Equatorial Guinea: Score Justification Summary

2026

1.1 Antimicrobial resistance (AMR)

1.1.1 AMR surveillance, detection and reporting

1.1.1a National plan for AMR priority pathogens

Score: 0

Equatorial Guinea does not have a national AMR plan for the surveillance, detection, and reporting of priority AMR pathogens.

According to the World Health Organization (WHO), Equatorial Guinea has a national AMR action plan under development. ¹ According to the WHO Tracking AMR Country Self Assessment Survey (TrACSS) 2022, Equatorial Guinea has neither developed nor implemented a AMR National Action Plan. ² However, there is no evidence of such plan on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ³ ⁴ ⁵ ⁶

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not include provisions on antimicrobial resistance related to surveillance, detection or reporting of priority AMR pathogens. ⁷

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸

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

Score: 0

Equatorial Guinea does not have a national laboratory system which tests for at least priority AMR pathogen.

The Baney Research Laboratory was established in 2019, and it can conduct tests COVID-19 and malaria. ⁹ ¹⁰ ¹¹ However, there is no mention of priority AMR pathogens, such as chikungunya, ebola, influenzas, MERS-CoV or Zika virus. ¹² ¹³ ¹⁴ The website of Guinea Ecuatorial Salud does not present details on Baney Research Laboratory's operations. ¹⁵ Moreover, the La Paz Medical Center can conduct diagnostics for Ebola. ¹⁶

Nevertheless, there is no evidence of coordinated infrastructure, protocols, data reporting, and routine testing across health facilities. ¹⁷ ¹⁸ ¹⁹ ²⁰ ²¹

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is no evidence Equatorial Guinea conducts environmental detection or surveillance activities for antimicrobial residues or AMR organisms.

The General Health Law (Law Decree No. 3 of 25 September 1981), the Environmental Regulation Law (Law No. 7 of 27 November 2003) and the Medicine Law (Law No. 3 of 18 November 2003) do not mention such surveillance activities. ²² ²³ ²⁴

There is no evidence of such activities on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ²⁵ ²⁶

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a measure to implement sentinel surveillance for meningitis caused by Haemophilus influenzae type b and yellow fever, as well as environmental surveillance for poliomyelitis. ²⁷ However, the plan does not provide further details on the implementation of these initiatives, nor does it reference surveillance efforts for other pathogens. ²⁸

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁹

1.1.2 Antimicrobial control

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

Score: 0

Equatorial Guinea has a national regulation in place requiring prescription for medicine use for humans. However, it does not specifically mention antibiotics.

Pursuant to Article 8 of the Medicine Law (Law No. 3 of 18 November 2003), the National Health Selection Committee is responsible for establishing the administrative requirements for the prescription of medicines. ³⁰ Article 10 further provides that the National Health Selection Committee will establish the list of prescription-only medicine. ³¹ However, the law does not mention antibiotics, and there is no publicly available list of prescription-only medicines on the official websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ³² ³³ ³⁴

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

Score: 0

There is no evidence the legal framework in Equatorial Guinea requires prescriptions for antibiotic use for animals.

Pursuant to Article 2, Section (a), of the Medicine Law (Law No. 3 of 18 November 2003), medicine is defined as any substance prepared with pharmaceutical action possessing curative or preventive properties for use in humans or animals. ³⁵ Under Article 8, the National Health Selection Committee is responsible for establishing the administrative requirements for the prescription of medicines. ³⁶ Additionally, Article 30 establishes that the prescription of medicines for animals must comply with the guidelines set by the Ministry of Agriculture, Livestock, Forests, Fisheries, and the Environment. ³⁷

However, the Medicine Law does not specifically reference antibiotics. ³⁸ Furthermore, there is no publicly available list of prescription-only medicines on the official websites of the Government of Equatorial Guinea (which gathers all information in Equatorial Guinea), or the Guinea Ecuatorial Salud. ³⁹ ⁴⁰ ⁴¹

1.2 Zoonotic disease

1.2.1 National planning for zoonotic diseases/pathogens

1.2.1a Laws/plans on zoonotic disease

Score: 0

There is no evidence Equatorial Guinea has a document on zoonotic diseases.

The Environmental Regulation Law (Law No. 7 of 27 November 2003) does not include provisions specifically addressing zoonotic diseases. ⁴² Article 112, Section 1, Subsection (d), states that urban planning legislation must take environmental considerations into account and include campaigns to combat various vectors of endemic diseases, such as insects, arthropods, mollusks, and rodents. ⁴³ However, the law does not specify which diseases are targeted or detail the methods to be used in combating these vectors. ⁴⁴

There is no evidence of such plan on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁴⁵ ⁴⁶ ⁴⁷ ⁴⁸

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a range of measures aimed at combating malaria, tuberculosis, and HIV. These include: (i) indoor residual spraying and the distribution of mosquito nets and larvicides; (ii) case management through laboratory diagnosis, antimalarial treatment, and prevention during pregnancy using intermittent preventive treatment (IPT); (iii) epidemiological surveillance, monitoring, follow-up, and evaluation; (iv) entomological studies focused on mosquito populations; (v) operational research on malaria vaccines and resistance to insecticides used in spraying; and (vi) community sensitization and mobilization. ⁴⁹ However, the plan is centered exclusively on human health and does not address priority zoonotic diseases. ⁵⁰

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁵¹

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

Score: 0

There is no evidence Equatorial Guinea has a document on zoonotic diseases. Likewise, there is no evidence of national legislation with measures for risk identification and reduction for zoonotic disease spillover events from animals to humans.

The Environmental Regulation Law (Law No. 7 of 27 November 2003) does not include provisions specifically addressing zoonotic diseases. ⁵² Article 112, Section 1, Subsection (d), states that urban planning legislation must take environmental considerations into account and include campaigns to combat various vectors of endemic diseases, such as insects, arthropods, mollusks, and rodents. ⁵³ However, the law does not specify which diseases are targeted or detail the methods to be used in combating these vectors. ⁵⁴

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a range of measures aimed at combating malaria, tuberculosis, and HIV. These include: (i) indoor residual spraying and the distribution of mosquito nets and larvicides; (ii) case management through laboratory diagnosis, antimalarial treatment, and prevention during pregnancy using intermittent preventive treatment (IPT); (iii) epidemiological surveillance, monitoring, follow-up, and evaluation; (iv) entomological studies focused on mosquito populations; (v) operational research on malaria vaccines and resistance to insecticides used in spraying; and (vi) community sensitization and mobilization. ⁵⁹ However, the plan is centered exclusively on human health and does not address priority zoonotic diseases. ⁶⁰

In 2016, the country launched the National Strategic Plan to Combat Malaria. ⁶¹ However, the document is not publicly available. ⁶² ⁶³ ⁶⁴ ⁶⁵ ⁶⁶ ⁶⁷

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁶⁸

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

Score: 0

There is no evidence the Equatorial Guinean legal framework account for the surveillance and control of multiple zoonotic pathogens of public health concern.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a range of measures aimed at combating malaria, tuberculosis, and HIV. These include: (i) indoor residual spraying and the distribution of mosquito nets and larvicides; (ii) case management through laboratory diagnosis, antimalarial treatment, and prevention during pregnancy using intermittent preventive treatment (IPT); (iii) epidemiological surveillance, monitoring, follow-up, and evaluation; (iv) entomological studies focused on mosquito populations; (v) operational research on malaria vaccines and resistance to insecticides used in spraying; and (vi) community sensitization and mobilization. ⁶⁹ However, the plan is centered exclusively on human health and does not address priority zoonotic diseases. ⁷⁰

In 2016, the country launched the National Strategic Plan to Combat Malaria. ⁷¹ However, the document is not publicly available. ⁷² ⁷³ ⁷⁴ ⁷⁵ ⁷⁶

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁷⁷

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

Score: 0

There is no evidence Equatorial Guinea has a department, agency or unit dedicated to zoonotic diseases that functions across ministries.

The National Institute of Agricultural Promotion of Equatorial Guinea (INPAGE, Instituto Nacional de Promoción Agropecuaria de Guinea Ecuatorial), established by Decree No. 53 of 6 May 1996, operates under the authority of the Ministry of Agriculture, Livestock, Forests, Fisheries, and the Environment. ⁷⁸

Pursuant to Article 2, INPAGE is tasked with contributing to the promotion of agricultural and livestock development, specifically focusing on the production, diversification, quality improvement, market research, and commercialization of agricultural and livestock products. ⁷⁹ However, there is no evidence that INPAGE engages in activities related to zoonotic diseases. ⁸⁰

Moreover, the Ministry of Agriculture, Livestock, Forests, Fisheries, and the Environment has the General Directorate of Livestock, Animal Health and Food Control. ⁸¹ However, the specific remits are not available. ⁸² ⁸³

1.2.1e Presence of One Health strategic plan

Score: 0

Equatorial Guinea does not currently have a comprehensive national One Health strategic plan in place. ⁸⁴⁸⁵⁸⁶⁸⁷ However, in 2025, Africa CDC and strategic health partners operating in Central Africa drew up an outline of a joint 2026–2027 roadmap to strengthen health security in the Central African region, including Equatorial Guinea. The joint roadmap 2026–2027 lays the foundations for a structured response that is more effective, efficient, sustainable and aligned with continental and regional frameworks such as the New Public Health Order for Africa, the Africa CDC Strategic Plan 2023–2027, the Regional Strategic Plans for Preparedness and Response to Public Health Emergencies, cross-border surveillance of diseases with epidemic potential under the ‘One Health’ approach, and the ECCAS ‘One Health’ Platform for the period 2025–2029, as well as the 2023–2027 Five-Year Strategic Plan of the OCEAC. ⁸⁸

1.2.2 Surveillance systems for zoonotic diseases/pathogens

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

Score: 0

There is no evidence of a national mechanism in Equatorial Guinea for owners of livestock to conduct and report on disease surveillance to a central government agency.

There is no evidence of such mechanism on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁹¹ ⁹² ⁹³ ⁹⁴

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁹⁶

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

Score: 0

There is no evidence the Equatorial Guinean legal framework safeguards the confidentiality of information generated through surveillance activities for animals.

There is no evidence of such provisions on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁹⁹ ¹⁰⁰ ¹⁰¹ ¹⁰²

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not include any mechanisms to enable livestock owners to report on diseases to the central government, or any safeguards for confidentiality related to surveillance activities for animals. ¹⁰³ The PNDS has a focus on data collection and confidentiality of collected data, but it related to human health (6.4). ¹⁰⁴

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ¹⁰⁵

1.2.2c Wildlife zoonotic disease surveillance

Score: 0

There is no evidence Equatorial Guinea conducts surveillance of zoonotic disease in wildlife, poultry, and livestock.

Pursuant to Article 11 of Law No. 8 of 31 December 1988, which regulates wildlife, hunting, and protected areas, the government must establish measures deemed necessary for the conservation, protection, development, and sustainable use of animals, without prejudice to the control of animals harmful to humans, agriculture, livestock, and public health. ¹⁰⁸ According to Article 14, the Ministry of Wildlife, Hunting, and Protected Areas (MIN-ABRF) may, under exceptional circumstances arising from imminent danger to certain endangered species and the need to manage these resources in an orderly manner, adopt urgent measures deemed necessary, including on privately owned land, with subsequent compensation to owners for any damages caused by such intervention. In cases of diseases or pests affecting wildlife, the MIN-ABRF may adopt any control measures it deems appropriate. ¹⁰⁹ However, there is no reference of active surveillance of zoonotic diseases. ¹¹⁰

Moreover, Article 133 of Law No. 11 of 20 November 2017, which regulates fishing and aquaculture activities in Equatorial Guinea, defines traceability as “the detailed monitoring ‘from the net to the plate’,” with the objective of certifying the legality of fishery products in external markets, eliminating those originating from illegal, unreported, and unregulated (IUU) fishing, as well as guaranteeing hygiene conditions and the food safety of consumers. ¹¹¹ It also states that the traceability of fishery resources allows authorities to conduct biological control of existing and cultivated species in order to protect national production from diseases and pests that could affect the productivity and survival of the species produced. ¹¹² As per Article 134, fishers must demonstrate the legality of their products. ¹¹³ However, there is no evidence of an active surveillance system for wildlife, but rather for fishing products. ¹¹⁴

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not include provision related to the surveillance of zoonotic diseases in wildlife, poultry, and livestock. ¹¹⁹

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ¹²⁰

1.2.3 International reporting of animal disease outbreaks

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 0

There is no publicly available evidence of a mechanism for Equatorial Guinea to report notifiable diseases to the World Organisation for Animal Health (WOAH).

Equatorial Guinea is a member of the WOAH, and there is a focal point at the country. ¹²¹ ¹²² However, there is no evidence of public mechanisms for routine reporting of notifiable diseases to the WOAH. ¹²³ ¹²⁴

1.2.4 Animal health workforce

1.2.4a Number of veterinarians per 100,000 people

Score: 0

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

Score: 0

1.2.5 Private sector and zoonotic disease

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

Score: 0

There is no evidence Equatorial Guinean legal framework includes mechanisms for working with the private sector in controlling or responding to zoonoses.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes provisions for integrating the private sector into the national health system. ¹²⁵ These measures involve the development of funding mechanisms, the promotion of dialogue with the private sector and non-governmental organizations, among other initiatives. ¹²⁶ However, the plan does not mention the involvement of these actors in the control or response to zoonotic diseases. ¹²⁷

There is no evidence of such mechanisms to work with the private sector on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ¹²⁸ ¹²⁹ ¹³⁰ ¹³¹

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ¹³²

Nevertheless, there are instances of ad-hoc cooperation between the public and the private sectors. In 2019, the MCD Global Health, alongside a consortium of companies led by Marathon Oil, supported the creation of the Baney Research Center. ¹³³ The Baney Research Center was initially focused on research about malaria, malaria vaccine trials, and other malaria-related issues, and then expanded for COVID-19-related research and diagnostics. ¹³⁴ ¹³⁵

1.3 Biosecurity

1.3.1 Whole-of-government biosecurity systems

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

Score: 0

There is no evidence Equatorial Guinea 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, including details on inventories and inventory management systems of those facilities.

The Baney Research Laboratory was established in 2019, and it can conduct tests COVID-19 and malaria. ¹³⁶ ¹³⁷ ¹³⁸ In 2020, the World Health Organization (WHO) certified the laboratory for quality control in the detection of SARS CoV-2 (COVID-19), and it successfully conducted tests for COVID-19 and detected positive cases. ¹³⁹ However, there is no evidence of a record, including details on inventories and inventory management systems of the facility. ¹⁴⁰ ¹⁴¹ ¹⁴²

There is no further evidence on the official page of the Government of Equatorial Guinea or the website of Guinea Ecuatorial Salud. ¹⁴³ ¹⁴⁴

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

There is no evidence Equatorial Guinea has a national biosafety legislation or regulations in place.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to provide training for laboratory personnel in biosecurity, including in sample getting and safe transportation techniques. ¹⁴⁵ However, there is no evidence of biosafety regulations. ¹⁴⁶

There is no evidence of such legislation on the Food and Agriculture Organization (FAO) legal database, the United Nations Office for Disarmament Affairs (UNODA), the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ¹⁵⁰ ¹⁵¹ ¹⁵² ¹⁵³

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ¹⁵⁴ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ¹⁵⁵

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is no evidence Equatorial Guinea has an established agency responsible for the enforcement of biosecurity legislation and regulations.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to provide training for laboratory personnel in biosecurity, as well as implementing international biosecurity standards in health services to prevent HIV transmission. ¹⁵⁶ However, there is no mention of an enforcement regulation agency. ¹⁵⁷

There is no evidence of any agency focused on the enforcement of biosecurity legislation on the Food and Agriculture Organization (FAO) legal database, the United Nations Office for Disarmament Affairs (UNODA), the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ¹⁶¹ ¹⁶² ¹⁶³ ¹⁶⁴

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ¹⁶⁵

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

Score: 0

There is no evidence Equatorial Guinea has a taken actions to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to provide training for laboratory personnel in biosecurity, including in sample getting and safe transportation techniques. ¹⁶⁶ However, there is no mention of consolidation of inventories of especially dangerous pathogens and toxins into a minimum number of facilities. ¹⁶⁷

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ¹⁷⁵ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ¹⁷⁶

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

Score: 0

There is no evidence Equatorial Guinea has in-country capacity to conduct Polymerase Chain Reaction (PCR)-based diagnostic testing for anthrax and Ebola, which would preclude culturing a live pathogen.

The Baney Research Laboratory was established in 2019, and it can conduct tests COVID-19 and malaria. ¹⁷⁷ ¹⁷⁸ ¹⁷⁹ In 2020, the World Health Organization (WHO) certified the laboratory for quality control in the detection of SARS CoV-2 (COVID-19), and it successfully conducted tests for COVID-19 and detected positive cases. ¹⁸⁰

However, there is no evidence that it can conduct PCR-based diagnostic for anthrax or Ebola. ¹⁸¹ ¹⁸² ¹⁸³ The website of Guinea Ecuatorial Salud does not present details on Baney Research Laboratory's operations. ¹⁸⁴

1.3.2 Biosecurity training and practices

1.3.2a Biosecurity training using a standardised, required approach

Score: 0

There is no evidence Equatorial Guinea requires biosecurity training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential.

In April 2020, the United Nations Population Fund (UNFPA), in partnership with the Ministry of Health and Social Welfare (MINSABS), through its COVID-19 Surveillance and Response Technical Committee, the Carlos III Institute, and the NGO MCDI, began implementing training for health care personnel and hotel staff working with people with COVID-19. ¹⁸⁵ The programme aimed to train trainers, improve biosecurity measures (such as the use of PPE, handwashing, and other guidelines), among other initiatives. ¹⁸⁶ However, it did not include personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. ¹⁸⁷

In November 2020, the Ministry of Health and Social Welfare, through the COVID-19 Surveillance and Response Technical Committee, conducted training for 59 instructors in a train-the-trainer programme on infection prevention and control in the Insular Region. ¹⁸⁸ The training, delivered by specialists from the World Health Organization (WHO), MCDI, and the Ministry of Health and Social Welfare, included familiarisation with the WHO KOBO scoring system for infection prevention and control (IPC) performance, the presentation of updated IPC guidelines, and the mandate of coordination centres. ¹⁸⁹ However, it did not include personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. ¹⁹⁰

Moreover, the National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) outlines a key actions to training human resources and acquiring technical and logistical equipment for preparedness and response to epidemics and health events, in line with the International Health Regulations (IHR). ¹⁹¹ However, there is no specific mention of training for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. ¹⁹²

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁰⁰ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ²⁰¹

1.3.3 Personnel vetting: regulating access to sensitive locations

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

Score: 0

There is no evidence regulations or licensing conditions in Equatorial Guinea specify that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are subject to drug testing, background checks, and psychological or mental fitness checks.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to provide training for laboratory personnel in biosecurity, as well as implementing international biosecurity standards in health services to prevent HIV transmission. ²⁰² However, there is no mention of establishing security measures for personnel with access to especially dangerous pathogens (e.g. drug testing, background checks, and psychological or mental fitness checks) . ²⁰³

There is no evidence of such conditions on the Food and Agriculture Organization (FAO) legal database, the United Nations Office for Disarmament Affairs (UNODA), the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ²⁰⁷ ²⁰⁸ ²⁰⁹ ²¹⁰

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²¹¹ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ²¹²

1.3.4 Transportation security

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

Score: 0

There is no evidence that the Equatorial Guinean legal framework governs the safe and secure transport of infectious substances.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to provide training for laboratory personnel in biosecurity, including in sample getting and safe transportation techniques. ²¹³ However, there is no evidence of a requirement for safe and secure transport of infectious substances. ²¹⁴

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²²²

1.3.5 Cross-border transfer and end-user screening

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

Score: 100

Equatorial Guinean legal framework regulates the oversight of cross-border transfer and end-user screening of dangerous pathogens, toxins, and pathogens with pandemic potential.

Pursuant to Title I of the General Health Law (Law Decree No. 3 of 25 September 1981), the Ministry of Health and Social Welfare is responsible for overseeing health control at ports, airports, and border posts. ²²³ According to Base VIII, the objective of border health defense is to prevent the entry of infectious diseases into Equatorial Guinea, as well as to avoid their transmission to other countries. ²²⁴

The measures outlined include inspection visits to ships and the issuance of health certificates; customs control over goods and livestock with regard to the possible transmission of infectious diseases; health surveillance of immigration and emigration; sanitary inspection of working conditions aboard ships; and health surveillance of civil maritime health services and personnel. ²²⁵ Nevertheless, the specific pathogens or toxins involved, as well as their associated hazardous potential, are not identified or detailed in the legislation. ²²⁶

Additionally, the National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a measure aimed at improving the availability of surveillance health services in border areas and at disease surveillance health centers. ²²⁷ However, the plan does not specify which diseases are targeted or detail the specific surveillance measures to be implemented. ²²⁸

1.4 Biosafety

1.4.1 Whole-of-government biosafety systems

1.4.1a Biosafety laws/regulations

Score: 0

There is no evidence Equatorial Guinea has a national biosafety legislation or regulations in place.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to provide training for laboratory personnel in biosecurity, including in sample getting and safe transportation techniques. ²²⁹ However, there is no evidence of biosafety regulations. ²³⁰

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²³⁸ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ²³⁹

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is no evidence Equatorial Guinea has an established agency responsible for the enforcement of biosecurity legislation and regulations.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to provide training for laboratory personnel in biosecurity, as well as implementing international biosecurity standards in health services to prevent HIV transmission. ²⁴⁰ However, there is no mention of an enforcement regulation agency. ²⁴¹

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁴⁹ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ²⁵⁰

1.4.2 Biosafety training and practices

1.4.2a Biosafety training using a standardised, required approach

Score: 0

There is no evidence Equatorial Guinea requires biosafety training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential.

In April 2020, the United Nations Population Fund (UNFPA), in partnership with the Ministry of Health and Social Welfare (MINSABS), through its COVID-19 Surveillance and Response Technical Committee, the Carlos III Institute, and the NGO MCDI, began implementing training for health care personnel and hotel staff working with people with COVID-19. ²⁵¹ The programme aimed to train trainers, improve biosecurity measures (such as the use of PPE, handwashing, and other guidelines), among other initiatives. ²⁵² However, it did not include personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. ²⁵³

In November 2020, the Ministry of Health and Social Welfare, through the COVID-19 Surveillance and Response Technical Committee, conducted training for 59 instructors in a train-the-trainer programme on infection prevention and control in the Insular Region. ²⁵⁴ The training, delivered by specialists from the World Health Organization (WHO), MCDI, and the Ministry of Health and Social Welfare, included familiarisation with the WHO KOBO scoring system for infection prevention and control (IPC) performance, the presentation of updated IPC guidelines, and the mandate of coordination centres. ²⁵⁵ However, it did not include personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. ²⁵⁶

Moreover, the National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) outlines a key actions to training human resources and acquiring technical and logistical equipment for preparedness and response to epidemics and health events, in line with the International Health Regulations (IHR). ²⁵⁷ However, there is no specific mention of training for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. ²⁵⁸

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁶⁶ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ²⁶⁷

1.5 Dual-use research and culture of responsible science

1.5.1 Oversight of dual-use research

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is no evidence that Equatorial Guinea has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential and other dual-use research.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) acknowledges that “the current situation of the Epidemiological Surveillance service highlights the lack of resources (human, material, logistical, and equipment-related) (…)” and notes that “in the last fifteen years, the country has carried out few national-level studies and surveys.” ²⁶⁸ With regard to HIV, the PNDS further identifies a lack of operational research. ²⁶⁹

While the Baney Research Center conducts research on malaria and SARS-CoV-2 (COVID-19), there is no evidence of an assessment to determine whether ongoing research involves especially dangerous pathogens, toxins, pathogens with pandemic potential, or other forms of dual-use research. ²⁷⁰ Similarly, the National University of Equatorial Guinea (UNGE), through its Faculty of Medical Sciences, offers health-related academic programs, but there is no indication that it conducts or evaluates research on hazardous biological agents or dual-use concerns. ²⁷¹

There is no evidence of such assessment on the Food and Agriculture Organization (FAO) legal database, the United Nations Office for Disarmament Affairs (UNODA), the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ²⁷² ²⁷³ ²⁷⁴ ²⁷⁵

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁷⁶ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ²⁷⁷

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

Score: 0

There is no evidence the legal framework of Equatorial Guinea requires oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and other dual-use research.

The General Health Law (Law Decree No. 3 of 25 September 1981) created the National Health School, which is focused on teaching health-related subjects. ²⁷⁸ According to Base III, the National Health School will also conduct scientific research based on other norms. ²⁷⁹ However, there are no further details or other provisions related to the subject. ²⁸⁰

There is no evidence of oversight requirements or if the National Health School is still active on the Food and Agriculture Organization (FAO) legal database, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ²⁸¹ ²⁸² ²⁸³

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁸⁴

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

Score: 0

There is no evidence of an agency responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and other dual-use research in Equatorial Guinea.

The General Health Law (Law Decree No. 3 of 25 September 1981) created the National Health School, which is focused on teaching health-related subjects. ²⁸⁵ According to Base III, the National Health School will also conduct scientific research based on other norms. ²⁸⁶ However, there are no further details or other provisions related to the subject, or any provision that the National Health School is responsible for the oversight of research with dangerous pathogens. ²⁸⁷

There is no evidence of oversight requirements or if the National Health Schools is still active or if the National Health School is still active on the Food and Agriculture Organization (FAO) legal database, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ²⁸⁸ ²⁸⁹ ²⁹⁰

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁹¹

1.5.2 Screening requirements for providers of genetic material

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

Score: 0

There is no evidence the Equatorial Guinean legal framework requires the screening of synthesized DNA against lists of known pathogens and toxins before it is sold.

There is no evidence of such requirements on the Food and Agriculture Organization (FAO) legal database, the United Nations Office for Disarmament Affairs (UNODA), the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ²⁹⁵ ²⁹⁶ ²⁹⁷ ²⁹⁸

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ²⁹⁹ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ³⁰⁰

1.6 Immunization

1.6.1 Vaccination rates

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

Official foot-and-mouth (FMD) vaccination figures for livestock in Equatorial Guinea are not publicly available through the OIE database. ³⁰¹

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

Equatorial Guinea has a national immunization plan.

Equatorial Guinea has implemented the World Health Organization (WHO) Expanded Vaccination Program (PAV) since 1986. which offers free vaccines for the population. ³⁰² ³⁰³ However, the plan is not available online. ³⁰⁴ ³⁰⁵ ³⁰⁶ In 2024, Equatorial Guinea implemented an HPV vaccine demonstration project in one district, planning a nationwide rollout by 2026. ³⁰⁷

In addition, the following vaccines are part of Equatorial Guinea’s vaccination schedule for newborns and children: BCG, HepB, OPV 0, OPV 1, Pentavalent 1, OPV 2, Pentavalent 2, IPV 1, OPV 3, Pentavalent 3, IPV, IPV 2, Vitamin A, MCV 1, MMR, IPV 3, Pentavalent 4, and MCV 2. ³⁰⁸

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

Score: 0

Equatorial Guinea has a national immunization plan. However, there is no evidence it includes measures to address vaccine hesitancy and build public trust in vaccines.

Equatorial Guinea has implemented the World Health Organization (WHO) Expanded Vaccination Program (PAV) since 1986. ³⁰⁹ ³¹⁰ However, the plan is not available online. ³¹¹ ³¹² ³¹³ In 2024, Equatorial Guinea implemented an HPV vaccine demonstration project in one district, planning a nationwide rollout by 2026. ³¹⁴

Equatorial Guinea has conducted national campaigns in the country to incentivise people to vaccinate with the support of the World Health Organization (WHO), offering free, safe and effective vaccines, with remarks to build trust in vaccines. ³¹⁵ ³¹⁶ ³¹⁷ However, there is no evidence they are part of the national immunization plan. ³¹⁸ ³¹⁹ ³²⁰

1.6.1e National advisory group for immunization strategy/plan

Score: 0

There is no evidence Equatorial Guinea has a national advisory group (NITAG) that provides technical guidance and advice on the immunization strategy/plan to government.

There is no evidence of a NITAG for Equatorial Guinea on the Global NITAG Network. ³²¹ According to the World Health Organization (WHO), Equatorial Guinea does not have a NITAG. ³²²

There is no further evidence of a NITAG on the Food and Agriculture Organization (FAO) legal database, the United Nations Office for Disarmament Affairs (UNODA), the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ³²³ ³²⁴ ³²⁵ ³²⁶

1.6.1f Presence of an immunization programme for influenza

Score: 0

There is no evidence Equatorial Guinea has an immunization programme for influenza.

Equatorial Guinea has implemented the World Health Organization (WHO) Expanded Vaccination Program (PAV) since 1986. which offers free vaccines for the population. ³²⁷ ³²⁸ However, the plan is not available online. ³²⁹ ³³⁰ ³³¹ In 2024, Equatorial Guinea implemented an HPV vaccine demonstration project in one district, planning a nationwide rollout by 2026. ³³² There is no mention of influenza. ³³³ ³³⁴ ³³⁵

According to World Health Organization (WHO) data, information on the introduction status of the seasonal influenza vaccine for Equatorial Guinea is only available for 2012, when it reported that the country had not yet introduced the vaccine. ³³⁸ Furthermore, WHO data on influenza vaccination coverage contains no records for Equatorial Guinea. ³³⁹

1.7 Climate change adaptation and vector transmission

1.7.1 Health system resilience

1.7.1a Strategy/plan for resilience of health system

Score: 0

There is no evidence that Equatorial Guinea has a strategy or plan to develop a health system that is resilient to the challenges that climate change and changing seasonal weather patterns pose, that includes the threat of infectious diseases.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a program to improve the supply and demand for quality health services (Subprogram 1), which incorporates strategies to develop and implement a strategic plan for primary health care. ³⁴⁰ According to the PNDS, the aim is to establish primary health care that is sustainable and strengthens the health system through: (i) strengthening disease prevention and health promotion measures through promotion, prevention, cure, and rehabilitation services, with primary care focused on vaccination, control, and treatment of communicable and non-communicable diseases, and services that promote, maintain, and improve maternal, newborn, child, and adolescent health; mental health; and sexual and reproductive health; (ii) provision of primary health care that is geographically accessible, equitable, safe, of high quality, comprehensive, efficient, acceptable, affordable, available, and providing integrated, continuous, person-centred, and gender-sensitive services; and (iii) provision of sustainable primary health care that improves the resilience of the health system to prevent, detect, and respond to infectious diseases and outbreaks. ³⁴¹ However, the PNDS does not mention developing a health system that is resilient to climate change and changing seasonal weather patterns. ³⁴²

There is no evidence of such plan on the Food and Agriculture Organization (FAO) legal database, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ³⁴³ ³⁴⁴ ³⁴⁵

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ³⁴⁶

Early Detection

2.1 Laboratory systems strength and quality

2.1.1 Lab capacity for detecting priority diseases

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

Score: 0

The national laboratory system in Equatorial Guinea has the capacity to conduct diagnostic tests for at least 1 out of the 10 WHO-defined core tests, namely rapid diagnostic testing for plasmodium spp (malaria).

The Baney Research Center can conducts diagnostic tests for malaria and SARS-CoV-2 (COVID-19). ³⁴⁷ ³⁴⁸ ³⁴⁹ In 2020, the World Health Organization (WHO) certified the laboratory for quality control in the detection of SARS CoV-2 (COVID-19), and it successfully conducted tests for COVID-19 and detected positive cases. ³⁵⁰

2.1.1b Plan to conduct testing during a public health emergency

Score: 50

Equatorial Guinea has a national plan for conducting testing during a public health emergency. However, there is insufficient evidence that it includes considerations for testing for novel pathogens, scaling capacity, and defining goals for testing.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a strategic goal to strengthen the management of health emergencies. ³⁵¹ The PNDS acknowledges deficiencies in the management of cancer patients, traffic accidents, and emergency or disaster situations. ³⁵²

To address these gaps, the plan outlines several key actions, including (a) training human resources and acquiring technical and logistical equipment for preparedness and response to epidemics and health events, in line with the International Health Regulations (IHR); (b) improving the availability of essential health surveillance services in all border zones and at health centers dedicated to disease and public health event surveillance; (c) enhancing the diagnostic capacity of laboratories, including the operationalization of the Baney reference laboratory for the rapid confirmation of epidemics; (d) developing and implementing a communication plan for health emergencies and public health events; and (e) improving the availability and quality of statistical information on notifiable diseases and public health events. ³⁵³

The PNDS also sets targets to improve early detection of epidemics, including cholera, Ebola, measles, poliomyelitis, and yellow fever, and to increase the number of suspected cases under surveillance that are investigated and confirmed. ³⁵⁴ Additionally, it includes a goal to establish a national surveillance, alert, and response plan for health emergencies by 2025. ³⁵⁵ However, there is no mention of novel pathogens. ³⁵⁶

Furthermore, Equatorial Guinea has established a Political Committee of Health Emergencies, which is tasked with coordinating responses to public health crises. ³⁵⁷ ³⁵⁸ However, there is little evidence of the full scope of its operations. ³⁵⁹ ³⁶⁰

2.1.2 Laboratory quality systems

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

Score: 0

There is no evidence Equatorial Guinea's reference laboratory is accredited.

The Baney Research Center can conducts diagnostic tests for malaria and SARS-CoV-2 (COVID-19). ³⁶¹ ³⁶² ³⁶³ In 2020, the World Health Organization (WHO) certified the laboratory for quality control in the detection of SARS CoV-2 (COVID-19), and it successfully conducted tests for COVID-19 and detected positive cases. ³⁶⁴

In March 2020, the Ministry of Health and Social Welfare announced the goal to accredit the Baney Research Center with ISO 15189 certification. ³⁶⁵ However, there is no evidence it has been achieved yet. ³⁶⁶ ³⁶⁷

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

Score: 0

There is no evidence Equatorial Guinea has a national laboratory that serves as a reference facility which is subject to external quality assurance review.

The Baney Research Center, established in 2019 for malaria-focused research, was certified by the World Health Organization (WHO) for quality control in detection of SARS-CoV-2 (COVID-19). ³⁶⁸ ³⁶⁹ The certification was the first recognition for Equatorial Guinea. ³⁷⁰

However, there is no evidence that the Baney Research Center is an official national laboratory system with coordinated infrastructure, protocols, data reporting, and routine testing across health facilities. ³⁷¹ ³⁷² ³⁷³ ³⁷⁴

2.2 Laboratory supply chains

2.2.1 Specimen referral and transport system

2.2.1a Nationwide specimen transport system

Score: 0

There is no evidence of a nationwide specimen transport system in Equatorial Guinea.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) presents measures to improve biosecurity, including in sample getting and safe transportation techniques. ³⁷⁵ However, there is no evidence of an existing nationwide specimen transport system. ³⁷⁶

There is no evidence of such transport system on the Food and Agriculture Organization (FAO) legal database, the United Nations Office for Disarmament Affairs (UNODA), the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ³⁸⁰ ³⁸¹ ³⁸² ³⁸³

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ³⁸⁴ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ³⁸⁵

2.2.2 Laboratory cooperation and coordination

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

Score: 0

There is no 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 National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) has measures to scale-up testing for HIV, but there is no mention of scale-up testing during an outbreak. ³⁸⁶ Additionally, it does not reference to the rapidly authorization or licensing of laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak. ³⁸⁷

The General Health Law (Law Decree No. 3 of 25 September 1981) and the Medicine Law (Law No. 3 of 18 November 2003) do not mention rapid authorization or licensing of laboratories to scale-up national testing capacity. ³⁸⁸ ³⁸⁹

There is no evidence of such mechanisms on the Food and Agriculture Organization (FAO) legal database, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ³⁹⁰ ³⁹¹ ³⁹²

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ³⁹³ Moreover, even though Equatorial Guinea is party to the BWC, there is no public evidence that it has submitted any Confidence-Building Measures reports. ³⁹⁴

2.3 Real-time surveillance and reporting

2.3.1 Indicator and event-based surveillance and reporting systems

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

Score: 0

There is no evidence Equatorial Guinea is conducting ongoing event-based and indicator-based surveillance and analysis for notifiable and novel infectious diseases.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not mention event-based and indicator-based surveillance and analysis for notifiable and novel infectious diseases. ³⁹⁵ The General Health Law (Law Decree No. 3 of 25 September 1981) and the Medicine Law (Law No. 3 of 18 November 2003) do not mention such mechanisms either. ³⁹⁶ ³⁹⁷

In 2023, the Ministry of Health and Social Welfare of Equatorial Guinea reported confirmed cases of Marburg virus to the WHO. ⁴⁰¹ ⁴⁰² However, there is no evidence it was part of ongoing event-based surveillance. ⁴⁰³ ⁴⁰⁴

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

Score: 0

There is no evidence that Equatorial Guinea has a mechanism for reporting notifiable diseases to the World Health Organization (WHO).

In 2023, Equatorial Guinea established a public health emergency operations centre with support from WHO and the United States Agency for International Development (USAID), which includes 10 permanent staff and 36 surveillance focal points. ⁴⁰⁵ Moreover, the WHO has an office in Equatorial Guinea. ⁴⁰⁶ However, there is no evidence that the country has a direct mechanism for reporting to the WHO, or that the staff of the operations centre has contact with the WHO. ⁴⁰⁷ ⁴⁰⁸

In 2023, the Ministry of Health and Social Welfare of Equatorial Guinea reported confirmed cases of Marburg virus to the WHO. ⁴⁰⁹ ⁴¹⁰ In response, the WHO provided support to investigate the origins of the outbreak and deployed experts in epidemiology, case management, and infection prevention. Additionally, the WHO supplied field tents, sample collection materials, and assisted with the transportation of samples to laboratories in Senegal and Gabon, while also supporting plans to establish diagnostic laboratories within Equatorial Guinea. ⁴¹¹ After Equatorial Guinea notified the WHO, it conducted further investigations, in which Advance Teams were deployed in the affected districts to trace contracts, isolate and provide medical care to people showing symptoms of the diseases. ⁴¹²

There is no evidence of a IHR focal point on the website of the WHO, or the Ministry of Health of Equatorial Guinea. ⁴¹³ ⁴¹⁴ ⁴¹⁵

2.3.2 Interoperable, interconnected, electronic real-time reporting systems

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 0

Equatorial Guinea operates an electronic reporting and surveillance system at the national level. However, there is no evidence it operates at the sub-national level.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) places significant emphasis on improving data collection. ⁴¹⁶ It states that “the physical collection of routine data will be systematic and mandatory in all health facilities across the country through the implementation of routine data management tools established under the Strategic Plan for Strengthening the Health Information System, which is currently being executed and includes various training activities and the reproduction and distribution of management materials.” ⁴¹⁷

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

Score: 50

Equatorial Guinea has an electronic reporting surveillance system that collects ongoing or real-time laboratory data. However, there is no further information on data disaggregation or its operation.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) places significant emphasis on improving data collection. ⁴²⁵ It states that “the physical collection of routine data will be systematic and mandatory in all health facilities across the country through the implementation of routine data management tools established under the Strategic Plan for Strengthening the Health Information System, which is currently being executed and includes various training activities and the reproduction and distribution of management materials.” ⁴²⁶

2.3.3 Wastewater surveillance

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 6 ES sites as of Q4 in 2025, although it is unclear whether these are at the national level and are ongoing.⁴³⁴

Moreover, there is evidence that Equatorial Guinea is strengthening its polio surveillance. According to the Bulletin, AFRO ES Consultants were supporting environmental surveillance (ES) optimization during late 2025, focusing on capacity building for sample collectors. This complemented Acute Flaccid Paralysis (AFP) surveillance following a 2014 outbreak, as part of the regional effort to detect circulating poliovirus.⁴³⁵

2.4 Surveillance data accessibility and transparency

2.4.1 Coverage and use of electronic health records

2.4.1a Common usage of electronic health records

Score: 0

Equatorial Guinea has electronic health records, but they are not commonly used.

2.4.1b Public health system access to individual electronic health records

Score: 0

The Equatorial Guinean national public health system has access to electronic health records of individuals in their country. However, there is no evidence the system has been fully implemented.

In March 2025, the Ministry of Health and Social Welfare, supported by the United Nations Development Programme (UNDP), the World Health Organization (WHO), and the United Nations Children’s Fund (UNICEF), officially launched the digitization process of the national health system. ⁴⁴² ⁴⁴³ The Ministry of Health and Social Welfare has the capacity to digitize and immediately access aggregated health care data at the district level, maintain individualized records and monitoring for routine immunization, provide personalized follow-up for patients with HIV/AIDS, collect information on the availability and qualifications of health personnel, and manage inventory control in health center and hospital dispensaries. ⁴⁴⁴

However, there have been no updates regarding the full implementation of this process or the availability of disaggregated data. ⁴⁴⁵ ⁴⁴⁶ ⁴⁴⁷ ⁴⁴⁸

2.4.1c Existence of data standards for health record data comparability

Score: 0

There is no evidence there are data standards to ensure data is comparable in Equatorial Guinea.

In March 2025, the Ministry of Health and Social Welfare, supported by the United Nations Development Programme (UNDP), the World Health Organization (WHO), and the United Nations Children’s Fund (UNICEF), officially launched the digitization process of the national health system. ⁴⁴⁹ ⁴⁵⁰ The Ministry of Health and Social Welfare has the capacity to digitize and immediately access aggregated health care data at the district level, maintain individualized records and monitoring for routine immunization, provide personalized follow-up for patients with HIV/AIDS, collect information on the availability and qualifications of health personnel, and manage inventory control in health center and hospital dispensaries. ⁴⁵¹ However, there is no evidence it has set data standards to ensure data is comparable. ⁴⁵² ⁴⁵³ ⁴⁵⁴ ⁴⁵⁵

2.4.2 Data integration between human, animal and environmental health sectors

2.4.2a Data sharing mechanisms

Score: 0

There is no evidence Equatorial Guinea has established mechanisms at the Ministry of Agriculture, Livestock, Forests, Fisheries to share data.

There is no evidence of such mechanisms on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁴⁵⁹ ⁴⁶⁰ ⁴⁶¹ ⁴⁶²

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁴⁶⁵

2.4.3 Transparency of surveillance data

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

Score: 0

There is no evidence Equatorial Guinea make de-identified health surveillance data on infectious diseases publicly available via reports on government websites.

There is no evidence of such data on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁴⁶⁹ ⁴⁷⁰ ⁴⁷¹ ⁴⁷²

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁴⁷⁹

2.4.4 Ethical considerations during surveillance

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

The Equatorial Guinean legal framework safeguards the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities.

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

Score: 0

The Equatorial Guinean legal framework safeguards the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities. However, there is no reference to protection against cyber attacks.

Pursuant to Article 10, Section (4), of Law No. 1/2016 of 22 July 2016 (Personal Data Protection Law), personal data relating to health and sexual life may only be obtained or processed with the express written consent of the data subject. ⁴⁹¹ Additionally, Article 12, Section (2), provides that personal data may be communicated to a third party solely for purposes directly related to the legitimate functions of the transferor and the transferee, with the prior consent of the data subject; except where such transfer is authorised by law, obtained from publicly available sources, or where the communication concerns public health. ⁴⁹² Nevertheless, Article 41, Sections (b) and (d), establish that obtaining personal data in a deceptive or fraudulent manner, as well as processing health-related data without consent, constitutes a very serious infringement, punishable by financial penalties ranging from XOF 5,000,001 (USD 8,878) to XOF 15,000,000 (USD 26,634). ⁴⁹³ Nevertheless, there is no mention of protection against cyber attacks. ⁴⁹⁴

The Strategic Plan for Strengthening the National Health Information System 2019–2023 (PEFSNIS, Plan Estratégico de Fortalecimiento del Sistema Nacional de Información Sanitaria), which envisions the development of a mechanism to preserve data and ensure its accessibility, enshrines the principle of data confidentiality. ⁴⁹⁵ It states that it also foresees the preservation of reports and other data files in protected electronic media for greater security of the database established and managed from the institutional website of the Ministry of Health and Social Welfare (MINSABS). ⁴⁹⁶ However, there is no specific mention of protection from cyber attacks. ⁴⁹⁷

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) places significant emphasis on improving data collection. ⁴⁹⁸ It underscores the requirement to ensure confidentiality of health information. ⁴⁹⁹ However, there is no mention of protection from cyber attacks. ⁵⁰⁰

Equatorial Guinea has not ratified the African Union Convention on Cybersecurity on 2 December 2019, which includes articles that specifically deal with the health information of individuals. ⁵¹¹

2.4.5 International data sharing

2.4.5a Cooperative commitments or agreements within regions

Score: 0

There is no evidence that Equatorial Guinea has made commitments via public statements, legislation or cooperative agreements to share surveillance data during a public health emergency with other countries.

In February 2025, Equatorial Guinea and India signed a cooperation agreement in the health sector aimed at strengthening medicine control. ⁵¹⁹ However, the agreement does not include provisions for data-sharing mechanisms during public health emergencies. ⁵²⁰ Similarly, a health cooperation agreement signed between Cuba and Equatorial Guinea in December 2020 did not disclose its terms publicly. ⁵²¹ ⁵²²

In April 2025, Equatorial Guinea and China signed a Memorandum of Understanding (MoU) that includes plans to establish an integrated epidemiological surveillance system, implement advanced diagnostic and treatment technologies, and provide specialized training for national healthcare personnel. ⁵²³ Nonetheless, the MoU does not refer to data-sharing mechanisms. ⁵²⁴

The country's adherence to the International Health Regulations (IHR 2005) serves as a primary legal and operational commitment. As a signatory, Equatorial Guinea is obligated to notify the World Health Organization (WHO) of public health events that may constitute a public health emergency of international concern. This legally binding framework necessitates the sharing of surveillance data with the WHO but does not specify provisions to share with other countries. ⁵²⁶

2.5 Case-based investigation

2.5.1 Case investigation and contact tracing

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

Score: 0

There is no evidence Equatorial Guinea has a national system in place to provide support at the sub-national level to conduct contact tracing in the event of a public health emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) do not mention such measures. ⁵³⁰

In 2023, the World Health Organization (WHO) provided training and supportive supervision of surveillance activities, including case investigation and contact tracing and coordinating with health care facilities for active surveillance related to the outbreak of Marburg virus disease. ⁵³⁴ However, there is no evidence this is part of a national system to support sub-national governments. ⁵³⁵

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

Score: 0

There is no evidence Equatorial Guinea provides wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support (paycheck, job security) and medical attention.

The General Health Law (Law Decree No. 3 of 25 September 1981) underscores that people with infectious diseases can be isolated or quarantined. ⁵³⁶ However, there is no mention of wraparound services. ⁵³⁷

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) do not mention such measures. ⁵³⁸

2.5.2 Point of entry management

2.5.2a Strategy for tracing and quarantining international travelers

Score: 0

There is no evidence of a joint plan or cooperative agreement 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.

Pursuant to Title I of the General Health Law (Law Decree No. 3 of 25 September 1981), the Ministry of Health and Social Welfare is responsible for overseeing health control at ports, airports, and border posts. ⁵⁴² According to Base VIII, the objective of border health defense is to prevent the entry of infectious diseases into Equatorial Guinea, as well as to avoid their transmission to other countries. ⁵⁴³

The measures outlined include inspection visits to ships and the issuance of health certificates; customs control over goods and livestock with regard to the possible transmission of infectious diseases; health surveillance of immigration and emigration; sanitary inspection of working conditions aboard ships; and health surveillance of civil maritime health services and personnel. ⁵⁴⁴ Nevertheless, there is no mention of a joint plan or cooperative agreement between the public health authorities and border control authorities. ⁵⁴⁵

Additionally, the National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a measure aimed at improving the availability of surveillance health services in border areas and at disease surveillance health centers. ⁵⁴⁶ there is no mention of a joint plan or cooperative agreement between the public health authorities and border control authorities. ⁵⁴⁷

2.6 Epidemiology workforce

2.6.1 Existence of applied epidemiology training program such FETP and FETPV

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

Score: 0

There is no evidence Equatorial Guinea applies epidemiology training programs or provides public resources to send citizens to another country to participate in applied epidemiology training programs.

There is no evidence of such programs in Equatorial Guinea on the website of the African Field Epidemiology Network (AFENET) or in the Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET). ⁵⁴⁸ ⁵⁴⁹ There is no evidence of such programs on the website of the Health Sciences Faculty of the National University of Equatorial Guinea. ⁵⁵⁰

There is no evidence of such training programs or funding for exchange of students on the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁵⁵¹ ⁵⁵²

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 0

There is no evidence of such programs in Equatorial Guinea on the website of the African Field Epidemiology Network (AFENET) or in the Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET). ⁵⁵³ ⁵⁵⁴ There is no evidence of such programs on the website of the Health Sciences Faculty of the National University of Equatorial Guinea. ⁵⁵⁵ This includes the lack of programmes specific for animal health professionals. ⁵⁵⁶ ⁵⁵⁷ ⁵⁵⁸

2.6.2 Epidemiology workforce capacity

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

Score: 0

There is no evidence that Equatorial Guinea has at least 1 trained field epidemiologist per 200,000 people.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not provide any data on the number of epidemiologists, even though it has a goal to train epidemiologists (indicator 44). ⁵⁶¹ There is no further information on the number of field epidemiologists on the website of the National Statistics Institute of Equatorial Guinea (INEGE). ⁵⁶²

Rapid Response

3.1 Emergency preparedness and response planning

3.1.1 National public health emergency preparedness and response plan

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 66.67

Equatorial Guinea has an overarching national public health emergency response plan in place, which addresses planning for multiple communicable diseases with epidemic or pandemic potential, namely cholera, Ebola, measles, poliomyelitis, and yellow fever. However, there is no evidence of funding.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) provides for strategies to address emergencies and manage disasters. ⁵⁶³ ⁵⁶⁴ It establishes a subprogram under Program 2 (Health Safety and Management of Emergency and Disaster Situations) for (1) epidemic management, in accordance with the provisions of the International Health Regulations (IHR), and (2) disaster management, also in line with the IHR. ⁵⁶⁵ The strategic actions identified to implement these subprograms include: (i) development of epidemiological multi-risk and health disaster mapping; (ii) development and implementation of response simulation plans; and (iii) advocacy for resource mobilization to fund the Emergency and Disaster Plan. ⁵⁶⁶ The plan sets the goal of reducing the population’s vulnerability to epidemics, emergencies, and other health events by 50%. ⁵⁶⁷

The measures include increasing early warning and epidemic response capacities, improving timely local reporting of notifiable diseases, expanding the number of health facilities applying the IHR, increasing the number of operational border posts for surveillance of diseases under monitoring, among other actions. ⁵⁶⁸

Nonetheless, there is no evidence of funding of PNDS in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁵⁶⁹ ⁵⁷⁰ ⁵⁷¹

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁵⁷²

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

Score: 0

The Equatorial Guinean overarching national public health emergency response plan has not been updated in the last three years.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) provides for strategies to address emergencies and manage disasters. ⁵⁷³ ⁵⁷⁴ Nonetheless, there is no evidence of any updates of the PNDS, including in the past three years, in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁵⁷⁵ ⁵⁷⁶ ⁵⁷⁷

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁵⁷⁸ ⁵⁷⁹

3.1.1c One health principles by covering multiple threat types

Score: 0

Equatorial Guinea has an overarching national public health emergency response plan in place. However, it does not cover multiple threat types, such as antimicrobial resistance, zoonotic disease spillover, biological accidents, or deliberate acts.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) provides for strategies to address emergencies and manage disasters. ⁵⁸⁰ ⁵⁸¹ It establishes a subprogram under Program 2 (Health Safety and Management of Emergency and Disaster Situations) for (1) epidemic management, in accordance with the provisions of the International Health Regulations (IHR), and (2) disaster management, also in line with the IHR. ⁵⁸² The strategic actions identified to implement these subprograms include: (i) development of epidemiological multi-risk and health disaster mapping; (ii) development and implementation of response simulation plans; and (iii) advocacy for resource mobilization to fund the Emergency and Disaster Plan. ⁵⁸³ The plan sets the goal of reducing the population’s vulnerability to epidemics, emergencies, and other health events by 50%. ⁵⁸⁴ However, there is no mention of antimicrobial resistance, zoonotic disease spillover, biological accidents, or deliberate acts. ⁵⁸⁵

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁵⁸⁹

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 100

Equatorial Guinea has an overarching national public health emergency response plan in place, which includes considerations of the impact of health equity, and mechanisms for identifying and considering the needs of vulnerable populations.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario), which provides for strategies to address emergencies and manage disasters, is based on equity and social justice. ⁵⁹⁰ The PNDS, under Program 2 (Health Safety and Management of Emergency and Disaster Situations), seeks to reduce the population's vulnerability to epidemics, emergencies, and other health events by 50%. ⁵⁹¹ It also includes strategies to improve the availability of essential health surveillance services in all border areas and health centers for surveillance of diseases and public health events, increase the number of health districts with health risk maps developed, increase the number of sanitary structure applying the INternational Health Regulations (IHR), creating regional and provincial health emergency committees, and others. ⁵⁹²

The PNDS is guided by the value of equity (p. 11) and its objective include that every "girl and boy, adolescents, and young individuals, men and women, can have good health through equitable access to quality health care services" (p. 35); it also includes a measure for the integration of prenatal care services in accordance with the new standards in all health centres and hospitals, in order to ensure equity in the provision of services (outpatient consultations and patient treatment, prevention of neonatal tetanus, malaria, syphilis, HIV, hepatitis B and C, infection prevention, IEC/CCC, management of essential medicines, and routine health information system data) (p. 54). ⁵⁹³

Moreover, it includes measures for vulnerable groups, namely women (p. 35), child (p. 35), adolescents (p. 35), sex workers (p. 73), gay men (p. 73), and people living with HIV (p. 73). ⁵⁹⁴

3.1.2 Private sector involvement in response planning

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

Score: 0

There is no evidence Equatorial Guinea has specific mechanisms for engaging with the private sector to assist with outbreak emergency preparedness and response.

There is no evidence of such mechanisms in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁵⁹⁵ ⁵⁹⁶ ⁵⁹⁷ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁵⁹⁸

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) acknowledges “deficient coordination of development partner interventions and of private sector initiatives in health.” ⁵⁹⁹ It includes commitments to strengthen governance and leadership in the health sector by improving coordination with development partners and private health actors and by developing a health financing model that incorporates participation from the private sector and other stakeholders. ⁶⁰⁰ However, there is no evidence that these mechanisms have been developed or implemented. ⁶⁰¹ ⁶⁰² ⁶⁰³

In June 2025, the Swiss pharmaceutical company Roche expressed interest in cooperating with the Government of Equatorial Guinea to support the ongoing training of health care personnel in the use of its equipment, provide specialized technical maintenance for diagnostic devices installed in the country, and introduce modern clinical analysis systems that integrate medical and genetic data to deliver more effective treatments. ⁶⁰⁴ Nonetheless, there is no evidence that this initiative is part of a structured mechanism for private sector engagement, nor that it is specifically oriented toward supporting outbreak preparedness or emergency response efforts. ⁶⁰⁵

Moreover, in October 2018, the company Marathon Equatorial Guinea Production Limited (MEGPL) donated to the Ministry of Health and Social Welfare a Isolation Unit or Emergency Medical Care Post in the International Airport of Malabo. ⁶⁰⁶ The Isolation Unit or Emergency Medical Care Post has an inpatient ward with five cubicles, accompanied by two rooms for monitoring inpatients, preserving samples, and sterilizing waste and materials used. ⁶⁰⁷ However, there is no evidence that this initiative was part of a structured mechanism for private sector engagement. ⁶⁰⁸

3.1.3 Non-pharmaceutical interventions planning

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

Score: 0

There is no evidence Equatorial Guinea has a plan in place to implement non-pharmaceutical interventions (NPIs) during an epidemic or pandemic.

There is no evidence of such plan or exercises in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶¹³ ⁶¹⁴ ⁶¹⁵ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available.

3.2 Exercising response plans

3.2.1 Activating response plans

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

Score: 0

There is no evidence Equatorial Guinea has an emergency response plan, or that it has conducted a national-level biological threat-focused exercise in the past year.

In January 2023, the World Health Organization (WHO) conducted a local simulation in the Coordination Center of Epidemiology and Public Health Emergencies focused on a yellow fever epidemics. ⁶¹⁶ However, there is no evidence the exercise was nationwide. ⁶¹⁷

There is no evidence of such plan or exercises in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶¹⁸ ⁶¹⁹ ⁶²⁰ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁶²¹

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

Score: 0

There is no evidence Equatorial Guinea has identified a list of gaps and best practices in response and developed a plan to improve response capabilities in the past year.

In January 2023, the World Health Organization (WHO) conducted a local simulation in the Coordination Center of Epidemiology and Public Health Emergencies focused on a yellow fever epidemics. ⁶²² However, there is no evidence the exercise was nationwide, or that it led to a plan for an improved response plan. ⁶²³

There is no evidence of such plan or exercises in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶²⁴ ⁶²⁵ ⁶²⁶ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁶²⁷

3.2.2 Private sector engagement in exercises

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

Score: 0

There is no evidence Equatorial Guinea has undergone a national-level biological threat-focused exercise that has included private sector representatives in the past year.

In January 2023, the World Health Organization (WHO) conducted a local simulation in the Coordination Center of Epidemiology and Public Health Emergencies focused on a yellow fever epidemics. ⁶²⁸ However, there is no evidence the exercise was nationwide, or that it led to a plan for an improved response plan. ⁶²⁹

There is no evidence of such plan or exercises in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶³⁰ ⁶³¹ ⁶³² Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁶³³

3.3 Emergency response operation

3.3.1 Emergency response operation

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

Equatorial Guinea has an Emergency Operations Center (EOC) in place.

In 2023, Equatorial Guinea established a public health emergency operations centre (PHEOC) with support from the World Health Organization (WHO) and the United States Agency for International Development (USAID), which includes 10 permanent staff and 36 surveillance focal points. ⁶³⁴ It it focused on coordinating preparedness, response and recovery efforts in the event of public health emergencies. ⁶³⁵

Equatorial Guinea has also established a Political Committee of Health Emergencies, which is tasked with coordinating responses to public health crises. ⁶³⁶ ⁶³⁷ However, there is little evidence of the full scope of its operations, or whether it serves an an EOC. ⁶³⁸ ⁶³⁹

In January 2023, the WHO conducted a local simulation in the Coordination Center of Epidemiology and Public Health Emergencies focused on a yellow fever epidemics. ⁶⁴⁰

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

Score: 0

There is no evidence that the Emergency Operations Center (EOC) in Equatorial Guinea is either required to conduct a drill for a public health emergency scenario at least once per year or that they conduct a drill at least once per year.

In 2023, Equatorial Guinea established a public health emergency operations centre (PHEOC) with support from the World Health Organization (WHO) and the United States Agency for International Development (USAID), which includes 10 permanent staff and 36 surveillance focal points. ⁶⁴¹ It it focused on coordinating preparedness, response and recovery efforts in the event of public health emergencies. ⁶⁴² However, there is no mention of its full scope of operation, or whether it conducts drills once a year since its establishment. ⁶⁴³

Equatorial Guinea has also established a Political Committee of Health Emergencies, which is tasked with coordinating responses to public health crises. ⁶⁴⁴ ⁶⁴⁵ However, there is little evidence of the full scope of its operations, or whether it conducts annual drills. ⁶⁴⁶ ⁶⁴⁷

In January 2023, the WHO conducted a local simulation in the Coordination Center of Epidemiology and Public Health Emergencies focused on a yellow fever epidemics. ⁶⁴⁸

There is no evidence of such plan or exercises in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶⁴⁹ ⁶⁵⁰ ⁶⁵¹ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁶⁵²

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

Score: 0

There is no evidence that the Emergency Operations Center (EOC) in Equatorial Guinea has conducted within the last year a coordinated emergency response or emergency response exercise activated within 120 minutes of the identification of the public health emergency.

In 2023, Equatorial Guinea established a public health emergency operations centre (PHEOC) with support from the World Health Organization (WHO) and the United States Agency for International Development (USAID), which includes 10 permanent staff and 36 surveillance focal points. ⁶⁵³ It it focused on coordinating preparedness, response and recovery efforts in the event of public health emergencies. ⁶⁵⁴ However, there is no mention of its full scope of operation, or whether it conducts drills once a year since its establishment. ⁶⁵⁵

In 2023, the country activated the PHEOC due to the outbreak of the Marburg virus disease, but there is no evidence it occurred within 120 minutes of the identification of the outbreak. ⁶⁵⁶

There is no evidence of such plan or exercises in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶⁵⁷ ⁶⁵⁸ ⁶⁵⁹ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁶⁶⁰

3.4 Linking public health and security authorities

3.4.1 Public health and security authorities linked for a biological event

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is no evidence Equatorial Guinea has conducted an exercise to respond to a potential deliberate biological event, or that there are standard operating procedures, guidelines, memoranda of understanding (MOUs), or other agreements between the public health and other authorities to respond to it.

There is no evidence of such plan or exercises in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶⁶¹ ⁶⁶² ⁶⁶³ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁶⁶⁴

3.5 Risk communication

3.5.1 Risk communication planning

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

Score: 0

There is no evidence Equatorial Guinea has a national public health emergency response plan, or other legal document in place with a section detailing a risk communication plan that is specifically intended for use during a public health emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a strategic goal to strengthen the management of health emergencies. ⁶⁶⁵ The PNDS acknowledges deficiencies in the management of cancer patients, traffic accidents, and emergency or disaster situations, and it includes a measure to developing and implementing a communication plan for health emergencies and public health events. ⁶⁶⁶ However, there is no evidence that the PNDS details the plan, or that the plan has been enacted. ⁶⁶⁷ ⁶⁶⁸

The Law on Civil Prevention and Protection of Equatorial Guinea (Law No. 4 of 31 May 2010) states that civil protection in cases of emergencies include health and social care. ⁶⁶⁹ Pursuant to Article 11, Section 3, in emergency situations, social communication means are mandated to collaborate with public authorities regarding spreading information to the population. ⁶⁷⁰ However, there are no detail of the procedure, and the law does not specifically address public health emergencies. ⁶⁷¹

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

Score: 0

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a strategic goal to strengthen the management of health emergencies. ⁶⁷² The PNDS has a measure to develop and implement of a communication plan on emergencies and public health events. ⁶⁷³ However, there is no evidence that the PNDS details the plan, or that the plan has been enacted. ⁶⁷⁴ ⁶⁷⁵ ⁶⁷⁶

THe Law on Civil Prevention and Protection of Equatorial Guinea (Law No. 4 of 31 May 2010) states that civil protection in cases of emergencies include health and social care. ⁶⁷⁷ Pursuant to Article 11, Section 3, in emergency situations, social communication means are mandated to collaborate with public authorities regarding spreading information to the population. ⁶⁷⁸ However, there are no detail of the procedure, and the law does not specifically address public health emergencies. ⁶⁷⁹

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

Score: 0

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a strategic goal to strengthen the management of health emergencies. ⁶⁸⁰ The PNDS acknowledges deficiencies in the management of cancer patients, traffic accidents, and emergency or disaster situations, and it includes a measure to developing and implementing a communication plan for health emergencies and public health events. ⁶⁸¹ However, there is no evidence that the PNDS details the plan, or that the plan has been enacted. ⁶⁸² ⁶⁸³ ⁶⁸⁴

The Law on Civil Prevention and Protection of Equatorial Guinea (Law No. 4 of 31 May 2010) states that civil protection in cases of emergencies include health and social care. ⁶⁸⁵ Pursuant to Article 11, Section 3, in emergency situations, social communication means are mandated to collaborate with public authorities regarding spreading information to the population. ⁶⁸⁶ In accordance with Article 5, the Ministry of the Interior and Local Corporations is responsible for civil protection, including coordinating and implementing such measures. ⁶⁸⁷ Nevertheless, there are no details of the procedure, and the law does not specifically address public health emergencies. ⁶⁸⁸

Moreover, Equatorial Guinea has established a Political Committee of Health Emergencies, which is tasked with coordinating responses to public health crises. ⁶⁸⁹ ⁶⁹⁰ However, there is little evidence of the full scope of its operations. ⁶⁹¹ ⁶⁹²

3.5.2 Public health systems communication

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

Score: 100

There is evidence that the public health system in Equatorial Guinea has actively shared messages via online media platforms (e.g. social media) to inform the public about ongoing public health concerns and/or dispel rumors, misinformation or disinformation in the past year.

In January 2024, the Ministry of Health and Social Welfare (MINSABS) published on its official Facebook page a post about fake news, stating that the MINSABS was engaged in a fight against false rumors and clarifying what constitutes fake news. ⁶⁹³ That same month, it issued a clarification refuting a rumor that a local hospital had been shut down, urging the public to visit the facility and to rely solely on official channels of communication. ⁶⁹⁴

On its X (formerly Twitter) account, MINSABS regularly posts to inform the public about ongoing public health concerns or to dispel rumors and misinformation. ⁶⁹⁵ In August 2025, it reported on a National HIV Prevention Campaign, which included measures to combat the stigma. ⁶⁹⁶ That same month, it published an informational video aimed at dispelling misinformation about HIV patients. ⁶⁹⁷

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

Score: 100

There is no evidence that senior leaders in Equatorial Guinea have shared misinformation or disinformation on infectious diseases in the past two years.

There is no evidence of such remarks on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁶⁹⁸ ⁶⁹⁹ There is no evidence on the Ministry of Health and Welfare's social media pages, namely Facebook and X (formerly Twitter) either. ⁷⁰⁰ ⁷⁰¹

3.6 Access to communications infrastructure

3.6.1 Internet users

3.6.1a Percentage of households with Internet

Score: 59.52

3.6.2 Mobile subscribers

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 0

3.6.3 Female access to a mobile phone

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

Score: 66.67

3.6.4 Female access to the Internet

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

Score: 58.33

3.7 Trade and travel restrictions

3.7.1 Trade restrictions

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

Score: 100

There is no evidence Equatorial Guinea has implemented restrictions on export/import of medical goods due to an infectious disease outbreak in the past year.

There is no evidence of such restrictions in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁷⁰² ⁷⁰³ ⁷⁰⁴ There is no evidence on the Ministry of Health and Welfare's social media pages, namely Facebook and X (formerly Twitter) either. ⁷⁰⁵ ⁷⁰⁶

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

Score: 100

There is no evidence Equatorial Guinea 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 in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁷⁰⁷ ⁷⁰⁸ ⁷⁰⁹ There is no evidence on the Ministry of Health and Welfare's social media pages, namely Facebook and X (formerly Twitter) either. ⁷¹⁰ ⁷¹¹

3.7.2 Travel restrictions

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

Score: 0

There is no evidence Equatorial Guinea has implemented inbound or outbound travel restrictions due to an infectious disease outbreak.

There is no evidence of such restrictions in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁷¹² ⁷¹³ ⁷¹⁴ There is no evidence on the Ministry of Health and Welfare's social media pages, namely Facebook and X (formerly Twitter) either. ⁷¹⁵ ⁷¹⁶

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

Score: 0

There is no evidence Equatorial Guinea uses a risk-based approach to international travel-related measures.

Even though vaccination against yellow fever is mandatory to enter the country, there is no evidence it is exclusive for travelers who had been in areas where yellow fever is endemic. ⁷¹⁷

There is no further evidence of a risk-based approach to international travel-related measures on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁷¹⁸ ⁷¹⁹ There is no evidence on the Ministry of Health and Welfare's social media pages, namely Facebook and X (formerly Twitter) either. ⁷²⁰ ⁷²¹

Health System

4.1 Health capacity in clinics, hospitals and community care centers

4.1.1 Available human resources for the broader healthcare system

4.1.1a Doctors per 100,000 people

Score: 1.75

4.1.1b Nurses and midwives per 100,000 people

Score: 10.2

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 0

There is no evidence Equatorial Guinea has a health workforce strategy in place to identify fields where there is an insufficient workforce and strategies to address these shortcomings.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes the objective of "substantially increase the quantity and quality of human resources in the health sector, giving priority to the national supply, including those in the diaspora". ⁷²² The PNDS outlines the lack of a national plan for human resources development in health, which is justified by (a) lack of staff forecasting and training plans for all categories; (b) lack of periodic evaluation of health personnel at all levels of the health system; (c) insufficiency (quantitative and qualitative) of personnel in all services and programs and; (d) deficient functioning of the Ministry of Health and Social Welfare organizational structure at all levels. ⁷²³

However, it presents a few initiatives, including (a) training physicians, epidemiologists, health technicians in hygiene and epidemiology, and other related specialists; and (b) providing laboratories with the quantity and quality of personnel, such as physicians, pharmacists, biologists, hematologists, and other technicians. ⁷²⁴ However, these initiatives are not detailed. ⁷²⁵

There is no evidence of such strategy in the Food and Agriculture Organization (FAO) legal database, on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁷²⁶ ⁷²⁷ ⁷²⁸

4.1.1d Health system capacity for essential health services

Score: 0

There is no evidence the Equatorial Guinean health system has sufficient capacity to deliver essential health services.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) highlights several structural weaknesses within the national health system. These include: (i) weak leadership and governance in the management of the health system; (ii) the absence of a National Human Resources for Health Development Plan; (iii) poor quality of health care infrastructure and medical equipment; (iv) irregular supply of electricity, potable water, maintenance services, and limited communication means in many hospitals and health centers; (v) an inadequate logistics management system for medicines and other health products; (vi) insufficient health financing, falling short of the 15% commitment made under the Abuja Declaration in 2001; (vii) a weak National Health Information System (SNIS) across all levels of the national health pyramid; and (viii) limited coverage and utilization of health care services across different levels, hindering progress toward the overarching goal of the “Health for All by 2020” program. ⁷²⁹ It also added that, pertaining to "primary health care, there is a lack of implementation of health policies in accordance with World Health Organization (WHO) norms and the real needs of the country". ⁷³⁰

Moreover, according to Fundación iO, primary health care in Equatorial Guinea is underdeveloped. The organization notes that “patient care and health facilities fall below Western standards. In less developed interior regions, even the most basic quality standards may be lacking. The best-equipped hospitals are private, the services provided are expensive, and care is only offered if the patient presents a prior payment guarantee”. ⁷³¹

4.1.1e Essential health services continuity plan for public health emergencies

Score: 0

There is no evidence Equatorial Guinea has a plan to ensure continuity of essential health services during a public health emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) enshrines the principle of continuity of essential health services during public health emergencies as Principle 11. ⁷³² While the plan includes measures aimed at strengthening the capacity to deliver health services during such emergencies, such as training health care professionals and expanding the availability of services, there is no evidence of a defined or operationalized framework to ensure the continuity of essential health services in practice during public health crises. ⁷³³

The Law on Civil Prevention and Protection of Equatorial Guinea (Law No. 4 of 31 May 2010) states that civil protection in cases of emergencies include health and social care. ⁷³⁴ Nevertheless, there are no details of the procedure, and the law does not specifically address public health emergencies. ⁷³⁵

Moreover, Equatorial Guinea has established a Political Committee of Health Emergencies, which is tasked with coordinating responses to public health crises. ⁷³⁶ ⁷³⁷ However, there is little evidence of the full scope of its operations. ⁷³⁸ ⁷³⁹

4.1.2 Facilities capacity

4.1.2a Hospital beds per 100,000 people

Score: 54.19

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

Score: 100

There is evidence Equatorial Guinea 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.

In 2023, the Ministry of Health and Social Welfare of Equatorial Guinea (MINSABS) reported confirmed cases of Marburg virus to the WHO. ⁷⁴⁰ ⁷⁴¹ In response, the WHO provided support to investigate the origins of the outbreak and deployed experts in epidemiology, case management, and infection prevention, and it also supported with further investigations, in which Advance Teams were deployed in the affected districts to trace contracts, isolate and provide medical care to people showing symptoms of the diseases. ⁷⁴²

During the Marburg virus outbreak in 2023, "suspected patients were hospitalized in designated temporary transit or treatment centers; confirmed patients were transferred and managed in a dedicated Marburg treatment center (MTC), where they received supportive care. The initial isolation and treatment ward was established in Ebibeyín; after transmission was identified in Bata, an isolation and treatment ward was designated within Bata Regional Hospital. A dedicated MTC was opened in the Mondong INSESO Hospital in Bata on March 28 and had capacity to manage 16 patients. Subsequently, all confirmed MVD patients in the continental region and suspected MVD patients in Bata and those referred from other districts were managed at the Mondong MTC. Teams deployed from health facilities were trained to conduct safe and dignified burials for deceased patients.". ⁷⁴³

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

Score: 100

There is evidence that Equatorial Guinea has demonstrated capacity to expand isolation capacity in response to an infectious disease outbreak in the past two years.

In June 2023, the World Health Organization (WHO) provided support to the Ministry of Health and Social Welfare in developing a tool for rapid assessment of health care facilities on the Invention Prevention and Control (IPC) measures related to the outbreak of the Marburg virus (such as screening and isolation capacity), including making this tool available online. ⁷⁴⁴ However, there is no specific measure that this is a permanent support. ⁷⁴⁵

in October 2018, the company Marathon Equatorial Guinea Production Limited (MEGPL) donated to the Ministry of Health and Social Welfare a Isolation Unit or Emergency Medical Care Post in the International Airport of Malabo. ⁷⁴⁷ The Isolation Unit or Emergency Medical Care Post has an inpatient ward with five cubicles, accompanied by two rooms for monitoring inpatients, preserving samples, and sterilizing waste and materials used. ⁷⁴⁸ However, it did not occur in the past 2 years. ⁷⁴⁹

There is no further evidence on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁷⁵⁰ ⁷⁵¹ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁷⁵²

4.2 Supply chain for health system and healthcare workers

4.2.1 Routine health care and laboratory system supply

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

Score: 0

There is no evidence of national or international procurement protocols in place which can be utilized by the Ministries of Health and Agriculture for the acquisition of laboratory supplies and medical supplies for routine needs.

In October 2024, the Congress of Equatorial Guinea concluded the analysis of the Public Contracts Bill, which includes the creation of the National Office of Public Procurement, under the purview of the Ministry of Economics. ⁷⁵³ ⁷⁵⁴ However, there is no evidence that the office has been established, or that it has enacted procurement protocols for the acquisition of laboratory supplies. ⁷⁵⁵ ⁷⁵⁶ ⁷⁵⁷ ⁷⁵⁸

In May 2018, the Government of Equatorial Guinea announced significant investments to purchase six containers of 40 types of medicines for public and private hospitals. ⁷⁵⁹ However, there is no mention of specific protocols. ⁷⁶⁰

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) acknowledges significant deficiencies in the pharmaceutical supply chain, in which it states that “the system lacks standards and procedures that ensure proper logistical management of medicines and other health products. There is no national committee for the selection of essential medicines to lead the procurement process, nor is there a unified supply system for medicines across public and private health care facilities, as the pharmaceutical sector has very few officially established suppliers in the country.” ⁷⁶¹

There is no further evidence of such procurement protocols on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁷⁶² ⁷⁶³ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁷⁶⁴

The Medicine Law (Law No. 3 of 18 November 2003) does not present such provisions either. ⁷⁶⁵

In addition, since 2021, the Government of Equatorial Guinea and the United States Department of Justice has funded a nationwide programme named MCD Global Health's Good Will Fund (GWF), which covers all 19 health districts in the country to ensure the availability of essential medicines, reproductive health supplies, and tools to diagnose and treat HIV, tuberculosis, and malaria. ⁷⁶⁶ The project has supported the procurement of nine GeneXpert machines capable of diagnosing HIV, tuberculosis, viral hepatitis B and C, and COVID-19, as well as the procurement and distribution of over 100 tons of essential medicines and medical supplies. ⁷⁶⁷ The project also introduced stock control and management tools across all 19 health districts. ⁷⁶⁸ Nevertheless, there is no evidence it constitutes a procurement protocol. ⁷⁶⁹

During the COVID-19 outbreak, the Ministry of Health emphasized that it had maintained established procurement strategies for essential medicines and health commodities across all national health programmes. ⁷⁷⁰ The Central Drug Purchasing Center (CENTRAMED) received specific budget allocation to standardize and coordinate procurement of medicines and medical supplies, in which the country has a nationwide distribution network of public and private pharmacies. ⁷⁷¹ However, there is no publicly available evidence that this procurement protocol has been set. ⁷⁷²

4.2.2 Stockpiling for emergencies

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

Score: 0

There is no evidence of that Equatorial Guinea has a stockpile of medical supplies for national use during a public health emergency defined by the overarching national public health emergency response plan.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) acknowledges the deficient logistics management system for medicines and other health products in Equatorial Guinea. ⁷⁷³ It points out that there are "frequent stock-out of medicines and other health products", with the "lack of standards and procedures that respect the logistics management chain of medicines and other health products". ⁷⁷⁴

There is no further evidence of a stockpile of medical supplies for use during a public health emergency on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁷⁷⁵ ⁷⁷⁶ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁷⁷⁷

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

Score: 0

There is no evidence of that Equatorial Guinea has a stockpile of laboratory supplies for national use during a public health emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) acknowledges the deficient logistics management system for medicines and other health products in Equatorial Guinea. ⁷⁷⁸ It points out that there are "frequent stock-out of medicines and other health products", with the "lack of standards and procedures that respect the logistics management chain of medicines and other health products". ⁷⁷⁹

There is no further evidence of a stockpile of medical supplies for use during a public health emergency on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁷⁸⁰ ⁷⁸¹ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁷⁸²

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is no evidence of that Equatorial Guinea conducts or requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) acknowledges the deficient logistics management system for medicines and other health products in Equatorial Guinea. ⁷⁸³ It points out that there are "frequent stock-out of medicines and other health products", with the "lack of standards and procedures that respect the logistics management chain of medicines and other health products". ⁷⁸⁴ Additionally, the PNDS states that there is a lack of management of the consumption of medicines and other health products in service delivery centers. ⁷⁸⁵

There is no further evidence of a stockpile of medical supplies for use during a public health emergency on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁷⁸⁶ ⁷⁸⁷ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁷⁸⁸

4.2.3 Manufacturing and procurement for emergencies

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

Score: 0

Equatorial Guinea does not have a plan to increase domestic manufacturing capacity of medical supplies for public health emergencies, to procure medical supplies during a public health emergency, or to expedite medical supplies through points of entry.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes provisions aimed at increasing population access to medical supplies by strengthening the supply and stock management system, including: (i) adoption and implementation of supply standards and procedures; (ii) definition and clarification of the organizational and functional relationships between CENTRAMED, as the National Supply Center, and the Directorate General of Pharmacy, Supply, and Traditional Medicine, to ensure the delivery of medicines to public and private health facilities; (iii) establishment and application of procedures for the disbursement of funds allocated for the purchase of essential medicines; and (iv) adoption of a National Pharmacy Policy along with its corresponding strategic implementation plan. ⁷⁸⁹ However, the PNDS does not specifically address the streamlining of medical supplies through points of entry, increasing domestic manufacturing capacity, or prioritizing procurement systems for use during public health emergencies. ⁷⁹⁰

The PNDS also adds that "the country does not have a pharmaceutical industry, thus, every pharmaceutical products are imported without quality assurance since Equatorial Guinea does not have a quality control system". ⁷⁹¹

There is no further evidence of such plan on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁷⁹² ⁷⁹³ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁷⁹⁴

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

Score: 0

Equatorial Guinea does not have a plan to increase domestic manufacturing capacity of laboratory supplies for public health emergencies, to procure laboratory supplies during a public health emergency, or to expedite laboratory supplies through points of entry.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes provisions aimed at increasing population access to medical supplies by strengthening the supply and stock management system, including: (i) adoption and implementation of supply standards and procedures; (ii) definition and clarification of the organizational and functional relationships between the Drug Purchasing Center and (CENTRAMED), as the National Supply Center, and the Directorate General of Pharmacy, Supply, and Traditional Medicine, to ensure the delivery of medicines to public and private health facilities; (iii) establishment and application of procedures for the disbursement of funds allocated for the purchase of essential medicines; and (iv) adoption of a National Pharmacy Policy along with its corresponding strategic implementation plan. ⁷⁹⁵ However, the PNDS does not specifically address the streamlining of laboratory supplies through points of entry, increasing domestic manufacturing capacity, or prioritizing procurement systems for use during public health emergencies. ⁷⁹⁶

There is no further evidence of such plan on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁷⁹⁸ ⁷⁹⁹ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸⁰⁰

4.2.3c Mechanism emergency logistics and supply chain management

Score: 0

There is no evidence that Equatorial Guinea has a system or mechanism for national and subnational levels for emergency logistics and supply chain management.

There is no further evidence of such system on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸⁰² ⁸⁰³ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸⁰⁴

In 2020, Equatorial Guinea created the Central Drug Purchasing Center (CENTRAMED) to coordinate and standardize the criteria of acquisition of medicines and other sanitary materials. ⁸⁰⁵ However, there is no mention that it established a system for emergency logistics and supply chain management. ⁸⁰⁶

4.3 Medical countermeasures and personnel deployment

4.3.1 System for dispensing MCMs during a public health emergency

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

Score: 0

There is no evidence Equatorial Guinea has a plan, program or guidelines in place for dispensing medical countermeasures (CMC) for national use during a public health emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) acknowledges the deficient logistics management system for medicines and other health products in Equatorial Guinea. ⁸⁰⁷ It points out that there are "frequent stock-out of medicines and other health products", with the "lack of standards and procedures that respect the logistics management chain of medicines and other health products". ⁸⁰⁸ Additionally, the PNDS states that there is a lack of management of the consumption of medicines and other health products in service delivery centers. ⁸⁰⁹

There is no further evidence of a stockpile of medical supplies for use during a public health emergency on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸¹⁰ ⁸¹¹ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸¹²

4.3.2 System for receiving foreign health personnel during a public health emergency

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

Score: 0

Equatorial Guinea does not have a public plan to facilitate workforce surge in an emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) has measures to improve the management of public health emergencies, such as increasing the training of health professionals, improve access to essential health care services in border zones and, and others. ⁸¹³ However, it does not mention plans to facilitate workforce surge, or on-demand hiring or reallocation of health professionals during public health care emergencies. ⁸¹⁴

There is no further evidence of such plan on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸¹⁵ ⁸¹⁶ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸¹⁷

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

Equatorial Guinea does not have a public plan in place to receive health personnel from other countries to respond to a public health emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) has measures to improve the management of public health emergencies, such as increasing the training of health professionals, improve access to essential health care services in border zones and, and others. ⁸¹⁸ However, it does not mention measures to receive health personnel from other countries to respond to a public health emergency. ⁸¹⁹

There is no further evidence of such plan on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸²⁰ ⁸²¹ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸²²

According to the International Federation of Red Cross and Red Crescent Societies (IFRC), "there are no specific provisions included in the relevant law regarding visa types that might apply to international assisting actors". ⁸²³ It also added that "the law does not appear to provide expedited procedures for international actors to register in Equatorial Guinea and therefore it appears that the normal rules and procedures would apply", and the IFRC recommended to request the Ministry of Health and Social Welfare to liaise with the National Committee for Emergencies with respect to granting special facilities to support entry of assistance should it be requested during the Marburg virus outbreak. ⁸²⁴

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

Equatorial Guinea does not have a public plan in place to redeploy existing health personnel within the country.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) has measures to improve the management of public health emergencies, such as increasing the training of health professionals, improve access to essential health care services in border zones and, and others. ⁸²⁵ However, it does not mention measures to redeploy existing health personnel. ⁸²⁶

There is no further evidence of such plan on the website of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸²⁷ ⁸²⁸ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸²⁹

4.4 Healthcare access

4.4.1 Access to healthcare

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 50

The Equatorial Guinea's constitution states that the State must promote primary health care for the population. However, there is no specific mention that it is either a guaranteed right or free.

Pursuant to Article 23 of the Fundamental Law of Equatorial Guinea (2012), the State must foster and promote primary health care as cornerstone of the development of the health sector. ⁸³⁰ In accordance with the General Health Law (Law Decree No. 3 of 25 September 1981), the State is responsible for adopting measures to safeguard and improve the health of its citizens. ⁸³¹

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

Score: 52.94

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

Score: 52.63

4.4.1d Coverage of essential health services through universal health coverage

Score: 39.58

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: 0

4.4.1f Rate of mortality amenable to health care

Score: 41.52

4.4.2 Paid medical leave

4.4.2a Guaranteed paid sick leave

Score: 66.67

Equatorial Guinea guarantees the right to paid sick leave to workers.

Pursuant to Article 81 of the General Labour Law (Law No. 4 of 3 December 2021), workers in Equatorial Guinea are entitled to paid sick leave provided they give prior notice and justification. ⁸³² The law grants three days of paid leave in the event of illness. After this period, if the worker remains unable to work, the employer is no longer responsible for payment, and the obligation shifts to Social Security. ⁸³³ However, the law does not specify whether this entitlement extends to absences due to mental health conditions. ⁸³⁴

4.4.3 Healthcare worker access to healthcare

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is no evidence the Government of Equatorial Guinea has issued legislation, policy, or a public statement committing to provide prioritized health care services to health care workers who become sick as result of responding to a public health emergency.

There is no evidence of such remarks, legislation or policy on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁸³⁵ ⁸³⁶ There is no evidence on the Ministry of Health and Welfare's social media pages, namely Facebook and X (formerly Twitter) either. ⁸³⁷ ⁸³⁸

4.5 Communications with healthcare workers during a public health emergency

4.5.1 Communication with healthcare workers

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

Score: 0

There is no evidence Equatorial Guinea's has a system for public health officials and health care workers to communicate during an emergency.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a strategic goal to strengthen the management of health emergencies. ⁸³⁹ The PNDS acknowledges that the health care systemm has an irregular supply of electricity, drinking water, and maintenance and inadequate means of communication in several hospitals and health centers. ⁸⁴⁰ It further adds that "there is little availability of means of communication in many health facilities (telephones, internet, radio frequency) to guarantee the exchange between professionals and decision-makers and to ensure a constant improvement of the chain for patient referral and counter-referral". ⁸⁴¹

THe Law on Civil Prevention and Protection of Equatorial Guinea (Law No. 4 of 31 May 2010) states that civil protection in cases of emergencies include health and social care. ⁸⁴² Pursuant to Article 11, Section 3, in emergency situations, social communication means are mandated to collaborate with public authorities regarding spreading information to the population. ⁸⁴³ However, there are no detail of the procedure, or if it includes public health care personnel= . ⁸⁴⁴

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

Score: 0

There is no evidence Equatorial Guinea's system for public health officials and health care workers to communicate during an emergency encompass health care workers in both the public and private sector.

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) includes a strategic goal to strengthen the management of health emergencies. ⁸⁴⁵ The PNDS acknowledges deficiencies in the management of cancer patients, traffic accidents, and emergency or disaster situations, and it includes a measure to developing and implementing a communication plan for health emergencies and public health events. ⁸⁴⁶ However, there is no mention of a communication system that includes public and private health care personnel. ⁸⁴⁷ ⁸⁴⁸

THe Law on Civil Prevention and Protection of Equatorial Guinea (Law No. 4 of 31 May 2010) states that civil protection in cases of emergencies include health and social care. ⁸⁴⁹ Pursuant to Article 11, Section 3, in emergency situations, social communication means are mandated to collaborate with public authorities regarding spreading information to the population. ⁸⁵⁰ However, there are no detail of the procedure, or if it includes public and private health care personnel alike. ⁸⁵¹

4.6 Infection control practices

4.6.1 Healthcare-associated infection (HCAI) monitoring

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

Score: 0

There is no evidence that the national public health system in Equatorial Guinea is monitoring for and tracking the number of health care associated infections (HCAI) that take place in health care facilities.

There is no evidence of such measures on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁸⁵² ⁸⁵³ ⁸⁵⁴ ⁸⁵⁵

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not mention such measures. ⁸⁵⁶ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸⁵⁷

4.6.1b Infection prevention and control programme

Score: 0

There is no evidence Equatorial Guinea has a nationwide infection prevention and control program in place.

There is no evidence of such program on the Food and Agriculture Organization (FAO) legal database, the WHO library of AMR national action plans, the official page of the Government of Equatorial Guinea, and the website of Guinea Ecuatorial Salud. ⁸⁵⁸ ⁸⁵⁹ ⁸⁶⁰ ⁸⁶¹

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) has the goal to reduce the number of sexually transmitted infections (STIs), including syphilis and HIV. ⁸⁶² Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸⁶³

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

Score: 0

There is no evidence Equatorial Guinea has a plan to ensure a safe environment in health facilities nationally.

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) has a strategic pillar of promoting a favorable environment for the health of the population. ⁸⁶⁴ However, there are no mention of ensuring a safe environment in health facilities nationally. ⁸⁶⁵

4.7 Capacity to test and approve new medical countermeasures

4.7.1 Regulatory process for clinical trials of unregistered interventions

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 0

There is no evidence of a national requirement for ethical review before beginning a clinical trial in Equatorial Guinea.

General Health Law (Law Decree No. 3 of 25 September 1981), the Environmental Regulation Law (Law No. 7 of 27 November 2003) and the Medicine Law (Law No. 3 of 18 November 2003) do not mention a requirement for ethical review before beginning a clinical trial in Equatorial Guinea. ⁸⁷⁰ ⁸⁷¹ ⁸⁷² There is no evidence of such measures on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸⁷³ ⁸⁷⁴

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not mention clinical trials. ⁸⁷⁵ Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸⁷⁶

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

Score: 0

There is no evidence of 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.

General Health Law (Law Decree No. 3 of 25 September 1981), the Environmental Regulation Law (Law No. 7 of 27 November 2003) and the Medicine Law (Law No. 3 of 18 November 2003) do not mention such expedited process. ⁸⁷⁷ ⁸⁷⁸ ⁸⁷⁹ There is no evidence of such measures on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸⁸⁰ ⁸⁸¹

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not mention clinical trials. ⁸⁸² Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁸⁸³

4.7.2 Regulatory process for approving medical countermeasures

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 accordance with Article 5 of the Medicine Law (Law No. 3 of 18 November 2003), the approval of new MCM in Equatorial Guinea requires evidence of efficacy, an acceptable risk-benefit ratio, reasonable cost, compliance with at least minimum quality standards, and any additional criteria deemed necessary by the government. ⁸⁸⁴ As stipulated in Article 6, the authority to grant such approval rests with the Ministry of Health and Social Welfare. ⁸⁸⁵

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 0

There is no evidence of an expedited process for approving medical countermeasures (MCM) for human use or recognition of approval decisions taking place elsewhere during public health emergencies.

In accordance with Article 5 of the Medicine Law (Law No. 3 of 18 November 2003), the approval of new MCM in Equatorial Guinea requires evidence of efficacy, an acceptable risk-benefit ratio, reasonable cost, compliance with at least minimum quality standards, and any additional criteria deemed necessary by the government. ⁸⁸⁶ As stipulated in Article 6, the authority to grant such approval rests with the Ministry of Health and Social Welfare. ⁸⁸⁷ There is no mention of an expedited process during emergencies. ⁸⁸⁸

There is no evidence of such measures on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸⁸⁹ ⁸⁹⁰

Commitment to International Norms

5.1 IHR reporting compliance and disaster risk reduction

5.1.1 Official IHR reporting

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

Score: 100

Equatorial Guinea has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁸⁹¹

5.1.2 Integration of health into disaster risk reduction

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

Score: 0

There is no evidence Equatorial Guinea integrated epidemics and pandemics into the national risk reduction strategy, and there is no standalone national disaster risk reduction strategy for epidemics and pandemics.

The Law on Civil Prevention and Protection of Equatorial Guinea (Law No. 4 of 31 May 2010) states that civil protection in cases of emergencies include health and social care. ⁸⁹² However, it does not specifically mention epidemics or pandemics. ⁸⁹³

The United Nations Office for Disaster Risk Reduction (UNDRR) planning examinations for public investment for Equatorial Guinea briefly mentions a previous epidemic in the past disaster section, but does not include information on risk reduction for future epidemics or pandemics. ⁸⁹⁴

The National Health Development Plan of Equatorial Guinea 2021–2025 (PNDS, Plan Nacional de Desarrollo Sanitario) mentions epidemics, but it is not a disaster risk reduction strategy. ⁸⁹⁵ It acknowledges an insufficient management of epidemics and disasters, and it seeks to reduce vulnerability of the population in the cases of epidemics. ⁸⁹⁶

There is no evidence of such activities on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸⁹⁷ ⁸⁹⁸

5.2 Cross-border agreements on public health and animal health emergency response

5.2.1 Cross-border agreements

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 0

There is no evidence Equatorial Guinea has cross-border agreements, protocols, or MOUse, with neighboring countries, or as part of a regional group, with regards to public health emergencies.

There is no evidence of such documents on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁸⁹⁹ ⁹⁰⁰

Equatorial Guinea has been a member of the African Union since 12 October 1968. ⁹⁰¹ On 15 July 2022, the African Union published its Revised Statute of the African CDC and its Framework of Operation; pursuant to Article 3, Member States will receive support to the implementation of early warning and response surveillance platforms, as well as preparedness and response systems, declare Public Health Emergency of Continental Security (PHECS), promote partnerships and collaborations among Member States to address emerging and endemic diseases, pandemics, and public health emergencies, implement capacity-building measures in public health, including through medium- and long-term leadership, field epidemiological, public health emergency and laboratory training programs, and others. ⁹⁰² However, there is no evidence that the group's long-term plan mentions agreements or MOUse. ⁹⁰³ ⁹⁰⁴

During the Marburg virus outbreak in 2023, the Africa CDC engaged with the Ministry of Health and Social Welfare of Equatorial Guinea and neighboring countries, namely Gabon and Cameroon, to support the cross-border context of the outbreak, and guide regional surveillance strategies in containing the outbreak. ⁹⁰⁵ However, there is no evidence this is regular or part of a cross-border agreement, protocol, or MOU. ⁹⁰⁶

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 0

There is no evidence that Equatorial Guinea has cross-border agreements, protocols, or MOUs with neighboring countries, as part of a regional group, with regard to animal health emergencies.

There is no evidence of such documents on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁹⁰⁷ ⁹⁰⁸

Equatorial Guinea has been a member of the African Union since 1968. ⁹⁰⁹ In 2019, the African Union Inter-African Bureau for Animal Resources (AU-IBAR) enacted the Animal Health Strategy for Africa 2019-2035, which includes the goal of promoting the establishment of early warning, emergency response mechanisms and disaster fund for animal resources at national, regional and continental levels. ⁹¹⁰ It includes goals to adapt emergency preparedness and response framework guidelines, train and simulate exercises at regional and national levels, establish regional response teams and mechanism, and establish a continental-level disaster fund. ⁹¹¹ However, there is no specific long-term plan for agreements, protocols, cooperation agreements, or MOUse. ⁹¹²

5.3 International commitments

5.3.1 Participation in international agreements

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

Equatorial Guinea has ratified the Biological Weapons Convention.

The country ratified through accession the Biological Weapons Convention on 29 July 1992 before the United States of America, and on 16 January 1989 before the Russian Federation. ⁹¹³

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

Score: 0

There is no evidence Equatorial Guinea has submitted confidence building measures for the Biological Weapons Convention in the past three years. ⁹¹⁴

5.3.1c Submission of UNSCR 1540 reports

Score: 100

Equatorial Guinea has provided the required United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee).

THe country submitted the required document on 17 October 2017. ⁹¹⁵

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 0

5.3.2 Voluntary memberships

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

Score: 0

Equatorial Guinea is part of the Proliferation Security Initiative (PSI). However, the country is not part of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP) or the Australia Group.

Equatorial Guinea is part of the PSI. ⁹¹⁶ However, the country is not a member in the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP), or the Australia Group. ⁹¹⁷ ⁹¹⁸

5.4 JEE and PVS

5.4.1 Completion and publication of a JEE assessment and gap analysis

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

Score: 0

Equatorial Guinea has not completed a Joint External Evaluation (JEE) and published a full public report in the last five years.

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁹¹⁹

5.4.2 Completion and publication of a PVS assessment and gap analysis

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

Score: 0

Equatorial Guinea has not completed and published a Performance of Veterinary Services (PVS) assessment in the last five years. ⁹²⁰

The country published its last PVS Evaluation in 2010. ⁹²¹

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

Score: 0

Equatorial Guinea has not completed and published a Performance of Veterinary Services (PVS) gap analysis in the last five years. ⁹²²

The country published its last PVS Evaluation in 2010. ⁹²³

5.5 Financing

5.5.1 National financing for epidemic preparedness

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

Score: 0

There is no evidence Equatorial Guinea has allocated national funds to improve capacity to address pandemic or epidemic threats within the past three years.

There is no evidence of the allocation of funds to address pandemic or epidemic threats on the official website of the Government of Equatorial Guinea, or on Guinea Ecuatorial Salud. ⁹²⁴ ⁹²⁵ There is no evidence on the Ministry of Health and Welfare's social media pages, namely Facebook and X (formerly Twitter) either. ⁹²⁶ ⁹²⁷

5.5.2 Financing under JEE and PVS reports and gap analyses

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

Score: 0

Equatorial Guinea has conducted a Joint External Evaluation (JEE), but it did not publish a report.

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁹²⁸

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

Score: 0

Equatorial Guinea has not completed and published a Performance of Veterinary Services (PVS) assessment or gap analysis. ⁹²⁹

There is no evidence that the country has ever completed or published a PVS. ⁹³⁰

5.5.3 Financing for emergency response

5.5.3a Emergency public financing during a public health emergency

Score: 100

Equatorial Guinea has a publicly identified special emergency public financing mechanism and funds which the country can access in the face of a public health emergency.

Equatorial Guinea has access to the African Public Health Emergency Fund (APHEF) established by the WHO Regional Committee in 2012 with the aim of providing catalytic resources for initiating timely responses to public health emergencies. ⁹³¹ ⁹³² ⁹³³

5.5.4 Accountability for international commitments to address epidemic threats

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

Score: 100

There is evidence Equatorial Guinea senior leaders have made public commitments to request support to improve the domestic capacity to address pandemics through financing in the past three years.

In October 2024, the Ministry of Health and Social Welfare (MINSABS) issued a formal communication urgently appealing for contributions to the Fund to Tackle Pandemic, calling upon African countries to sustain their financial and institutional commitments by highlighting the importance of continued support to ensure the fund’s operational capacity and effectiveness. ⁹³⁴

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

Score: 100

Equatorial Guinea has requested financing from donors to improve the country's domestic capacity to address epidemic threats in the past three years.

In 2023, Equatorial Guinea requested funds from the Global Fund to tackle malaria and HIV. ⁹³⁵ It received USD 6.16 million from 2023 to 2025. ⁹³⁶

Moreover, it received technical support from the Red Cross for training against Marburg virus disease (MVD) in 2023. ⁹³⁷

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

Score: 0

Equatorial Guinea has not fulfilled its full contribution to the WHO within the past two years.

According to the latest available statement of the World Health Organization (January 2025), Equatorial Guinea has not yet paid its assessed contributions for 2024 and 2025. ⁹³⁸ In 2024, the assessed contributions amounted to USD 68,910, whereas for 2025 it amounted to USD 68,900. ⁹³⁹ Equatorial Guinea is up to date with payments for previous years (2022-2023). ⁹⁴⁰

5.6 Commitment to sharing of genetic & biological data & specimens

5.6.1 Commitment to share data and specimens in emergency/non-emergency research

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

Score: 0

There is no evidence of a publicly available plan or policy in Equatorial Guinea 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 that goes beyond influenza.

There is no evidence of such activities on the websites of the Government of Equatorial Guinea or Guinea Ecuatorial Salud. ⁹⁴⁴ ⁹⁴⁵

The National Health Development Plan of Equatorial Guinea 2021-2025 (PNDS, Plan Nacional de Desarrollo Sanitario) does not mention sharing genetic data, clinical specimens, or isolated specimens. ⁹⁴⁶

Equatorial Guinea conducted a WHO Joint External Evaluation (JEE) in 2019, but the report is not publicly available. ⁹⁴⁷

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

Score: 100

There is no evidence that Equatorial Guinea has not shared samples in accordance with the PIP framework in the past two years.

There is no evidence that Equatorial Guinea failed to share samples in accordance with the PIP framework on the Advisory Group Annual Report fo the Director -General (2024). ⁹⁴⁸ There is no evidence that the country failed to share samples on the official website of the World Health Organization (WHO). There is no evidence on the Pandemic Influenza Preparedness Framework: Annual Progress report, 1 January – 31 December 2024 (2025) either.

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

Score: 100

There is no evidence that Equatorial Guinea has not shared pandemic pathogen samples during an outbreak in the past two years.

In February 2023, Equatorial Guinea collected blood samples from contacts related to the Marburg virus disease (MVD), and shipped it to the Institut Pasteur in Dakar, Senegal. ⁹⁴⁹ ⁹⁵⁰ In March 2023, it sent more samples to the Regional Hospital of Ebebiyin. ⁹⁵¹ ⁹⁵²

Risk Environment

6.1 Political and security risk

6.1.1 Government effectiveness

6.1.1a Policy formation

Score: 25

6.1.1b Quality of bureaucracy

Score: 0

6.1.1c Excessive bureaucracy/red tape

Score: 0

6.1.1d Vested interests/cronyism

Score: 0

6.1.1e Corruption

Score: 13

6.1.1f Accountability of public officials

Score: 0

6.1.1g Human rights risk

Score: 0

6.1.2 Orderly transfers of power

6.1.2a Orderly transfers of power

Score: 0

6.1.3 Risk of social unrest

6.1.3a Risk of social unrest

Score: 50

6.1.4 Illicit activities by non-state actors

6.1.4a Risk of terrorism

Score: 75

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 25

6.1.5 Armed conflict

6.1.5a Presence or risk of armed conflict

Score: 75

6.1.6 Government territorial control

6.1.6a Government territorial control

Score: 100

6.1.7 International tensions

6.1.7a International tensions

Score: 50

6.2 Socio-economic resilience

6.2.1 Literacy

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

Score: 93.61

6.2.2 Gender equality

6.2.2a UNDP Gender Inequality Index score

Score: 0

6.2.3 Social inclusion

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

Score: 99.69

6.2.3b Share of employment in the informal sector

Score: 0

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

Score: 0

6.2.4 Public confidence in government

6.2.4a Public confidence in government

Score: 0

6.2.5 Local media and reporting

6.2.5a Robust, open, diverse local media and reporting

Score: 0

6.2.6 Inequality

6.2.6a Gini coefficient

Score: 61.5

6.3 Infrastructure adequacy

6.3.1 Adequacy of road network

6.3.1a Adequacy of road network

Score: 25

6.3.2 Adequacy of airports

6.3.2a Adequacy of airports

Score: 50

6.3.3 Adequacy of power network

6.3.3a Adequacy of power network

Score: 50

6.4 Environmental risks

6.4.1 Urbanisation

6.4.1a Urban population (% of total population)

Score: 21.58

6.4.2 Land use

6.4.2a Change in forest area (percentage points)

Score: 41.11

6.4.3 Natural disaster risk

6.4.3a Natural disaster risk

Score: 75

6.5 Public health vulnerabilities

6.5.1 Access to quality healthcare

6.5.1a Total life expectancy (years)

Score: 41.94

6.5.1b NCD mortality rate

Score: 72.53

6.5.1c Population aged 65+

Score: 84.96

6.5.1d Tobacco use (% of adults)

Score: 99.1

6.5.1e Level of adult obesity (%)

Score: 76.94

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

Score: 57.63

6.5.2 Access to potable water and sanitation

6.5.2a Access to potable water

Score: 63.95

6.5.2b Access to at least basic sanitation facilities

Score: 65.95

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

Score: 0

6.5.3 Public healthcare spending levels per capita

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

Score: 10.39

6.5.4 Trust in medical and health advice

6.5.4a Trust medical and health advice from the government

Score: 50

6.5.4b Trust medical and health advice from medical workers

Score: 50

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