical countermeasures (MCM) for national use during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that Côte d’Ivoire: “A three-year assessment of emergency preparedness must be carried out,” “A national multi-risk and multi-sectoral plan must be developed”, “A system for assessing community preparedness must be put in place” and “A national multi-risk, multisectoral preparedness and response plan must be developed in the event of a public health emergency” (p. 41); it does not contain evidence that a plan for dispensing MCMs during a public health emergency is in place. ⁴⁹¹ The National Office for Civil Protection (ONPC) (L’Office National de la Protection Civile) (ONPC) includes an emergency plan, but it does not address public health emergencies. ⁴⁹² There is insufficient evidence of an overarching national public health emergency response plan or similar document that would address dispensing MCMs on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁹³, the Ministry of Environment and Sustainable Development ⁴⁹⁴, the Ministry of Water and Forests ⁴⁹⁵ and the National Civil Protection Agency (ONPC) ⁴⁹⁶.

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 0

There is insufficient evidence that Côte d'Ivoire has a public plan to facilitate a workforce surge in an emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Human Resources section that Côte d’Ivoire lacks a plan to facilitate such a surge: “A national strategic plan for multi-sectoral reinforcement of personnel in the event of an emergency must be developed and implemented” and “A continuing training plan for EIRs must be developed and implemented” (p. 39). ⁴⁹⁷ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to facilitating a workforce surge in an emergency. ⁴⁹⁸ The is no evidence of a plan facilitate workforce surge in an emergency on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁴⁹⁹, the Ministry of Environment and Sustainable Development ⁵⁰⁰, the Ministry of Water and Forests ⁵⁰¹, the National Civil Protection Agency (ONPC) ⁵⁰² and the National Institute of Public Hygiene (INHP) ⁵⁰³.

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is insufficient evidence that Côte d'Ivoire has a public plan to facilitate a workforce surge in an emergency, including receiving health personnel from other countries. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Human Resources section that Côte d’Ivoire lacks a plan to facilitate such a surge: “A national strategic plan for multi-sectoral reinforcement of personnel in the event of an emergency must be developed and implemented” and “A continuing training plan for EIRs must be developed and implemented” (p. 39). ⁵⁰⁴ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to facilitating a workforce surge in an emergency. ⁵⁰⁵ The is no evidence of a plan facilitate workforce surge in an emergency on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵⁰⁶, the Ministry of Environment and Sustainable Development ⁵⁰⁷, the Ministry of Water and Forests ⁵⁰⁸, the National Civil Protection Agency (ONPC) ⁵⁰⁹ and the National Institute of Public Hygiene (INHP) ⁵¹⁰.

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

There is insufficient evidence that Côte d'Ivoire has a public plan to facilitate a workforce surge in an emergency, including geographical or role redeployment. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Human Resources section that Côte d’Ivoire lacks a plan to facilitate such a surge: “A national strategic plan for multi-sectoral reinforcement of personnel in the event of an emergency must be developed and implemented” and “A continuing training plan for EIRs must be developed and implemented” (p. 39). ⁵¹¹ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to facilitating a workforce surge in an emergency. ⁵¹² The is no evidence of a plan facilitate workforce surge in an emergency on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵¹³, the Ministry of Environment and Sustainable Development ⁵¹⁴, the Ministry of Water and Forests ⁵¹⁵, the National Civil Protection Agency (ONPC) ⁵¹⁶ and the National Institute of Public Hygiene (INHP) ⁵¹⁷.

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 75

The constitution of Côte d’Ivoire includes an explicit guarantee of the right to medical care but does not specify free care. Article 9 of the Constitution of the Republic of Côte d’Ivoire states, “Everyone has the right to education and vocational training. Everyone also has the right to access health services.” Article 32 also states, “The State undertakes to guarantee the specific needs of vulnerable persons. It shall take the necessary measures to prevent the vulnerability of children, women, mothers, the elderly, and persons with disabilities. It undertakes to guarantee vulnerable persons access to health services, education, employment, culture, sports, and leisure activities.” ⁵¹⁸

4.4.1b Access to skilled birth attendants (% of population)

Score: 76.47

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 91.5

4.4.1d Coverage of essential health services through universal health coverage

Score: 33.33

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 58.9

4.4.1f Rate of mortality amenable to health care

Score: 83.43

4.4.2a Guaranteed paid sick leave

Score: 66.67

Workers in Côte d’Ivoire are entitled to paid sick leave; the provision does not specify if mental health conditions are covered. Articles 28 and 29 of the Interprofessional Collective Agreement of July 19, 1977 (Convention collective interprofessionnelle du 19 juillet 1977) cover sick leave in Côte d’Ivoire. Specifically, they entitled workers to a set amount of paid sick leave depending on seniority (ranging from 1 month to 2 months’ salary plus half pay for 1 to 4 months). Workers are required to notify their employer within 48 hours of their illness and provide a medical certificate if necessary. The provision does not explicity address whether mental health care is covered. ⁵¹⁹

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is insufficient evidence that Côte d’Ivoire has legislation, a policy, or a public statement committing to prioritizing healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Human Resources” section that Côte d’Ivoire lacks a plan to facilitate manage health personnel during a public health emergency: “A national strategic plan for multi-sectoral reinforcement of personnel in the event of an emergency must be developed and implemented” and “A continuing training plan for EIRs must be developed and implemented” (p. 39). ⁵²⁰ The 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, does not contain objectives related to prioritizing healthcare services to health workers who become sick responding to a public health emergency. ⁵²¹ The is no evidence of such a pledge or commitment on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵²², the Ministry of Environment and Sustainable Development ⁵²³, the Ministry of Water and Forests ⁵²⁴, the National Civil Protection Agency (ONPC) ⁵²⁵ and the National Institute of Public Hygiene (INHP) ⁵²⁶.

4.5.1a Existence of system for communication during a public health emergency

Score: 0

There is insufficient evidence of a system in place for public health officials and healthcare workers to communicate during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not include evidence of such a system. ⁵²⁷ Neither the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ⁵²⁸ nor the 2021 National Health Development Plan (Plan National de Développement Sanitaire) PNDS 2021-2025 ⁵²⁹ mentions such a system or developing such a system. There is no information about a system for public health officials and healthcare workers to communicate on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵³⁰, the Ministry of Environment and Sustainable Development ⁵³¹, the Ministry of Water and Forests ⁵³², the National Civil Protection Agency (ONPC) ⁵³³ and the National Institute of Public Hygiene (INHP) ⁵³⁴.

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

There is insufficient evidence of a system in place for public health officials and healthcare workers (either public or private) to communicate during a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not include evidence of such a system. ⁵³⁵ Neither the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ⁵³⁶ nor the 2021 National Health Development Plan (Plan National de Développement Sanitaire) PNDS 2021-2025 ⁵³⁷ mentions such a system or developing such a system. There is no information about a system for public health officials and healthcare workers to communicate on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵³⁸, the Ministry of Environment and Sustainable Development ⁵³⁹, the Ministry of Water and Forests ⁵⁴⁰, the National Civil Protection Agency (ONPC) ⁵⁴¹ and the National Institute of Public Hygiene (INHP) ⁵⁴².

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 0

There is insufficient evidence that the national public health system is monitoring for and tracking the number of healthcare-associated infections (HCAI) that take place in healthcare facilities. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Infection prevention and control” section that “Guidelines for the surveillance of healthcare-associated infections (HAIs) should be implemented in all referral hospitals and veterinary clinics” (p. 48). ⁵⁴³ The Multisectoral National Action Plan to Combat Antimicrobial Resistance (PAN-RAM) 2021-2025, in its section on AMR in the hospital sector, reports in “Strategic Objeitive 4: Reduce the incidence of infections through effective sanitation, hygiene and prevention measures” that the “National guide for surveillance and prevention of healthcare-related infections obsolete and not disseminated,” and there is a “Lack of data on the incidence and national prevalence of healthcare-associated infections” (pp. 146-147). ⁵⁴⁴ Neither the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ⁵⁴⁵ nor the 2021 National Health Development Plan (Plan National de Développement Sanitaire) PNDS ⁵⁴⁶ discusses or contains evidence of an infection prevention and control program in place nationally. There is no evidence that the national public health system is monitoring for and tracking the number of healthcare-associated infections (HCAI) on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵⁴⁷, the Ministry of Environment and Sustainable Development ⁵⁴⁸, the Ministry of Water and Forests ⁵⁴⁹, the National Civil Protection Agency (ONPC) ⁵⁵⁰ and the National Institute of Public Hygiene (INHP) ⁵⁵¹.

4.6.1b Infection prevention and control programme

Score: 100

There is evidence of a national infection prevention and control program but it is not publicly available. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Infection Prevention and Control” section that Côte d’Ivoire “has a national strategic plan for infection control, 2023-2027, with a budget allocated” (p. 48). ⁵⁵² However, that plan is not available on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵⁵³, the Ministry of Environment and Sustainable Development ⁵⁵⁴, the Ministry of Water and Forests ⁵⁵⁵, the National Civil Protection Agency (ONPC) ⁵⁵⁶ and the National Institute of Public Hygiene (INHP) ⁵⁵⁷.

4.6.1c National plan to ensure a safe environment in health facilities

Score: 0

There is insufficient evidence that Côte d’Ivoire has evidence of a plan to ensure a safe environment in health facilities nationally. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not report on evidence of a plan to ensure a safe environment in health facilities nationally. ⁵⁵⁸ Both the 2018 National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS ⁵⁵⁹ and the Multisectoral National Action Plan to Combat Antimicrobial Resistance (Plan d’Action National multisectoriel de lutte contre les Résistances aux Antimicrobiens) (PAN-RAM) 2021-2025 include objectives related to improving AMR resistance but do not focus on measures to ensure a safe environment in health facilities nationally (p. 111 of the PANSS; p. 20 of the PAN-RAM). The National Health Development Plan (Plan National de Developpement Sanitaire) 2021-2025 does not include evidence of a plan to ensure a safe environment in health facilities nationally. ⁵⁶⁰ The is no evidence of a plan to ensure a safe environment in health facilities nationallyon the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵⁶¹, the Ministry of Environment and Sustainable Development ⁵⁶², the Ministry of Water and Forests ⁵⁶³, the National Civil Protection Agency (ONPC) ⁵⁶⁴ and the National Institute of Public Hygiene (INHP) ⁵⁶⁵. A 2023 academic article in the journal BMJ Health Services Research, which evaluated hospitals in Abijan, Cote d'Ivoire, according to the WHO Infection Prevention and Control Assessment Framework (IPCAF) noted that "to achieve the objectives of the “My Health, My Life” policy, the Ministry in charge of health made a firm commitment to sanitize hospitals in 2017, which was declared the 'Year of Hygiene," but does not include evidence of a specific plan to improve hospital hygene nationwide. ⁵⁶⁶

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 100

Côte d’Ivoire has a national requirement for ethical review before beginning a clinical trial. According to the 2024 “Guidelines on Clinical Trials, Applications for Authorization and Substantial Modifications” from the Ivorian Pharmaceutical Regulatory Authority (L’Autorité Ivoirienne de Régulation Pharmaceutique —AIRP), Côte d’Ivoire requires both approval from the AIRP and the national ethical committee before a clinical trial can take place: “No clinical trial may be undertaken without authorization issued by the Ivorian Pharmaceutical Regulatory Authority, abbreviated AIRP, after advice from the national ethics committee” (p. 9). ⁵⁶⁷

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 100

Côte d’Ivoire has an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or mutual recognition of clinical trial results taking place elsewhere to treat ongoing pandemics or epidemics. Chapter 7 “Conditions for Implementation in Urgency of Clinical Trials” of the 2024 “Guidelines on Clinical Trials, Applications for Authorization and Substantial Modifications” from the Ivorian Pharmaceutical Regulatory Authority (L’Autorité Ivoirienne de Régulation Pharmaceutique —AIRP) covers “Special conditions that will apply for the conduct of clinical trials in cases of Public Health Emergencies” (p. 28). The chapter covers eligibility for such emergency processing, the pre-submission requirements and then the procedure by which the AIRP will handle the submission (Section 7.2). ⁵⁶⁸ Chapter 8 of those guidelines covers the procedure for approving clinical trials occurring elsewhere (p. 31), with Section 8.1 covering the conditions under which clinical trials occurring elsewhere can be accepted by the AIRP. ⁵⁶⁹

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

There is a government agency responsible for approving new medical countermeasures (MCM) for humans in Côte d’Ivoire. The Ivorian Pharmaceutical Regulatory Authority (L’Autorité Ivoirienne de Régulation Pharmaceutique —AIRP) is responsible for “The Marketing Authorization for Pharmaceuticals and the Marketing Authorization,” the “Authorization to open and operate pharmaceutical establishments and medical biology laboratories,” “The Authorization for the Import and Export of Pharmaceuticals,” the “Inspection of pharmaceutical establishments and medical biology laboratories,” “Vigilance and market surveillance,” Authorization and inspection of clinical trials,” “Quality control,” and Authorization for the promotion and advertising of pharmaceutical products” according to its website. ⁵⁷⁰

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 0

There is insufficient evidence that Côte d’Ivoire has an expedited process for approving medical countermeasures (MCM) for human use or recognition of approval decisions taking place elsewhere during public health emergencies. Chapter 7 “Conditions for Implementation in Urgency of Clinical Trials” of the 2024 “Guidelines on Clinical Trials, Applications for Authorization and Substantial Modifications” from the Ivorian Pharmaceutical Regulatory Authority (L’Autorité Ivoirienne de Régulation Pharmaceutique —AIRP) covers “Special conditions that will apply for the conduct of clinical trials in cases of Public Health Emergencies” (p. 28) but does not address MCMs broadly. The chapter covers eligibility for such emergency processing, the pre-submission requirements and then the procedure by which the AIRP will handle the submission (Section 7.2). ⁵⁷¹ Chapter 8 of those guidelines covers the procedure for approving clinical trials occurring elsewhere (p. 31), with Section 8.1 covering the conditions under which clinical trials occurring elsewhere can be accepted by the AIRP, but does not address MCMs broadly. ⁵⁷²

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Côte d'Ivoire has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁵⁷³

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 0

There is insufficient evidence that Côte d’Ivoire has a national risk reduction strategy that integrates epidemics and pandemics. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Management of Health Emergencies” section that “Risk mapping and vulnerability assessment in all sectors must be realized” (p. 42); the JEE does not contain evidence of a national risk reduction strategy. ⁵⁷⁴ The 2019 draft of Côte d’Ivoire’s National Disaster Risk Reduction Strategy (SN-RRC) 2020-2030 includes information on pandemics and epidemics ⁵⁷⁵; however, the finalized version is not available on the website of the National Civil Protection Agency (ONPC) and it is not clear that the strategy is in effect; the website of the ONPC does not list another risk reduction strategy. ⁵⁷⁶ There is no evidence of a standalone national disaster risk reduction strategy for epidemics and pandemics on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵⁷⁷, the Ministry of Environment and Sustainable Development ⁵⁷⁸, the Ministry of Water and Forests ⁵⁷⁹, the National Civil Protection Agency (ONPC) ⁵⁸⁰ and the National Institute of Public Hygiene (INHP) ⁵⁸¹.

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 100

Côte d’Ivoire has cross-border agreements, protocols, or MOUs with neighboring countries, or as part of a regional group, with regards to public health emergencies.

According to the First WHO Joint External Evaluation for Côte d'Ivoire conducted in December 2016, the country has cooperation protocols with Algeria and Chad regarding epidemic control in West Africa (p.44). The Ouagadougou Protocol for Controlling Epidemics in West Africa, Algeria and Chad was signed in 1996. ⁵⁸²⁵⁸³ Côte d'Ivoire also routinely reports information about diseases to the World Health Organization and the West Africa Health Organization. Côte d'Ivoire is also a part of the Global Outbreak Alert and Response Network (GOARN). GOARN members send and receive experts and staff as needed when a member country experiences a disease outbreak. In 2014-2015, Côte d'Ivoire sent 15 health workers (8 physicians, 4 nurses, and 3 technicians) to Guinea during that country's Ebola outbreak. GOARN is also active in its response to pandemics such as the Coronavirus one. ⁵⁸⁴⁵⁸⁵ Côte d'Ivoire is also part of the Mano River Union (MRU), an intergovernmental body established to promote economic and regional integration among its four member countries. Sierra Leone, Liberia, and Guinea are the other three member countries. In 2006, MRU's mandate was expanded to encompass health, e.g., cross-border neglected tropical disease issues. ⁵⁸⁶ The Second JEE for Côte d'Ivoire, the Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not include further evidence of cross-border agreements, protocols or MOUs with neighboring countries. ⁵⁸⁷

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 0

There is insufficient evidence that Côte d’Ivoire has cross-border agreements, protocols, or MOUs with neighboring countries, or as part of a regional group, with regard to animal health emergencies. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, does not contain evidence of cross-border agreements, protocols, or MOUs with neighboring countries, or as part of a regional group, with regard to animal health emergencies. According to the Food and Agriculture Organization of the United Nations (FAO), Côte d'Ivoire is part of two major regional networks: the West and Central Africa veterinary laboratory network for Avian Influenza and other transboundary diseases (RESOLAB) and the regional network of national epidemic surveillance systems for Avian Influenza and other priority animal diseases in West and Central Africa (RESEPI). These networks bring together the animal health experts in the region in order to prepare and implement regional control strategies for major animal diseases, including Avian Influenza, Foot-and-Mouth Disease, Peste des Petits Ruminants (sheep and goat plague), and rabies, as well as "serve to build capacities in preparedness, early warning, response and monitoring of veterinary services to countries in the region". ⁵⁸⁸ There is insufficient evidence of such agreements on the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁵⁸⁹, the Ministry of Environment and Sustainable Development ⁵⁹⁰, the Ministry of Water and Forests ⁵⁹¹, the National Civil Protection Agency (ONPC) ⁵⁹² and the National Institute of Public Hygiene (INHP) ⁵⁹³.

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

Côte d’Ivoire is a signatory to and has ratified the Biological Weapons Convention (BWC). The United Nations Institute for Disarmament Research (UNIDIR) reports that Côte d’Ivoire ascended to the BWC on 23/03/2016. ⁵⁹⁴

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 100

Côte d’Ivoire has submitted confidence-building measures to the Biological Weapons Convention (BWC) in the past three years. According to the UN BWC Confidence Building Measures data, Côte d’Ivoire has submitted yearly confidence building measures since 2022. ⁵⁹⁵

5.3.1c Submission of UNSCR 1540 reports

Score: 100

Côte d’Ivoire has provided the required United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee). ⁵⁹⁶

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 0

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

Côte d’Ivoire is not a member of any of the listed groups.

Côte d’Ivoire is not a member of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction ⁵⁹⁷, the Australia Group (AG) ⁵⁹⁸ or the Proliferation Security Initiative (PSI). ⁵⁹⁹

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

Côte d’Ivoire has completed a Joint External Evaluation (JEE) and published a full report in the last five years. Côte d’Ivoire completed a Joint External Evaluation (JEE) in 2023; the full report is available on the website of the World Health Organization (WHO). ⁶⁰⁰

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

Côte d’Ivoire has not completed and published a Performance of Veterinary Services (PVS) assessment in the last five years.

According to the World Organization for Animal Health (WOAH), Côte d’Ivoire has performed the following assessments: PVS Evaluation (initial): 2006; PVS Evaluation (follow-up): 2011; PVS Evaluation (aquatic): 2016; PVS Gap-Analysis: 2012; PVS Legislation: 2013; and PVS Laboratories: 2015. ⁶⁰¹

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

Côte d’Ivoire has not completed and published a Performance of Veterinary Services (PVS) gap analysis in the last five years.

According to the World Organization for Animal Health (WOAH), Côte d’Ivoire has performed the following assessments: PVS Evaluation (initial): 2006; PVS Evaluation (follow-up): 2011; PVS Evaluation (aquatic): 2016; PVS Gap-Analysis: 2012; PVS Legislation: 2013; and PVS Laboratories: 2015. ⁶⁰²

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 0

There is insufficient evidence that Côte d’Ivoire has allocated national funds to improve its capacity to address pandemic or epidemic threats within the past three years. The 2021 National Health Development Plan (PNDS) 2021-2025 includes roughly 11 billion USD budget request for its total implementation (p. 100). Table 8 breaks down the funding by effect, with dedicated funding for emergency responses under “Effect 6: The health system ensures an effective response to public health emergencies” (p. 102); funding will include roughly 171.6 million USD over 5 years. ⁶⁰³ However, the website of the Ministry of Budget and State Entities does not include evidence of specific allocation for the PNDS. ⁶⁰⁴

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

There is insufficient evidence that the Joint External Evaluation (JEE) report or the National Action Plan for Health Security (NAPHS) allocate or describe specific funding from the national budget to address the identified gaps. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Finance” section that “There is no specific budget line allocated to IHR activities” (p. 11). ⁶⁰⁵ Côte d’Ivoire has an NAPHS, the National Health Security Action Plan (Plan D’action National De Securite Sanitaire) – PANSS, but it is from 2018. ⁶⁰⁶

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

Côte d’Ivoire has not completed and published a Performance of Veterinary Services (PVS) assessment or gap analysis in the last five years.

According to the World Organization for Animal Health (WOAH), Côte d’Ivoire has performed the following assessments: PVS Evaluation (initial): 2006; PVS Evaluation (follow-up): 2011; PVS Evaluation (aquatic): 2016; PVS Gap-Analysis: 2012; PVS Legislation: 2013; and PVS Laboratories: 2015. ⁶⁰⁷

5.5.3a Emergency public financing during a public health emergency

Score: 100

There a publicly identified special emergency public financing mechanism and funds which Côte d’Ivoire can access in the face of a public health emergency. The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports in the “Financing” section that each element of the health sector has their own emergency fund: “The coordination and allocation of funds for public health emergency response is provided for in each of the budget lines of the different sectors of the RSI domains. The National Institute of Public Hygiene, which houses the national RSI focal point, is responsible for focusing on the needs of coordinating interventions from the sectors concerned, their use and the execution of related activities” (p. 11). ⁶⁰⁸

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 100

Côte d’Ivoire has made a public commitment to improve the country’s domestic capacity to address pandemic or epidemic threats by expanding financing or requesting support to improve capacity. In January 2024, the President of Côte d’Ivoire, Alassane Ouattara, met with the US Secretary of State Anthony Blinken during Blinken’s visit to Abidjan; agreements included “$105 million in FY 2023 to support HIV prevention, care and treatment in the fight to end HIV/AIDS as a public health threat by 2030” and “$81 million to strengthen systems and interventions for the prevention, detection, and response to infectious disease threats such as COVID-19, Ebola, and Avian Influenza”. ⁶⁰⁹

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

Côte d’Ivoire has requested financing or technical support from donors to improve the country’s domestic capacity to address epidemic threats. In January 2024, the President of Côte d’Ivoire, Alassane Ouattara, met with the US Secretary of State Anthony Blinken during Blinken’s visit to Abidjan; agreements included “$105 million in FY 2023 to support HIV prevention, care and treatment in the fight to end HIV/AIDS as a public health threat by 2030” and “$81 million to strengthen systems and interventions for the prevention, detection, and response to infectious disease threats such as COVID-19, Ebola, and Avian Influenza”. ⁶¹⁰

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 100

There is no evidence that Côte d’Ivoire has failed to fulfill its full contribution to the WHO within the past two years. The WHO’s "Statement of Account Côte d'Ivoire As at 28 February 2025" found that Côte d’Ivoire had no outstanding balance. ⁶¹¹

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is insufficient evidence of a publicly available plan or policy for sharing genetic data, clinical specimens, and/or isolated specimens (biological materials) along with the associated epidemiological data with international organizations and/or other countries in Côte d’Ivoire.

The Joint external evaluation of the main capacities of the International Health Regulations (2005) of Côte d’Ivoire: Mission report, 04-08 December 2023, reports that Côte d’Ivoire “has legislation regulating biological safety and security activities within the various laboratory levels, already taking into account the P4 level” (p. 25). ⁶¹² The 2018 National Health Security Action Plan (PANSS) ⁶¹³ and the National Health Development Plan (PNDS) 2021-2025 ⁶¹⁴ do not contain a policy or plan for sharing genetic data, clinical specimens or isolated specimens. The is no evidence of such a plan on the websites of the websites of the Ministry of Health, Public Hygiene and Universal Health Coverage ⁶¹⁵, the Ministry of Environment and Sustainable Development ⁶¹⁶, the Ministry of Water and Forests ⁶¹⁷, the National Civil Protection Agency (ONPC) ⁶¹⁸ and the National Institute of Public Hygiene (INHP) ⁶¹⁹.

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no public evidence that Côte d’Ivoire has not shared samples in accordance with the Pandemic Influenza Preparedness (PIP) framework in the past two years. The most recent report on the PIP framework, covering 1 January to 30 June 2024, does not contain evidence that Côte d’Ivoire has not shared samples in accordance with the framework. ⁶²⁰

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no public evidence that Côte d’Ivoire has not shared pandemic pathogen samples during an outbreak in the past two years.

Neither the World Health Organization (WHO) ⁶²¹ nor the WHO Regional Office for Africa ⁶²² reports that Côte d’Ivoire has not shared shared pandemic pathogen samples during an outbreak in the past two years.

6.1.1a Policy formation

Score: 50

6.1.1b Quality of bureaucracy

Score: 25

6.1.1c Excessive bureaucracy/red tape

Score: 25

6.1.1d Vested interests/cronyism

Score: 25

6.1.1e Corruption

Score: 45

6.1.1f Accountability of public officials

Score: 25

6.1.1g Human rights risk

Score: 25

6.1.2a Orderly transfers of power

Score: 25

6.1.3a Risk of social unrest

Score: 50

6.1.4a Risk of terrorism

Score: 50

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 25

6.1.5a Presence or risk of armed conflict

Score: 75

6.1.6a Government territorial control

Score: 100

6.1.7a International tensions

Score: 75

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 52.8

6.2.2a UNDP Gender Inequality Index score

Score: 20.05

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 63.73

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 33.33

6.2.4a Public confidence in government

Score: 50

6.2.5a Robust, open, diverse local media and reporting

Score: 50

6.2.6a Gini coefficient

Score: 64.7

6.3.1a Adequacy of road network

Score: 25

6.3.2a Adequacy of airports

Score: 50

6.3.3a Adequacy of power network

Score: 50

6.4.1a Urban population (% of total population)

Score: 49.46

6.4.2a Change in forest area (percentage points)

Score: 34.38

6.4.3a Natural disaster risk

Score: 75

6.5.1a Total life expectancy (years)

Score: 33.94

6.5.1b NCD mortality rate

Score: 66.59

6.5.1c Population aged 65+

Score: 94.28

6.5.1d Tobacco use (% of adults)

Score: 67.37

6.5.1e Level of adult obesity (%)

Score: 83.91

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 94.35

6.5.2a Access to potable water

Score: 76.97

6.5.2b Access to at least basic sanitation facilities

Score: 39.92

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 0

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 6.99

6.5.4a Trust medical and health advice from the government

Score: 0

6.5.4b Trust medical and health advice from medical workers

Score: 50