National One Health Strategic Plan (OHSP) 2022-2026

1.0 Introduction ............................................................................13

1.1 Country Profile ...............................................................................................................................13

1.1.2 Cieography ...............................................................................................................................13

1.1.2 Administrative structure ......................................................................................................14

1.1.3 Climate ............................................................................................................................................ 14

1.1.4 Economic activities ...................................................................................................................14

1.2 Evolution of One Health Approach ............................................................................15

1.2.1 Olobal Steps Toward One Health .........................................................................................15

1.3 Economics of One Health ......................................................................................................16

2.0 Situational Analysis ............................................................. 18

2.1 Oeneral Situational Analysis .........................................................................................18

2.2 Zoonotic Disease Profiles ......................................................................................................18

2.2.1 Burden of Zoonoses in Africa .........................................................................................18

2.2.2 Burden of Zoonoses in Zambia .........................................................................................19

2.2.3 Surveillance for Zoonotic Diseases in Zambia ................................................................19

2.2.4 Prioritisation of Zoonotic Diseases in Zambia ................................................................19

2.3 Antimicrobial Resistance ..................................................................................................... 20

2.3.1 Capacity and structures to conduct surveillance of antimicrobial resistance ............ 20

2.4 Environmental Health ...................................................................................................... 21

2.5 Food Safety ...............................................................................................................................22 2.s International Health Regulations (IHR) 2005 ............................................................... 23

2.6 Strengths, Weaknesses, Opportunities and Threats Analysis for One Health Implementation in Zambia .................................................................................................................. 29

2.6.1 Oovernance and Coordination ........................................................................................ 29

2.6.2 Surveillance ..............................................................................................................................30

2.6.3 Preparedness and Response ........................................................................................ 30

2.6.4 Advocacy, Communication and Training ........................................................................... 30

2.6.5. Research ............................................................................................................................... 31 / / / CONTENTS 6 / / / CONTENTS 7

3.0 Organizational Functions .................................................... 42

3.1 One Health Steering Committee ........................................................................................ 42

3.2. One Health Coordinating Committee (OHCC) ............................................................... 42

3.3. Technical Working Croups (TWC) ........................................................................................ 43

3.3.1. Covernance and coordination ........................................................................................ 43

3.3.2. Surveillance TWO .................................................................................................................. 43

3.3.3. Preparedness and Response TWO ........................................................................................44

3.3.4. Advocacy, Communication and Training ...........................................................................44

3.3.5. Research TWC ..................................................................................................................44

4.0 Five-Year Strategic Direction ............................................. 45

4.1 Vision ...........................................................................................................................................45

4.2 Mission .............................................................................................................................. 45

4.3 Thematic Coals .................................................................................................................. 45

4.4 Core Values and Principles ..................................................................................................... 45

4.5 Objectives, Strategies and Activities ........................................................................... 45 5. Monitoring and evaluation lM&El framework ...................... 54

5.1 Two-Vear Implementation Plan ........................................................................................ 73 List of contributors .................................................................... 87 FOREWORD The world is facing unprecedented, interconnected threats to the health of people, animals, and the environment; addressing these threats requires cross-sectoral, systems-wide approaches. This is encapsulated in the One Health concept which recognizes the interconnection between people, animals, plants, and their shared environment. One Health is a collaborative, multidisciplinary, and multisectoral approach that can address urgent, ongoing , or potential health threats at the human-animal-environment interface at subnational , national, global, and regional levels. This approach includes ensuring balance and equity among all the relevant sectors and disciplines. In today's highly connected world , a disease can be transported from an isolated village to any major city in as little as 24 hours. Zoonoses - diseases that move between animals and people - and other health threats within the human-animal-ecosystem interface pose ongoing and increasing risks to public health and global health security. Approximately 73 percent of emerging pathogens originate from animal hosts, the majority being w ild animals. The COVID-19 pandemic and its origins as a zoonotic pathogen is a particularly pertinent example of this interconnectedness and only came to confirm the correctness of the One Health approach to Health policy. However, One Health is concerned about many of the other major threats of our time such as climate change and disease emergence, anti-microbial resistance, ecosystem destruction with loss of biodiversity, and the fragility of food and feed systems. In a globalized world , it is imperative that all nations and societies better manage One Health. Zambia's unique location as a land -linked country also places it at a higher risk of being a hotspot for emerging and re-emerging infectious disease threats in the region arising from international travel. Over the last decade, the surrounding regions have experienced animal-originating outbreaks of Ebola, Marburg haemorrhagic fever, Rift valley fever, Crimean Congo haemorrhagic fever and yellow fever. These outbreaks have resulted in significant illness, death and social disruption in the affected communities and beyond. In addition to the dangers of well-known zoonotic diseases like Rabies and Anthrax, more insidious threats lurk at the human-animal -ecosystem interface, with the growing resistance of microbes to antibiotics. Threats like these cannot be addressed in a vacuum . The complex interactions that result in disease emergence require strong and consistent collaboration among all sectors responsible for Human health , Animal health and the Environment. It is against this backdrop that the ZNPHI as the institution mandated to coordinate One Health, in collaboration with other Ministries, Departments and Agencies has developed a five-year strategic plan and a one-year implementation plan - The National One Health Strategic Plan (OHSP) 2022 -2026 for Zambia . To validate this plan , the National Bridging Workshop (NBW) was held in Livingstone from 19 - 21 October 2022 using a One Health approach. This OHSP plan was jointly developed with the Department of Veterinary Services in the Ministry of Fisheries and Livestock, the Ministry of Health , the Ministry of Green Economy and Environment, the Ministry of Local Government and Rural Development, Academia , development partners, the private sector as well as non-governmental organisations. This Plan addresses some of the gaps identified in the Joint External Evaluation of the IHR core capacities. In addition , it reflects the shared commitment to enhance multi-sectoral collaborations in addressing public health events at the human-animal-environment interphase. If successfully implemented, the plan will institutionalise One Health, address zoonotic diseases, enhance food safety and security and keep Zambia heathier and safer. We call upon you all to support the implementation of the One Health strategy. Prof. Lackson Kasonka Permanent Secretary - TS Ministry of Health Dr. Anna Songolo Permanent Secretary Ministry of Fisheries and Livestock Mr. John Msimuko Permanent Secretary Ministry of Green Economy and Environment ACKNOWLEDGEMENTS The Zambia National Public Health Institute (ZNP HI ) w ishes to acknowledge the multisectoral team and the various line ministries that provided input in an Al l- of-Government approach towards the comp letion of the f ive -year National One Hea lth Strateg ic Plan for Za mbi a. This work would not have been completed wit houtthe support of the UN agencies and cooperating partners, led by the W HO country off ice as we ll as t he technical support rendered by the UK Hea lth Security Agency. Fu rthermore, I wou ld like to apprec iate the Zambia National Public Hea lt h In stitute staff for t h eir efforts and commitments towards the successful completion of this five-year strategic p lan for the implementation of One Health in Zambia. I also w ish to acknowledge al l supportive individuals and organisations that provided expert opinion, essenti al inputs and valuable comments on the in iti al drafts that preceded the final document. These include the Africa Centres for Disease Control and Prevention (ACDC), the US Centres for Disease Contro l and Prevention (US CDC) , experts from the University of Zamb ia Schoo l of Veterinary Medicine (UNZAVET). Africa Centre of Exce ll ence for Infectious Diseases of Hu mans and Anima ls (ACEIDHA) and other individuals not mentioned by name. A full list of contributors to this p lan is provided at the end of the document. ~ Prof. Roma Chi lengi Director General, ZNPHI Zambia National Public Health Institute (ZNPHI) 13 1.0 lntroouction 1.1 country Profile Zambia is a land-linked country situated in the south-central part of Africa, between latitudes Bo and 780 and longitudes 22 o and 340. The total surface area is 752, 678 square kilometres. Zambia shares borders with 8 countries; Angola, Botswana, Congo DRC, Namibia, Malawi, Mozambique, Tanzania and Zimbabwe (Fig7). ZAMBIA: PHYSICAL LEGEND D Country border C:J Pro.,inail border - Maje,, d Warer body Nation park Elevation ( meters) C 0 - 199 - 500-999 - 1000 • 1499 - JSOO • 1999 - Above 2000 0 100 200 300 400 km Fig 1: Map showing Zambia's neighbouring countries and its lakes, rivers, national parks, towns and cities

1.1.2 Geography Zambia's ma in landmass is a p lateau that li es between 910m and 7,370m (3,000-4,500 ft.) above sea level. In the northeast, the Muchinga Mountains exceed 7,800 m (5,900 ft.) in height. Elevations below 610 m (2,000 ft.) are encountered in the va ll eys of the major river systems. The major rivers inc lude; Zambezi , Kafue, Luapula and Luangwa. The major lakes inc lu de Tangany ika , Mweru , Bang weu lu and Kariba.

1.1.2 Administrative structure Zambia is divided into ten provinces, namely; Copperbelt, Centra l, Eastern , Luapula , Lusaka, Muchi nga , Northern , North-western, Southern and Western. Each province is headed by a minister appointed by the Repub lican President. Provinces are further divided into d istricts. Currently, Zambia has a total number of 776 Districts.

1.1.3 Climate Zamb ia experiences a sub-tropica l climate. There are three ma in seasons: a hot and dry season (August to November). a rainy season (November t o April) , and a cool dry season (May to Mid-August) [ref]. Cl imate ch ange continues to have a negative impact on agricu lture, food security, w il dl ife, safe water, energy and health in Zambia.

1.1.4 Economic activities Zamb ia's annual rea l Gross Domestic Product (GDP) growth rate was favourab le during the period 2006 to 2007, averaging at 8.7%, w ith the highest annua l growth rat e reg istered at 70.3% in 2070. Growt h was ma inly driven by the const ruction , transport, and m ining sectors, spurred by increased investment in the m in ing sect or. Between 2077 and 2076, however, the econom ic growth rate slowed down and averaged 4.9%. Th is was driven by Information Communication and Technology (ICT). wholesale and retai l trade, as well as the construction sector. During the period 2077-2027 , growth decl ined further with real growth rate averaging 7.4% largely due to unfavorab le weather conditions which impacted the agricu ltura l and energy sectors in the earlier years of the period. In 2020, economic growth cont racted by 2.8%, registering the first recession since 7998. This was main ly due to the effect of disruptions in supp ly cha ins and cont ainment meas u res associated w ith the COVID-79 pandemic on sectors such as tourism, construction , wholesa le, reta il trade and man u factur ing. In 2027, rea l GDP growth recovered to 3.6% with ag ri culture, manufacturing, energy, who lesale and reta il trade as wel l as the ICT sectors driving growth (BNDP,2022). Min ing rema ins a dominant sector mak ing Zamb ia a mono economy [ref]. The country has undertaken policy reforms aimed at creating an enabling economic environment, which enhances private-sector participation and u ltimate ly achieves economic growth . Aga inst the backdrop of these pol icy reforms, the country has achieved consistent positive gross domestic product (GDP) growth over the past decade. 15

1.2 Evolution of one Health Approach

1.2.1 Global steps Toward one Health One Hea lth is an integrated, unifying approach to balance and optimize t he hea lth of people, an ima ls and the environment. It is pa rt icu larly important to p revent, pred ict, detect, and respond to g lobal hea lth threats such as the COV ID-19 pan d em ic. The approach mob il izes m u lt ip le sectors, disc iplines and commun it ies at varying levels of soc iety to work toget her. This way, new and better ideas are developed that address root causes and create long-term , sustainable solutions. One Health is not new, but it has become more important in recent years. This is because many facto rs have ch anged interactions between people, anima ls, plants, and the environment. Human populat ions are growi n g and expanding into new geographic areas. As a resu lt, more peop le live in close contact w ith wi ld and domestic animals , both livestock and pets. A ni ma ls play an important role in our lives, whether for food, live lihoods, travel , sport, education , or compan ionship. Close contact w ith anima ls and their environments provides more opportu nities for d iseases to pass between anima ls and peop le. Fu rthermore, the earth has also experi enced changes in cl imate and land use, such as deforestation and intens ive farming pract ices. Disruptions in environmental conditions and hab itats can provide new opport un it ies for diseases to pass to an ima ls. The movement of people, an imals, and an imal products has increased f rom international travel and trade. As a result, diseases can spread quickly across borders and around the globe. These changes have led to the spread of existing or known (endem ic) and new or emerging zoonotic d iseases, which are d iseases that can spread between animals and peop le. Every year, m illions of people and an imals around t he world are affected by zoonotic diseases. Successfu l pub lic health interventions require the cooperation of human, an imal, and environmental hea lth partners. Professiona ls in human heal t h (doctors, nurses, publ ic heal t h practitioners , epidemiologists). anima l health (veterinarians, paraprofessionals, agr icultu ra l workers). environment (ecolog ists, wild life experts). and other areas of expertise need to communicate, col laborate on , and coordinate activities. Other re levant p layers in a One Hea lth approach could include law enforcement, pol icymake rs, agricultu re, commun it ies , and even pet owners. No one pe rson, organ ization , or secto r can address issues at the an imal- human-environment interface alone. In Ap ri l 2070, the three ma in internationa l organisations charged w ith protecting pub lic and anima l hea lth that is; the Food and Ag ri culture O rgan ization of the United Nations (FAO). the World Organ isation for Animal Hea lth (WOAH) and the World Health Organization (WHO). jointly designed a long-term strategic approach to international collaboration, aimed at coord inating global activities to address hea lth risks at the human-animal-envi ronment interface. Numerous mechanisms have already been developed to aid cooperation at the technical level, but the tripartite accord recognises that: 'there is a need to strengthen anima l and h u man hea lth institutions', and that: 'protocols and standard. shou ld be jointly developed' to achieve al ignment and coherence of related g lobal-standard setting activities and address gaps existing in the cou ntry's capacit ies. On 17 March 2022, the four organ izations - FAO, WOAH, UNEP and WHO signed a Memorandum of Understanding (MoU) for joi nt One Heal t h works. The new Quadripartite MoU provides a lega l and formal f ramework for the four organizations to tackle the cha llenges at the human, ani mal, p lant and ecosystem interface using a more integrated and coordinated approach . This framework wil l also cont ribute to reinforce nat ional and regiona l hea lth systems and services. The World Health Organ izat ion (WHO) works closely with the Food and Ag riculture Organ ization of the United Nations (FAO) , the World O rgan ization for Anima l Heal t h (WOAH) and t h e Uni t ed Nations Environmental Protection (UN EP) to promote mu lt i-sectoral responses to food safety hazards, risks from zoonoses, envi ronmental threats, and othe r pub lic hea lth th reats at the human-an imal-environment ecosystem interface and provide guidance on how to reduce these risks. On human and anima l health , both t he O IE and WHO have developed appropriate frameworks and tools re lated to thei r mandates. These frameworks and tools are aimed at support ing t heir Member States to bui ld sustainable nationa l and regiona l capacit ies and partne rships to ensure an imal and pub lic hea lth security t hrough preparedness p lanning, prevention, early detection and rapid response to emerg ing diseases and other anima l and publ ic hea lth eme rgencies.

1.3 Economics of one Health The impact of emerg ing and re-emerging infectious d iseases and other public hea lth events (PHEs) on publ ic health is both cl ear and well documented , often wel l beyond the sphere of human hea lth. The PH Es have sign if icant negative impact on ag ri cu lt u ra l production, trade, and trave l for the reg ion directly affected and may extend further beyo n d man-made borders. It is this impact which creates a st rong incent ive for a whole -of-society approach to tackl ing d isease th reats. Disease management is typical ly viewed as the responsib il ity of the hea lth sector. Yet conside ri ng the wide econom ic impact of outbreaks and the multi-sectora l benefits of disease p revent ion is perhaps the best way to encourage nations to move away f rom a reactive approach to pandemics. Considering the economics of "One Health" may be a w ise tool in convincing countries and commun ities of the benefits in moving toward improved risk assessment and management. Global economic impacts of ep idemics suggest high return on investment in prevention and one hea lth capacity. Most recent outbreaks are zoonotic in nature and have resulted in h igh hea lth impacts but also substantial economic costs locally, regiona lly and globa lly. A 2071 repo rt by the The Organ ization for Economic Cooperation and Development (OECD) shows that pandemics are a prime g loba l catastrophic threat- a f ind ing that is cons istent with a number of other assessments (OECD 2077). Further, the report ind icated that potential losses resulting from a severe influenza pandemic , for instance, wh ich may lead to 71 m ill ion human fatal it ies wou ld be $3 tril lion, or 4.8 percent of the global GDP. In add it ion, tackl ing endemic zoonoses wou ld reduce a major sou rce of human sufferi ng and economic losses that disproportionately affects many of the poorest households in deve loping countries. For instance, Echinococcosis, imposes a human and econom ic burden in developing countries that each year costs at least 7.5 mil lion hea lthy life- years , as wel l as US$2 bi ll ion in livestock losses. A typical episode may involve a pathogen that originates in w ildl ife, passes to livestock, and is t hen transm itted from livestock to humans. Exposure to the pathogen in animals cou ld be fo llowed by symptoms in an imals. Then there is a rise of exposure in humans, who subsequently coul d deve lop symptoms, may seek treatment, and infect each other. If the disease reaches 17 the point of spreading among humans, the disease wi ll have already done substantia l damage. Moreover, the spread of the disease among humans at that point may be difficu lt to slow or reverse, and the cost of disease control wi ll usually increase rapid ly. This pattern of progress ion is evident from t he h ig h and rising cost of control li ng H IV/AIDS, which is also of zoonot ic orig in. Thus, effect iveness of zoonotic d isease control requ ires early detection at the source of the disease in an imals, an early and acc u rate d iagnosis, and rapid d isease control measu res. De lays substantially reduce effectiveness. The more effective an approach is, the more lives it wi ll save, and the hig h er the benefits in terms of avoided losses. Authorit ies too often start look ing for the d isease in an imals and undertake d iagnostic and control efforts only after human cases and deaths have been observed. When d isease survei ll ance and control take this form, humans essential ly se rve as a sentinel spec ies-human death and illness act as indicators of d isease in anima ls. Because surveil lance, d iagnosis, and control of zoonotic d isease take place at t he interface between anima ls and humans, systematic communication and substantia l coo rdination between human, w ild life, and veterinary health services is an important p ractical necessity.And this communication and coordination also needs to extend to t h ose services t h at monit or food sa fety. One Health is an approach to ensure that this critical ly important interdiscip lina ry col laborati on occurs. This co llaboration reduces the gaps between institut ions and d iscip lines that can cause costly delays, and even fai lures, in disease detect ion and control.

2.0 Situational Analysis

2.1 General Situational Analysis Current and future public heal t h threats at the human-anima l-environmental interface at country, reg ional and g lobal level requ ire transformationa l and collaborative approaches under the One Health umbrel la. In ana lysing the current One Health situation in Zamb ia, this strategy focuses on four priority publ ic hea lth threats: zoonotic d isease, antimicrob ial res istance, environmental hea lth and food safety. These threats have been identified as priorities due to the high negative impact they have shown on the Zamb ian nationa l pub lic health sector as well as the economy. Emerging and re-emerging zoonotic diseases have the potentia l for serious negative impacts on pub lic health, economy (trade, tourism). food safety and food security, socia l impacts on vulnerable populations including refugees, and other related socioeconomic impacts. Environmental hea lth concerns linked to public health events arising from potentia l biosecurity threats of highest global concern are present in Zambia, such as Anthrax , Botulism, Plague and Viral hemorrhagic fevers (VHFs). These biological agents and/ or their products can be man ipu lated and intentiona lly used to infect humans, animals (domestic or w ildl ife) and plants in mass ive proportions. Furthermore, Antimicrob ial Res istance (AMR) threatens Zamb ia's achievement of the Sustainab le Development Goa ls. Zambia has already put in place an AMR Nationa l Action Plan; th is plan adopts a One Hea lth approach to AMR , and w ill be coord inated through the Zambia Nationa l Publ ic Hea lth Institute (ZNP H I). It is therefore a priority to integrate effective coordination and imp lementation of AMR, Zoonoses , food safety, and environmenta l activities into a One Health Strateg ic Plan . 2.2 zoonotic Disease Profiles

2.2.1 Burden of zoonoses in Africa Over recent years, pub lic awareness of the risks posed to human health by various diseases of an imal origin has been great ly increased by the emergence of new d iseases such the Corona virus D isease 2079 (COVID 79) which pose a worldwide threat to both human and anima l health. Unfortunately, most African countries have lim ited capacity to effectively dea l with these emerging and re-emerg ing zoonotic diseases. Further, the situation is compounded by inadequate surve illance systems and lack robust scientif ic evidence-based solutions. Due to these limitations, the true burden of zoonotic diseases in Africa is always underestimated. Scientific evidence has shown that most African countries bear the greatest burden of zoonoses [ref]. Besides the public hea lth burden , zoonotic disease outbreaks have serious impact on the economy and public hea lth systems of affected countries wherever they occur. 19

2.2.2 Burden of zoonoses in Zambia Zambia has a considerable burden of endemic diseases. Diseases like anthrax, zoonotic tubercu losis and rabies (Ref) are w idespread espec ially among livestock keepers, but their neg lected nature (Neglected Tropical Diseases [NTDs]) provides a false perception of low publ ic health importance. Additiona lly, due to their occurrence in remote reach and neglected commun ities, these diseases are further classif ied under Poverty Related Diseases (PRDs). Despite the huge burden of endemic zoonoses (comprising both NTDs and PRDs) and inc reased risks of emergence of novel zoonotic diseases, there is still little awareness about them , even among various hea lth profess iona ls in Zambia. Whi le there is no sing le inte rvention that can add ress all zoonoses, it is now increas ingly recogn ized that the estab lishment of inter-sectoral col laborative mechan isms is the most eff icient strategy to address existing and emerg ing zoonoses. However, the coordination mechan isms in place are more adm inistrative in nature and not always effective in promoting diffusion of knowledge across sectors. W ith the advent of COVI D-19, there has been a serious need that was fe lt by various health sectors. The country envisions estab lishing a formal coord inat ion mechanism backed w ith leg islation to address the emergence of Zoonotic diseases. 2.2.3 surveillance for zoonotic Diseases in Zambia The su rveillance of Zoonotic Diseases in Zambia remains uncoordinated. The human hea lth and anima l health sectors run pa ral lel zoonotic disease survei llance and control programs. As a resu lt, there is little data sharing between the sectors , and resources that cou ld well be utilized in less costly preventive measures are often reserved for response. Following the occurrence of a Zoonotic d isease, response is frequently characterized by a series of emergency activit ies to conta in and manage infection in human popu lations. Once estab lished that the infection is of anima l origin, this is often fo ll owed by cul ling of animal populat ions which further exacerbates poor living conditions for the traditional livestock keepers. There is therefore a need to establ ish a coordination mechan ism for data sharing and coordination in the response to zoonotic disease occurrence. 2.2.4Prioritisation of zoonotic Diseases in Zambia Zoonoses are one of the h ighest pub lic hea lth priorit ies in Zambia. There is inadequate One Hea lth coordination, research, advocacy, educational and adm inistrative basis for the control of zoonoses. Furthermore, there is an urgent need to develop effective measures for survei ll ance, emergence response, d iagnosis, prophylaxis and therapy for zoonoses in Zambia. Thus, there is need to fo r process that brings together representatives from human , an ima l, and envi ronmental hea lth sectors, as well as other relevant partners, to prioritize zoonotic diseases of greatest concern for multisectora l, One Hea lth collaboration in Zambia through a One Health Zoonotic Disease Prioritization p latform. This One Health Strategic p lan is meant in part to fac ilitate this process.

2.3 Antimicrobial Resistance In the human hea lth sector, there are national programmes specif ic to AMR activit ies for TB, Malaria and HIV. Additiona lly, data on antimicrobial susceptibi lity are collected through routine laboratory testing from selected hea lth facilit ies such University Teaching Hospita l (UTH) in Lusaka , Ndola Teaching Hospita l, Arthur Davison Ch ildren's Hospital etc for epidemic prone bacterial pathogens such as Salmonella Typh i, Shigel la species, Neisseria men ingitidis, Vibrio Cholerae, Methicillin Res istant Staphylococcus aureus (M RSA). Extended Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae, and Vancomycin Resistant Enterococci (VRE). There is also a Ped iatric Bacterial Mening it is survei ll ance program at the UTH which has so far detected penicil lin-resistant Streptococcus pneumoniae (ref) . In addition , Zambia has enrolled into Global Antimicrobial Res istance and Use Survei ll ance System (GLASS) which provides a platform for data sharing. In the animal hea lth sector, there is no ded icated nationa l programmes aimed at combating AMR. However, there is a nationa l Veterinary Drug Residue Monitoring (VDRM) p lan , wh ich is yet to be fu lly implemented. Under th is plan , a pi lot survei llance of VDR in milk is be ing conducted in Central and Lusaka Provinces, focusing on penicill ins, sulphonam ides and tetracyc lines. There is also a surveillance of Veterinary Drug Res idue Monitoring (VDRM) in m ilk funded by FAO. The re are Veterinary Drug Residues (VDR) surveil lance activit ies be ing conducted at the CVR I in beef, pork, and pou ltry from the major meat process ing plants in Lusaka .. Add itionally, data on antim icrob ial susceptibil ity are col lected th rough routine laboratory testing at the School of Veterinary Medicine and the University Teach ing Hospita ls of the University of Zamb ia. Through the Fleming Fund , integrat ed AMU/AMR nationa l survei llance is being carried out in p ilot p rovinces. ZAM RA registers and regu lates al l med icines and all ied substances for human and veterinary use in Zamb ia. It conducts routine post-marketing surve illance (PMS). pharmacovig ilance and qua lity control testing activit ies on selected registered medic ines, including antimicrob ials. It also licenses facil ities for manufacture, wholesa le, storage and distribution of medicines and allied substances. In addit ion , it conducts enforcement activit ies to curb illegal distribut ion of registered and unreg istered med icines. However, there are limited AMR specif ic regu latory activities being conduc t ed. ZAMRA, in collaboration w ith relevant professional bod ies, enforces provisions related t o dispensing of prescription only medic ines, though with limitat ions. The nat iona l CODEX comm ittee is in p lace with members drawn from relevant areas, with the mandate to coordinate the review and fo rmu lation of standards for foods and food safety; however, standards which have an impact on AMR have not been f ul ly imp lemented. 2.3.1 capacity and structures to conduct surveillance of antimicrobial resistance In t he human hea lt h sector, laboratories wh ich are expected to conduct ant imicrob ial susceptibi lity testing (AST) are avai lab le in most of the hosp ita ls. For most laboratories , the capacity of staff to reliab ly isolat e, 21 ident ify, and conduct AST is poor due to lack of tra ining in aspects of AST. Avai lab ility of reagents, SOPs, infrastructure and specia lised equipment required to conduct AST is inadequate and varies by level of the fac il ity. Of the faci lities assessed , on ly two of the Level 111 hosp ita ls namely; UTH and Arthur Davison Chi ldren's Hospita l (ADH) and the nationa l reference laboratories (TDRC and CDL) are able to conduct AST re liably. Moreover, the UTH has been using the WHONET software for collection , analysis, and sha ring of AST data. In the an imal health sector, under the Department of Veterinary Services (DVS). there is a Nationa l Laborat ory at the Centra l Veteri nary Research Inst itute (CVR I). six (6) Reg iona l Laboratories in selected provinces as well as laboratories at district level, and Private laboratori es. A lthoug h CVR I has the capacity to screen for VDR , the capa ci t ies (human and material resources) to isolate, identify, and cond u ct AST at all leve ls needs strengthen ing. There is capacity for phenotyp ic and genotyp ic cha racterisation of bacteria, fungi and v iruses at U NZA School of Veterinary Med icine.

2.4 Environmental Health Environmental Hea lth covers the theory and practice of assessing , correcting , controll ing and preventing factors in t h e Environment which can adversely af fect the heal t h of the present an d future generations (WHO, 1993) . The p illars of Environmenta l health include Commun ity Health; Food Safety and Hyg iene; Pol lution Control ; Occ u pationa l Hea lth and Safety; Bu ilt Environment and overarch ing components su ch as Port Hea lth, Cl imat e Change m itigat ion and adaptation measu res. On the ot her hand, environmental prot ection is concerned with prot ecting the natu ra l envi ronment for the benefi t of h u man health and the ecosyst em. Environment and the factors associated w ith it are other parts of the ca uses of many ep idem ic diseases both in the developed and develop ing nations. In Zambia , environmenta l hea lth prob lems arise from popu lation pressure on housing, poor environmental san itation , coup led w ith lack of saf e water and bas ic housing fac ilities. Despite t he deplorab le state of environmental hea lth (lack of safe wa t er, bad housing conditions, and so on). there is no re liable and timely means of surve illance or any mon itoring system Currently, environment al health su rve illance remains in its infancy in Zambia. The scope of its surveil lance lies across various sectors wh ich inc lude Environment, Human Health, Mining, Animal Hea lth, Tourism and W il dl ife, each al igned to specific objectives. The introduction of the Environmental ep id emiology module to the Zambia Field Epidemiology train ing Program (FETP) and the masters in Ecological Pub lic hea lth at the Un ivers ity of Zambia, seeks to produce a group of rap id responders capab le of responding t o acute environmental incursions across al l aspects of environmenta l health ( Zambia NHSP, 2022) . Additional ly, this w ill result in estab lish ing linkages of various environment re lated activities t o human hea lth by ensuring human activi t ies such as land use, m ining etc are conducted w ithin the confines of environmenta l hea lth to reduce the emergence of zoonotic diseases arising at human-wild life interphase. In the area of pollution prevention and control , poison ing is among the major pub li c hea lth problems and Zamb ia is no exception . The country has seen an increase in t he number of poison ing cases as confi rmed by post-mortem (MoH , 2020). Further, the Worl d Hea lth Organisation has comp iled st atistics on the distribution of poison ing cases in Africa and Zambia was above the regional average (WHO, 2078). To address th is, the Ministry of Hea lth in col laborating with Chemicals Observatory for the Sound Management of Chemicals in Africa (Africa ChemObs). Zamb ia Environmenta l Management Agency (ZEMA) and other stakeholders fac il itated the estab lishment of the Nat ional Po ison Cent re. Response plans for chemical events have been estab lished, which include t he Enviro n menta l Emergency Response Plans under ZEMA and the National Publ ic Health Emergency Preparedness and Response Plan under MOH . ZEMA is also implementing the Global Harmon ised System (C HS) of chemica l ident ifi cation and labeli ng and the Transporta t ion of Dangerous Goods (TDC) (W HO/J EE, 2077). However, there is still limited; laboratory capacity to identify all priority chemicals, human resources, and financial support for chemica l management. To det ect and respond to chem ica l events, coordination and col laborat ion between different government agencies inc luding ZEMA, MoH and Min istry of Agricultu re is necessary. However, a proper coord inat ion mechan ism between different agenc ies is stil l not in p lace (WHO/J EE, 2077) . Points of Ent ry play a p ivota l role in ad dress ing health threats across internationa l borders. Cu rrent ly Zamb ia has fourteen (74) designated Points of Ent ry and t wenty-fou r (24) authorised Points of Entry. In the recent past, strides have been made to acqui re infrastructure and human resource to support implementation of port hea lth services at thi rteen (73) authorized Points of Entry. Regarding cl imate variabil ity and change, MoH spearheaded the development of a Hea lth Nationa l Adaptation Plan (HNAP) to cl imat e change. The p lan aims at ensuring that the hea lth of the popu lation in Zamb ia is protected from the effects of cl imate change (HNAP, 2079). Furthermore, the Vu lnerabi lity Risk Assessment and Mapping (VRAM) undertaken high lighted the possib le effects of climate change on public health secu rity (ZNPH I SP, 2022). Radiological and nuclear emergencies , though very rare, have severe impact on human, an imal and envi ronmental health when they happen. To coun t er rad io log ica l and nuclear hazards, events or emergencies, timely detection and an effective response mechanisms are req ui red. The Rad iation Protection Authority (RPA) is t he national regula t ory body for all matters re lating to rad iation protection inc lud ing rad iation mon itoring in the count ry. The Authority conducts annua l Safety Assessments for registered fac ilit ies that use radiation sources in various sectors. The ava il ab ility of an emergency and response plan to m it igate the impact of an event occu rring, is one of the conditions for issuing a licence. Assessments for radioactivity in consumer products, monitoring of imported and local foods to det ect any potentia l contam inat ion wi t h rad ioactive material and envi ronmental radiation mon ito ring are still in their infancy due to inadequate laboratory infrast ructu re. However, laboratory capacity at the Nationa l Institute for Sc ientific and Industrial Research for systematic analysis of radioactiv ity is being enhanced with assistance from cooperating partners. Legislation related to management of radia t ion utilization is in place, however, there is no specific nationa l po licy on rad iolog ical and nuclear emergency preparedness and response. RPA and Disaster Management and Mit igating Un it (DMMU ) are working towards estab lish ing a national coord ination mechan ism for rad iation emergencies. A nationa l Nuclear and Radiological Response Plan is being drafted. This wi ll include strateg ies and plans for detection , assessment, and t ime ly response to rad iolog ica l and nuclear eme rgencies.

2.5 Fooo Safety Over the past three decades, approximately 75 percent of new human infectious diseases have been zoonotic [ref]. The globa l popu lation has now exceeded 7 bi llion people, and an estimated 30 bil lion food anima ls were produced to help feed this population and meet its growing demand for protein from anima l sources [ref]. The result is a phenomenal globa l food system that is both a major agricultural and b usiness accompl ishment and an unpara lleled cha llenge that is creating major soc ietal issues that, to some extent, 23 threaten human, an imal, and environment al health. In addition, the cu rrent era of emerging infect ions and pace of emergence is acce lerated w ith changing ecosystems, risky human behaviour, poverty, travel, trade, g lobal ization , popu lation growth , and our interconnectedness. Food as a potential veh ic le for disease transmission is embedded in t his comp lex system; food safety has taken on a growing importance and has become a critical pub lic heal t h imperative. As a f u rther consequence, the safety of food is be ing increasing ly scrutin ized by the public, and food-borne illnesses are signi fi cant, costly, and a global problem. Th e CodexAl imentarius Commission provides guidance on standards an d gu idel ines relating to food safety. The app licat ion of a One Health model w here potential solutions are v iewed and del ivered more hol istica lly and w ith an emphasis on p revention is a compelling and timely strategy. Food safety is becom ing an important priority in Zamb ia. In addition t o t he Codex Ali mentarius st andards, the government has revised its food safety strategy and has prepared new leg islation to improve and modern ize food sa fety governance. In t he private sector, severa l food enterprises are upg rading their food safety practices meet ing international standards and to be ab le to cater for increasing demand. These improvemen ts are timely and appropriate. Whi le t h e extent of food borne risks is not fu lly known in Zamb ia, recurrent foodborne il lnesses suc h as cholera and t yphoid outbreaks, are common in Zambia and resu lt in sign ificant human and econom ic cost s. Despite t his, the pub lic awareness remains low, mak ing the population high ly vu lnerable to life threatening outbreaks of food poisoning. The ca uses of food poison ing and contamina t ion range from production and hand li ng practices to the unsafe use of vet erinary drugs and agricu lture chemica ls. In v iew of the above, sustainable food production and environmenta l stewardship is paramount and w ill requ ire a One Health approach. Th is approach can be app lied to food safety, sustainable food prod u ction, and environmental stewardship by bring ing together inter-discip lina ry teams to create a One Hea lth network to address food safety cha ll enges.

2.5 International Health Regulations llHRJ 2005 Zamb ia responds to public health events and emergencies in line w ith the Interna t ional Health regulations (IHR) 2005. The IHR gu idel ines were enacted in 2005 and Zambia as a member of WHO is lega lly bound to the imp lementation of the guidelines. In 2006, the Resolution AFR/RC56/R2 of the Regional Committee for Africa in Addis Ababa ca lled forthe implementat ion of the I HR 2005 among member countries in the context of the Int egrated Disease Surve illance and Response (I DSR). The IH R 2005 has an expanded scope to include all public heal t h emergenc ies of international concern. The implementation of IHR 2005 guide lines focuses on the 8 core capac it ies including leg islation , policy and coordi nation , survei llance, prepa redness, response, risk communications, laborat ory, and human resources at national and sub-national levels. A developed checklist and indicators for mo nitoring progress in the development of IHR Core Capacities in St ate Parties have been developed and have been defined us ing capab ility leve ls (i.e. the level of performance attained by a State Party for a g iven indicator, component and core capac ity). The aim of the check list is to enable sel f- assessment of the status of States Parties' core capacity development and identify areas for strengthening. The t able l gives t h e scores of t he core capacities based on the latest (2077) Joint Externa l Eva lu ation (J EE) that was done in Zambia [ref ]. National legislation, policy and P.l.l Legislation, laws, regulations, financing administrative requirements, policies, or other government 2 instruments in p lace are sufficient for implementation of IHR (2005) P.l.2 The State can demonstrate that it has adjusted and aligned its domestic legisla- tion, policies and 2 administrative arrangements to enable compliance with IHR (2005) IHR coordination, communication P.2.l A functional mechanism is and ad vocacy estab li shed for the coordination and integration of re levant sectors in the implementation of IHR Antimicrobial resistance P.3.l Antimicrobial resistance detection P.3 .2 Survei llance of infections caused by antimicrobial-resistant pathogens P.3.3 Health care-associated infection (HCAI) prevention and control 3 programs P.3 .4 Antimicrobial stewardsh ip activities 3 Zoonotic diseases P.4 .l Surveillance systems in place for priority zoonotic diseases/pathogens 3 P.4.2 Vet e rinary or anima l health workforce P.4 .3 Mechanisms for responding to infectious and potential zoonotic diseases are established and functional Food safety P.5.l Mechanisms for multisectoral collaboration are established to 2 ensure rapid response to food safety emergencies and outbreaks of food borne diseases 25 ,..,...., ..... Biosafety and biosecurity .......... P.6.l Who le-of-government biosafety and biosecu rit y system is in p lace ... 2 for human, an ima l and agricu ltu re fac il ities P.6.2 B iosafet y and b iosecu rit y tra in ing and p ractices Immunization P.7.l Vacc ine coverage (measles) as part of nationa l program P.7.2 Nat iona l vaccine access and de livery Natio nal laborat ory system D.l.l Laboratory testing for detectio n of priority diseases Rea l-t ime surveill ance D.l.2 Spec imen refe rra l and transport 2 system D.l. 3 Effective modern po int -of -care and laboratory-based d iagnostics 3 D.l.4 Labo rat ory qua lity sys t em 3 D.2.l Ind ica t or- and event-based 3 surve ill ance syst ems D.2.2 Interoperable, interconnected, e lectron ic rea l-t ime reporti ng system 2 D.2.3 Integration and ana lysis of surve ill ance data 3 D.2.4 Synd rom ic su rve illance systems 3 Repo rt ing D.3.l System for efficient reporti n g to 2 FAO, O IE and W HO D.3.2 Reporti ng network and protoco ls in country 2 Workforce development D.4.l Human resources avai lable 3 to implement IHR core capacity requ irement s D.4 .2 FETPl or other applied epidemio logy training program in 3 place D.4.3 Wor kfo rce strategy 2 National legislation, policy and P.l.l Legislation, laws, regulations, financing administrative requirements, 2 po licies, or other government instruments in place are sufficient for implementation of IHR (2005) P.l.2 The State can demonstrate that it has adj usted and aligned its 2 domestic legisla- t ion, pol ic ies and administrative arrangements to enable compliance w ith IHR (2005) IHR coordinat ion, communication P.2.l A functional mechanism is and advocacy established for the coord ination and integration of relevant sectors in the implementation of IHR Antimicrob ial resistance P.3.l Antimic rob ial resistance detection P.3.2 Surveillance of infections caused by antimicrobial-resistant pathogens P.3 .3 Health care-associated infection (HCAI) prevention and contro l 3 programmes P.3.4 Antimicrobial stewardship activities 3 Zoonotic d iseases P.4.l Surveill ance systems in p lace for pr io rity zoo notic d iseases/pathogens 3 P.4.2 Veterinary or animal health workforce P.4.3 Mechan isms for responding to infectious and potential zoonotic diseases are estab lished and functional 27 ...,.,. .I'. Food safety P.5.l Mechan isms for mu ltisectoral co llaboration are established to 2 ensure rapid response to food safety emergenc ies and outbreaks of foodborne diseases B iosafety and b iosecurity P.6.l Who le-of-government b iosafety and biosecu ri ty system is in place 2 for human, an ima l and ag ricu ltu re faci lities P.6.2 B iosafety and biosecurity training and practices Immunization P.7.l Vaccine coverage (measles) as part of nationa l programme P.7.2 Nationa l vaccine access and de livery Nationa l labo rato ry system D.l.l Labo ratory t esting fo r detection of p riority d iseases D.l.2 Specimen referral and transport system 2 D.l.3 Effective modern po int-of-care 3 and laboratory-based diagnostics D.l.4 Laboratory qua lity system 3 Rea l-time surve ill ance D.2.l Ind icator- and event-based surve ill ance systems 3 D.2.2 Interope rable, interconnected, 2 e lectron ic rea l-time reporti ng system D.2.3 Integration and ana lys is of surve ill ance data 3 D.2.4 Syndromic su rve illance systems 3 Report ing D.3.l System for efficient reporting to 2 FAO, OIE and WHO D.3.2 Reporting network and protoco ls in country 2 Wo rkforce development D.4 .l Human resources avai lable to implement IHR co re capac ity 3 requ irements D.4 .2 FETPl o r other applied epidemio logy training prog ramme 3 in place D.4.3 Workfo rce strategy 2 Prepa redness R.l.l Nationa l mu lti-hazard pub lic hea lth eme rgency prepared ness and response p lan is developed an d implemented R.l.2 Priority public hea lth risks and resources are mapped and utilized Emergency response operations R.2.l Capacity to activate emergency operations R.2.2 EOC opera ti ng procedures and p lans R.2.3 Emergency operations programme R.2.4 Case management procedures implemented for IHR re levant hazards . Linking pub lic hea lth and security R.3 .l Pub lic hea lth and security authorities authorit ies (e.g . law enforcement, border contro l, customs) are linked during a suspect or conf irmed b io logica l event Med ica l countermeasures and R.4.l System in p lace for send ing and personnel deployment receiv ing medica l countermeasures during a pub lic hea lth emergency R.4 .2 Syst em in p lace for sending and receiv ing hea lth personnel during a pub lic hea lt h emergency Risk communication R.5.l Risk commun icat ion systems (p lans, mechanisms, etc .) 2 R.5.2 Interna l and partner communicat ion and coord ination 3 R.5.3 Public communication R.5.4 Commun icat ion engagement with affected commun it ies R.5.5 Dynam ic listen ing and rumour management 29 Points of entry PoE.l Routine capacities established at points of entry PoE.2 Effective public health response at po ints of entry Chemical events CE .l Mechanisms estab lished and 2 funct ioning for detecting and responding to chem i- cal events or emergencies CE .2 Enabling environment in place 3 for management of chemical events Radiation emergencies RE.l Mechanisms established and functioning for detecting and 2 responding to radio- logica l and nuclear emergencies RE.2 Enabling environment in place for management of radiation 2 emergencies Scores: l=No capacity; 2=Limited capacity; 3=Developed capacity; 4=Demonstrated capacity; S=Sustainable capacity.

2.6 Strengths, weaknesses, Opportunities and Threats Analysis for one Health Implementation in Zambia

2.6.1 Governance and coordination The Government of Zambia and its stakeholders supports the quadripartite approach of m it igation against publ ic hea lth events using in multisectoral One Health met hodology. This approach requires good coordination mechanism that is legally supported so that everyone works towards a common goal. Zamb ia has lega l and poli cy frameworks that exist for di fferent sect ors. The enactment of ZNPHI Acts of Parliament no.19 of2020 provided for t h e estab li sh ment of an instit ution that is respons ible for anchorin g of coordination mechanism for One Health activities in the Count ry. This is supported by other avai lable p ieces of legislation and policy documents in the key sectors including an imal health , human health, plant health and the environment. Further, t he coun t ry has a good political w ill that has prioritized addressing publ ic health events in a mu lti sectora l One Health approach at the national and sub nationa l levels. In this rega rd there are professional mu ltisector p latforms that are existing and helps to mitigate in t imes of publ ic health events. However, the imp lementation of activities on One Hea lth are being hampered because of con t inued work ing in silos exacerbated by the lack of a National One p latform. The p latform wou ld enab le all players to execute the ir mandates in a coord inated way. There is also need to review and harmon ise different pieces of legislation that supports t h e One Health approach to mitigation of public hea lth events. 2.6.2 surveillance Zambia has a number of d isease su rveillance gu idel ines and SOPs. In addition , contingency plan are in existence for pathogens such as HlNl and monkey pox. Laboratori es exist at central level w ith the capacity to detect human , anima l and environ ment threats w hi ch include; Centra l Veterinary Research Inst itute, National Food Laboratory, UNZAVET Laboratory and ZNP H RL. Furthermore, there are experts availab le to perform different survei ll ance du t ies and t here are survei ll ance data collect ion tools, systems and report ing channels in the d iffere nt sectors. Despite these positives, One Hea lth Surveil lance remai n s a chal lenge in Zamb ia. Presently, t h ere is no prioritised list for zoonotic diseases as well as contingency p lans for most pathogens. There is also lack of policies to gu ide reso u rce sharing and coord inat ion to respond to common publ ic health events. There is inadequat e capac ity and human resource to det ect and confirm pub lic health events at sub -nationa l level. Additiona lly, there is st ill inadequat e human resource at subnat ional levels and no integrated electronic p latform for su rve illance dat a exists.

2.6.3 Preparedness and Response Zamb ia has developed strateg ic documents to faci litate pub lic hea lth preparedness and response, these include, NAPHS, All Hazards plan and HlNI contingency plan. Efforts are underway to fi na lize other key documents such as t he VRAM, and Integrated SOPs. The establ ishment of the Public Health Emergency Operation Centre (P HEOC) th rough the ZNP HI Act provides for the coord ination of response to Pub lic Health Events. Th is further augments the operations of the Nationa l Emergency Operation Centre (EOC) at DMMU. There is existence of Emergency Preparedness and Rap id Response Comm ittees at National and Sub-national level. However, as Zambia en deavours to st rengthen the One hea lth Preparedness and Response, it still faces a lot of chal lenges wh ich include, inherent bias towards human health and inadequat e infrastru ctu re capacity at provincial leve l especial ly in the An imal health, Plant hea lth and Envi ronmental h eal t h sectors. Cu rren t ly sectors are working in si los due to lack of joint gu idel ines in response to pub lic heal t h event s. Other cha ll enges inc lude, non-prioritization of One hea lth response in institution acti on p lans , epidemic preparedness p lans not regu larly updated and tested, inadequate human resource, isolation faci lities not meet ing IP C standards, and inadequate publ ic funds for emergency response lead ing to donor dependency.

2.6.4 Advocacy, communication and Training The commun ity has been recognized as a major stakeholder in the imp lement ation of One Hea lth advocacy, 31 communication and tra ining activities. A ca ll centre which serves as a commun ication link between public health profess ionals and the community exists. Furthermore, One Health training cou rses have been estab lished in some training institutions in Zambia up to doctora l level. Desp ite these achievements, advocacy, communication and training using One Health approach has continued to encounter major cha llenges. These include, inadequate financial resources, primary and secondary schoo l curricula do not capture elements of One Health, multisectoral commun ication channels are not fully estab lished. Presently, there is an inherent communication bias towards human health rather than One Hea lth and there is a lack of One Hea lth-related Information Education and Communication (IEC) and Behavioral Change Commun ication (BCC) mat erials. Whereas capacity bui lding exists for human resource t raining in One Hea lth , there is a lack of an integration policy fo r personnel into thei r respective sectors upon completion of train ing.

2.6.5. Research Zambia has demonstrable capacity to conduct One Hea lth research given the availabi lity of infrastructure and facilit ies to handle One Health threats coup led with the existence of multid iscip linary human capacity/ personnel. However, the lack of One Hea lth nati ona l agenda, inadequate lega l and support pol icy f rameworks have res ulted into uncoord inated, non-integrated approach to One Health research. This current scenario has resulted into a non-fu nctiona l intersectora l collaborative One Health Platform needed to respond to publ ic hea lt h events at the anima l-human-environmenta l interface. Table 2 be low ou t lines the deta iled SWOT ana lysis of imp lementation of One Health in Zamb ia by core thematic areas. 32 / / / 2.0 SITUATIONAL ANALYSIS ONE HEALTHGOVERNANCE AND COORDINATION Existence of different interest groups such as food safety, surveillance, antimicrobial Weak multisectoral coordination, Various stakeholders work in silos, resistance (AMR) and zoonosis Lack of an established One Health Platform supported with Memorandums of Institution based coordination exists in human health, animal health, plant health and understanding and/or legislature environmental health Legislative process is expensive and complex Establishment of ZNPHI through an Act of parliament to anchor One Health Low perception and understanding of zoonoses and other Public Health Events Existence of human health/ animal health collaboration at national level Inadequate resources Resource allocation does not recognise zoonotic nature of diseases (sectors Animal Health Disease Act No. 27 of 2010 funded separately) Veterinary and Veterinary Paraprofessionals Act No. 45 of 2010 Lack of One Health Policy guidelines Public Health Act Cap 295 of 1995 Inadequate integration of One Health Concept in University/Institutions National Agricultural Policy Curriculum Wildlife Policy, 2015 ZN PH I Act No. 19 of 2020 Food safety Act No. 7 of 2019 The Medicines and Allied Substances Act No. 3 of 2013 Availability of Systems and infrastructure such as lab diagnostics in key sectors Efforts towards creation of a functional National One Health platform (need for representation of all sectors) Existence of epidemic preparedness platforms at national and sub national levels Existence of sector specific reporting channels 33 / / / 2.0 SITUATIONAL ANALYSIS ONE HEALTHGOVERNANCE AND COORDINATION Good political will across different sectors to create a national One Health coordination Profession al rivalry mechanism Bureaucratic barriers among different sectors Availability of experts (multidisciplinary/multisectoral) to coordinate the One Health Competing priorities programme Resources are project oriented with starting and ending dates Presence of disaster management mitigation unit (DMMU) Existence of Global and regional One Health Frameworks, Guidance, and Strategies to Conflicting interests on priority setting amongst key players which Zambia is signatory Conflicting interests in different ministries Existence of large expertise base High personnel turnover Availability of basic institutional set up within involved ministries Political instability among neighbouring countries Existence of multilateral and bilateral development partners and local partners Existence of parallel projects with different priorities. Existence of various local One Health implementing partners Presence of (multiple) emerging and re-emerging zoonotic diseases such as Recognized needs for the multisectoral collaboration Ebola 34 / / / 2.0 SITUATIONAL ANALYSIS •mmaDRVEllWII Existence of disease surveillance guidelines Weak inter-sectoral and intra-sectoral coordination of public health surveillance activities IDSR (3rd Edition) surveillance guidelines are sector specific and not harmonised in a one health IHR (2005) approach COVID -19 SOPs Inadequate human resource at subnational levels Event Based Surveillance guidelines Limited disease awareness at lower levels (Farmers /livestock keepers) Existence of an animal health surveillance system housed at the National Livestock Lack of an integrated electronic platform for surveillance data. Epidemiology and Information Centre (NALEIC) Integrated SOPs and guidelines eg IDSR 3rd edition not widely disseminated Availability of some disease (including AMR) surveillance field and laboratory SOPs among OH stakeholders and protocols Inadequate capacity to detect and confirm type of chemical, and zoonotic Existence of the Laboratory network for animal health from 7 Provincial Laboratories diseases at sub-national level (only National Food Laboratory and CVRI at to the National Level (Central Veterinary Research Institute) national level can detect at the moment) Existence of contingency plan for diseases e.g HlNl and monkey pox Contingency plans only caters for a few pathogens sector specific reporting channels of surveillance data exist Lack of priority list of zoonotic diseases Capacity to detect human, animal and environment threats Systems and infrastructure available (lab diagnostics) Availability of elDSR/AMR DHIS2 for reporting surveillance data Availability of M-health EBS pilot project Availability of BSL3 at the University of Zambia accessible to all OH sectors and intersectoral use of laboratory diagnostic capacity Availability of cross border surveillance platforms 35 / / / 2.0 SITUATIONAL ANALYSIS U11 lmtftlllllll81 Existence of EBS can be expanded to include events in animals and environment. Conflic ting and/or competing interests on priority setting and resource Possibility to integrate existing survei llan ce data co llection and reporting tools in allocation by various sectors different sectors Climate change leading to increase in Emerging and re-emerging public health Existence of partners that support disease survei llan ce events Un-balanced partner support across different public health sectors 36 / / / 2.0 SITUATIONAL ANALYSIS ONE HEALTH PREPAREDNESS AND RESPONSE Existence of Multi Hazard preparedness plan, and IDSR guidel in es Epidemic preparedness plans are not regularly updated and tested Existence of multisectoral Rapid response teams at all administrative levels Inad equate infrastructure capacity at provincial level especia lly Anima l health, Existence of multisectoral Epidemic preparedness platforms at all administrative levels Plant health and environmenta l health sectors Availability of experts and trained personnel across different sectors for outbreak La ck of joint outbreak investigation guide lin es investigation and response Th e existing emergency preparedness and response teams do not utilize the Availability of a fund for epidemic preparedness and response for public health one health approach emergencies In adequate prioritization one health response in In stitution action plans . Existence of the Public Health Emergency Operation Centre (PHEOC) at ZNPH I Inad equate human resources Existence of EOCs in lin e ministries In sufficient funds and cha llenges in accessing ava ilable funds during Existence of National Emergency Operation Centre (EOC) at DMMU emergencies Emergency preparedness teams are not functional in absence of outbreaks In adequate isolation facilities meeting IPC standards Inad equate risk assessment capacities Donor financial dependency to support, hence it has increased donor fatigue EOCs in lin e ministries are not fully integrated with the national PHEOC Inh erent bias towards human health sector in support for response activities 37 / / / 2.0 SITUATIONAL ANALYSIS 111 1m.1,-■.111:,_ Existence of political wi ll and recognition of importance of response to health threats Occurrence of public health emergencies including those of Internationa l Existence of goodwi ll from cooperat ing partners to support response to public health concern threats Globa l interconnectivity Availability Financial support for preparedness and emergency response from the Uncontrolled influ x of refugees and displaced people especial ly through porous national treasury border points The unpredictability of emerging and re-emerging diseases 38 / / / 2.0 SITUATIONAL ANALYSIS ·,Mfr 1·· tit'lid..l..,_.MM'UUQI . finfAM ·•MlfflW wu; , mwm P ~'h l'WIUII ___19.ffl•Pflll . o,_ ,.,,uw The community has been recognised as a major stakeholder in the implementation of In adequate financial resources for advocacy, communication and training one health activities Primary and secondary school curricu la do not capture elements of One Health A ca ll centre which serves as a communication link between public health One Health communication channels not fully established professionals and the genera l public exists Weak mechanisms for analyzing and sharing data among One health Availability of One Hea lth training programmes stakeholders Inh erent communication bias towards human health rather than One health Lack of one health -related Inform ation Education and Communication (IEC)/ Behavioral Change Commun ication (BCC) materials lack of an integration policy for personnel into their respective sectors upon completion of O H training La ck of awareness among community members on the human, anima l interface and how their activities contribute to c limate change and emergence and re-emergence of infectious pathogens 39 / / / 2.0 SITUATIONAL ANALYSIS Ol ftflll IDIOfJAOYJOMMUNltlTIDM ANbtBINl18 Zambia is signatory to existence of Global and regional One Hea lth Frameworks, Conflic tin g interests in advocacy, communication and training priority setting Guidance, and Strategies, this can be used for advocacy among key players and participating agencies Functions of the existing cal l center can be expanded to comprehensively cover One Some cu ltural beliefs and practices predispose communities to One Health- health matters related risks (e.g. Game hunting) and hinder implementation of RCCE activities High demand for capacity building and professional development among One Health Constrained resources are a threat to implementation of advocacy, stakeholders communication and training activities The existing Risk Communication and Community Engagement platform under human health can be utilized for One-Health related communication Existence of Training institutions that can incorporate One Health in their curricula 40 / / / 2.0 SITUATIONAL ANALYSIS 111m.11111111 Availability of Infrastructure and facilities to conduct research into OH threats such as Each institution is conducting research in isolation [Research SILOS] BSL-3 at UNZAVET, the Africa Center of Excellence for Infectious Diseases for Humans Inadequate information sharing among institutions on One Health research and Animals (ACEIDHA). a research center for OH at UNZA, ZNPHI RL, ZARI, and CIDRZ Inadequate support by policy makers Existence of multidisciplinary Human capacity/personnel to handle research in OH Poor funding to research and development sector Existence of Long-term collaborative platforms and partners in OH research e.g .; Inadequate lab facilities and infrastructure specifically dedicated to research SATREPS-Viral Zoonoses Research in Africa, housed at UNZA Conversion of research labs to diagnostic labs for the purpose of monetary gain Presence of political will that encourages multi -sectoral research Inadequate research themes in OH research Presence of OH-postgraduate studies at UNZA that foster research in OH : i.e. One Failure to adequately communicate OH research outcomes for the purpose of Health Analytical Epidemiology, One Health Laboratory Diagnostics, One Health Food policy formulation Safety, Failure to uptake OH Research findings/outputs by policy makers [Sector Participating institutions are currently conducting relevant and reliable research Advisory Groups (SAGs). don't consider research as an important factor] related to One Health National research agendas do not address One Health issues Existence of research information sharing systems Inadequate laboratory capacity for research of highly infectious pathogens Existence of rich and diverse natural resources for use in research (where biosafety containment is required) Presence of the Zambia National Public Health Institute as a National OH coordinating Centre Presence of the National Health Research Authority (NHRA) which regulates health research . 41 / / / 2.0 SITUATIONAL ANALYSIS 111m.11111111 Zambia lies in a high-risk region for occurrence of emerging/re-emerging public High staff turn-over and brain drain health threats, this provides an opportunity for research Poor enabling environment for researchers [i .e . Low salaries] Existence of external funding agencies for OH research Possibility for loss of intellectual property rights as well as publishing copyrights Expression of interest from development partners for research and innovation as most of the research is externally funded Existence of National, Provincial and District Task Forces aimed at OH threats such as Externally developed research protocols not answering to our immediate OH the Rabies Task Force at National and District levels research themes [requesting our researchers to restrict their work to Prevalence, KAP studies, pathogen isolation/characterisation without studies such as in vaccinology for instance]-hence research remaining rudimentary Donor fatigue may lead to reduced support of research Global economic down-turn derailing already established OH research themes Change in government policies making research unsustainable Certain customs and culture will not allow some types of research to be conducted 42 3.0 organizational Functions 3.1 one Health Steering committee The OH St eering Comm ittee w ill provide overal l oversight t o coordination of One Hea lth approach in Zamb ia. The One Health Steering Comm ittee wi ll be composed of Permanent Secretaries from the key sectors and organizations on pub lic hea lth events. These inc lude; The Permanent Secretary, Techn ica l - Min istry responsib le for Human Hea lth The Permanent Secretary - M in istry responsible for An imal Health The Permanent Secretary - M in istry responsible for Agricu lture The Permanent Secretary - M in istry responsible for Tourism and Natural Resources The Permanent Secretary - Min istry responsib le for Environment The Permanent Secretary - M in istry responsible for Local Government The Permanent Secretary - M in istry responsible for Water Supply and Sanitation The Permanent Secretary - M inistry responsible for Lega l affa irs and The National Coordinator - Disaster Management and Mitigation Unit (DMMU) The One Health Steering Comm ittee may co-opt cooperating partners (b ilateral and mu lti latera l partners) in its d ischarge of dut ies. These may inc lude but not lim ited to: The Un ited Nations Resident Coordinator (UNRC) The Country Representative for the World Health Organ ization (WHO) The Country Representative for the Food and Agricu lture Organization (FAO) The Country Delegate for Un ited Nations Env ironment Program (UNEP) The Country De legate, World Organization for Anima l Hea lth (WOAH) The RCC coordinator, Africa Centers for D isease Prevention and Control (Africa CDC) The Country Director, World Bank The Country Head of Miss ion , US Centers for Disease Prevention and Control (US CDC) The UK H ealth Security Agency (UKHSA) The Zambia National Pub lic Hea lth Director General shal l be the secretariat to the One Health steering committee. 3.2. one Health coordinating committee lOHCCl The OHCC wi ll be the technical coordinating comm ittee for sectors in One Health. The OHCC shall comprise representation from various Ministries. The OHCC may co-opt Non-governmental organizations and cooperating partners inc luding mu lt ilateral and bi latera l cooperating partners. The OHCC w ill be composed of the following institutional membe rship: The Representative - Disaster Management and Mitigation Unit (DMMU) The Director, Publ ic Hea lth , M inistry of Health Director, Cli n ical Care Services, M inistry of Health The Director - Health Promotion , Environment and Socia l Determinants of Health, Ministry of Hea lth The Director, Department of Veterinary Services The Director, Department of Livestock Development Di rector, Department of Fisheries The Director, Department of Ag ricu lture The Director , Department of Nationa l Parks and W ildlife The Director, Department of Environmental Protection The Director, Department of M u nicipa l Infrastructure Development The Director, Department of Physical Planning The Director, Department of Water Supp ly and San itation The Director, Surve illance and D isease Intelligence, ZNPHI The Director, Emergency Preparedness and Response, ZNP HI The Director, Strategic Information Management, ZNPHI The Director, Laboratory Network Systems, ZNPHI The Zambia Nationa l Pub lic Hea lth Institute w ill serve as secretariat to the OHCC.

3.3. Technical working Groups [TWGJ The TWGs w ill be composed of technical representation from various Ministries , Non-governmental organizations and cooperating partners based on t he fo llow ing thematic areas: Governance and coordination , Surveillance, Preparedness and Response, Advocacy Commun ication, and Tra ining, and Research.

3.3.1. Governance and coordination The Governance and Coordination TWG wil l be responsib le for the dai ly management of the OHA in the country and coordination of various sectors in OH . This TWG w ill be composed among others the OH foca l po ints from ZNPHI, line ministries across sectors , mu lt ilateral and b ilateral partners. The Governance and Coordination TWG w ill provide the secretariat to the TWGs and w ill report to the Nationa l OHCC. The ro les and responsib ilit ies w ill be to: Mobi lise resources Facil itate intersectora l coordination of pub lic hea lth events surveil lance Facil itate intersectora l coordination of pub lic hea lth emergenc ies investigations Co Opting the subject matter experts as necessary to response to a public heal t h emergencies To faci litate and coordinate t he monitoring and eva luation of the O H strategic p lan 3.3.2. surveillance TWG The ro les and responsib ilit ies of the Su rvei llance TWG are to: Identify and advise on publ ic health events 44 Prepare gu idel ines for publ ic health events survei llance Proposal preparations fo r different su rvei ll ance programs Provide techn ical guidance on surveil lance of pub lic health events To mon itor and eva luate survei ll ance programme To prepare reports on publ ic hea lth events survei llance to OHCC Prepare and implement early warning system for publ ic health events Meeting schedu le: Quart erly/when needed

3.3.3. Preparedness and Response TWG The roles and responsib ilit ies of the Epidemic Preparedness and Response TWG are to: Prepare SOPs for epidemic p reparedness and response Prepare proposa ls on epidemic p reparedness and response for resource mobi lization Provide techn ical guidance to the nat ion on pub lic health epidem ic preparedness and response Prepare work p lans and budgets for the nati onal epidemic preparedness and response Prepare national reports and present to the O HCC on ep idemic preparedness and response

3.3.4. Advocacy, communication and Training The roles and responsib ilit ies of the Advocacy and Commun ication TWG are to: Operationa lize OH st rategy under respective thema t ic area Prepare annual plan as per strategy Report to OHCC on the prog ress to the imp lementat ion of OH st rategy Develop and imp lement communication and advocacy strategies Coordinate behavior change commun ication and risk commu nication

3.3.5. Research TWG The Research and Deve lopment TWG wi ll be comprised of members from the academia , research institu t ions and other sector institutions in OH. The roles and responsibi lities of the Researc h and Development TWG are to: Coordinat e, develop and implement research and knowledge management activities Operationa lize OH strategy under respective themati c area Prepare annual plan as per st rategy Report to OHCC on the progress to the implementation of OH strategy

4.0 Five-Year strategic Direction

4.1 Vision A nation w ith a sustainably ba lanced and optimized health of people, animals and ecosystems.

4.2 Mission To bu il d a strategic , functional and sustainable platform that advances One Hea lth.

4.3 Thematic Goals The strategic p lan is divided into the follow ing core thematic areas and goals: Governance and Coordination - To have a functional and well coordinated One Hea lth nationa l program Survei ll ance - To have a functional One Hea lth surve ill ance system to contribute to the reduction of zoonotic d iseases and other publ ic health events Preparedness and Response - To strengthen preparedness plann ing and improve the abi lity to respond to p ublic health threats through the One health approach at all levels (commun ity, d istrict, provincial and nationa l) Advocacy Communication and Training - Enhance awareness on One Health for profess iona ls, poli cy- makers and the community Research - Opt imize the health of human, an imal and environment through evidence based OH research 4.4 core Values and Principles Partnership and Coord ination - Bringing together al l stakeholders in OH to work harmoniously to advance human, anima l, plant and environmenta l health Innovation- Adoption of new and improved approaches and processes for managing OH Susta inab ility- Ensure con t inuous ava il ab ility of resources and capacities for implementation of the OH approach in cl u d in g promot in g sustainab le ecosystem management Accountabi lity-Acknowledg in g and accepting responsib ility for One Hea lth activities by al l stakeholders Integrity - Promotion of eth ical va lues and standards in the management and imp lementation of OH activities

4.5 Objectives, Strategies and Activities The objectives, strateg ies and activities envisioned to be implemented in the five-year period are out lin ed in tab le 3 below 46 / / / 4.0 FIVE-YEAR STRATEGIC DIRECTION Thematic Area 1: Governance and Coordination Cioal: To have a functional and well coordinated One Health national programme Objective Strategy I Strategic activities l.0 To review different pieces of legislation on l.l Mobilize national One Health Key stakeholders to work Il.l.lEngage a consultant to review and recommend different pieces of One Health across different sectors by 2024 on One Health legislation legislation on One Health l.l.2 Hold a workshop for the consultant to present the findings to the stakeholders l.l. 3 Workshop to validate the consultant report

2.0 To operationalise the the national One 2.1. Reviewing and implementation of the staff in g 2.l.l Review and and make recommendations to improve the ZNPHI Health coord inating mechanism by 2026 structure in relation to One Hea lth in all lin e ministries. staffing structure 2.l.2 Make the road map and implement it to ensure the approval O H

2.2 Establish national One Health Steering Committee desks in lin e ministries (OHSTC) involving PS level, One Health coordination 2.2.l Hold meetings to develop and va lid ate terms of reference for the platform (OHCP) at Directorate level and One Health OHSTC, OHCP and OH-TWG/s) Technical workings groups (OH -TWG) based on the 2.2.2 Convene meetings for OHSTC, O HCP and OH-TWG/s thematic areas 2.2.3 Request for One Health Focal Points nominations from key institutions

2.2.4 Request for nominations for One Health members to be part of the OHTWG/s based on the Thematic areas

3.0 To mobilize operational resources in order 13.l Advocacy and lobbying for One Health funding 3.l.l Conduct advocacy for government budget allocation for One to support the activities of the national One Health Health strategic plan 3.l.2 Conduct advocacy for increased partner funding to support One Health activities 3.l.3 Develop OH financing concept notes and proposals 47 / / / 4.0 FIVE-YEAR STRATEGIC DIRECTION Thematic Area 2:0ne health surveillance, Coal: A Functional One Health Surveillance System to contribute to the reduction of public health events Obje-ctlve Strategy a~lvities l.To achieve one health survei ll ance among key l.l . Establish linkages of the existing sector survei llance l.l.l. Assessment of the existing survei ll ance systems stakeholders for ear ly detection of Zoonotic systems. l.l.2 Conduct Workshops with stakeholders to identify the data Diseases and other public health events by the needs for integrated survei llan ce system end of 2024. l.l. 3. Develop an integrated surveill ance sys t em for the highest priority zoonotic diseases and public health threats l.l. 4 . Review of the OH survei ll ance System l.2. Establish O H policies and guidelines to facilitate data l.2.l. Advocacy meetings with policy and decision makers on OH linkages l.2.2. Stakeholder engagement Workshops on policy and guidelines l.3. Develop prioritized list of zoonotic diseases and other l.3.l. Workshop to develop One health list for priority zoonotic threats of public health importance diseases l.4 . Capacity Building on One Hea lth survei llance across l.4 .l. Trainin g Needs Assessment on O H surveillance al l sectors l.5. Conduct a situation analysis of O H status in Zambia l.5.l. Conduct a baselin e and end lin e survey on O H implementation in Zambia 48 / / / 4.0 FIVE -YEAR STRATEGIC DIRECTION -- ·~ -~ ' ·-~ 2. To strengthen and establish laboratory 2.7. Situation analysis of laboratory capacities across all 2.l.l. Mapping of existing laboratory faci lities and capacities across capacity to diagnose priority zoonotic diseases sectors the sectors and public health events at all provincia l levels 2.2. Integration of existing sector diagnostic faci lities as 2.2.l. Establish a laboratory network by2026 informed by the situation ana lysis. 2.2.2. Establish a laboratory courier system for samples

2.2.3. Tra ining of laboratory personne l in specific diagnostics

2.2.4. Workshops to develop, harmonize and review SOPs for priority zoonotic diseases across all sectors

2.2.5. Equipping of laboratories

2.2.6. Infrastructure development

2.2.7. Laboratory Diagnostic Mentorship trainings

2.2.8. Trainings in qua lity management system

2.2.9. Implementation of proficiency testing 49 / / / 4.0 FIVE-YEAR STRATEGIC DIRECTION Thematic Area 3: Preparedness and Response Cioal: To strengthen preparedness planning and improve the ability to respond to public health threats through the One Health approach at all levels (community, District,Provincial and National) Obje-ctlve Strategy ActMtles l. To strengthen capacity for preparedness to respond l.l. Setting up a system to ensure sustainable resources. l.l.l Establish a coordinated and functional availability of to Zoonotic diseases,public health events of known and Multidisciplinary emergency preparedness and response unknown etiology at all levels by 2026 teams with TORS l.2 Support capacity building for one health workforce. l.l. 2 Create a one health human resource mobilizing mechanism for emergency response l.l.3 Operationa lise access to emergence funds to support all relevant sectors to carry out immediate investigation in public health events l.2.l Conduct trainings in EPR and RRT teams using OH approach at subnationa l level l. 3 Develop exercise response plans l.3.l Conduct tabletop simulation exercises l. 3.2 Conduct field simulation exercises 50 / / / 4.0 FIVE-YEAR STRATEGIC DIRECTION ••• '~ " ~ 2.To strengthen the coordination of emergency 2.l. Develop coordinating mechanism for emergency 2.l.l Develop integrated guidelin es,SOPs and preparedness and response to public health events. preparedness and response to public health events contingency plans for coordinated emergency among relevant ministries and agencies by 2026 preparedness and response of public health events. 2.l.2 Test the cont in gency plans developed

2.2 Establishment of public Health Emergency Operation 2.2.l Procure equipment and software for PHEOC, Centers (PHEOC) at all levels develop and install PHEOC dashboard for response tracker

2.2.2 Assessment of requirements to establish provincial PHEOCs

2.2.3 Train PHEOC staff in established plans and procedures

2.2.4 Create a database for subject matter experts on priority Zoonotic diseases and other public health threats.

2.2.5 Establish a O H emergency platform at different levels. 51 / / / 4.0 FIVE-YEAR STRATEGIC DIRECTION Thematic area 4. Advocacy, Communication and Training Cioal: Enhance awareness on One Health for professionals, policy-makers and the community Obje-ctlve Strategy Activities l. To develop capacity for OH advocacy and l.l. Integration of One Health into the current communication l.l.l Hold meetings to review the health communication communication programs at all levels of strategies strategy for incorporation of OH communication and government and among stakeholders by June 2026 advocacy principles (the meetings can bring together a group of multi-sectoral and muti-deciplinary professionals) l.l.2 Disseminate the updated communication and Advocacy strategy through workshops l.l.3 Hold meetings to develop One health advocacy and communication packages l.2. develop One health advocacy and communication training packages l.3. develop O H communication and advocacy TOT and cascaded training plan l.4. conduct ToT (including for training institutions) in One health advocacy and communication l.5. Cascade One health advocacy and communication trainings (including for media personnel) 52 / / / 4.0 FIVE -YEAR STRATEGIC DIRECTION ' -- ·~ -- ~ l. 6. Sensitization of stakeholders on One Health through l. 6.l Hold meetings to develop sensitization materials (print, different media platforms socia l media, e lectronic) l. 6.2 Print and publish One health advocacy and communication materials l. 6.3 Conduct dissemination and sensitization meetings including media houses 2. To increase the knowledge base by incorporating 2.l. Developing One Health advocacy and communication 2 .l.l Conduct a desk review (including co llecting preliminary One Health initiativesin pre-service training materials, tailored for training institutions data) of preservice and in service curricular to exam ine One health content) 2 .l. 2 Developing One Health advocacy and communication training materials including on line modules

2.2 Developing One Hea lth advocacy and communication 2 .2.l hold curricu la review workshops training materials including on line modules To integrate One health 3. To increase awareness on One Hea lth to policy 3.l. Lobbying and advocacy to policy and decision makers 3.l.l Conduct One Health sensitization meetings/ and decision makers by July 2026 workshops for policy and decision makers 3 .l. 2 Ho ld a dissemination meeting for policy makers on One Health components 53 / / / 4.0 FIVE -YEAR STRATEGIC DIRECTION Thematic Area 5: Research Cioal: Optimize the health of human, animal and environment through evidence based OH research 10*tlV. I -~ - Stra~-- ~ l) By December, 2023, align In stitutiona l co ll aborative l.l Strengthen and establish institutional agreements on l.l.l Develop, review and revise MoUs and MTAs/DTAs to Research to One Health by 75% co ll aborative research. include One Health among relevant research institutions. l.l.2 Assess inventory on existing capacity and develop databases l.2. Improve existing laboratory and human resource l.2.l Procure laboratory requisites based on capacity in One Health research needs l.2.2 Trainin g of research teams in One Health themes l.2.3 Hold meetings to harmonize Institutiona l policy and regulations on utilization of laboratory services towards One Health research 2) By December 2023 , coordinate the establishment of 2 . .l. Establish a national One Health research agenda 2.l.l Hold workshops and Trainin gs t o Stream line One Health research themes among all institutions co llaborative One Hea lth research themes 2.l.2 Develop co llaborative O H research proposals 2.l.3 Quar t erly O H coordination workshops 2.l.4 Conduct One Hea lth Research 54 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK Ob~ve S\r~~y ~rat~ii:nrotfyities 3) Between 2023 and 2027, develop and enhance 3.l. Effectively communicate One Health research 3.l.l Participate and present One Health research findings existing communication channels between One Health concepts to policy and decision makers in existing fora (NRIS, NSTC-SRF, ZHRC, ASVMSS etc.) researchers and policy makers 3.l.2 Utilize social media and conventional media agencies/ websites to disseminate One Health research findings to the general public 3.l.3 Organize policy dialogue and discussions among policy makers on policy briefs 5. Monitoring and evaluation lM&EJ framework The M&E framework will help to measure the progress in the implementation of activities, as well as progress in achieving the intended objectives and targets. The coordinating structure will coordinate all stakeholders, at national, provincial, and district levels and Community, to ensure optimum utilization of available M&E resources for enhanced monitoring and evaluation. Progress implementation of the One Health 2022-2026 strategic plan will be routinely monitored on a monthly, quarterly, bi-annual, and annual basis whilst the evaluation of the strategic plan will be done through midterm review and end-term evaluation. The midterm review will provide the opportunity to gather additional information , assess progress, as well as to make appropriate mid-course corrections The M&E will include reviews of; i. Objectives ii . Coverage of interventions in comparison to targets iii. Status of indicators in line with core thematic areas iv. Major activities and how well they are implemented The M&E framework below gives the objectives and activities planned for the 5 years; indicators for monitoring implementation; means and frequency of monitoring these indicators; as well as sources of information. 55 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK M&E-Result Framework t> a, t a Objective Output lndi~ator Indicator :deflnh;ion so:urc::es:/ Frequency .Le a d T~ETS MQV 2022 2023 2024 2025 2026 Theme: Governance and Coordination To have a functional and well-coordinated One Health national program To strengthen legal # of Orientation on OHA at Number of orientation meetings Reports Biannual ZNPH I 0 2 2 l l framework ( policy and national level held/Total number planned legislation) on One Health # of Orientation on OHA at Number of orientation meetings Reports Quarterly ZNPH I 0 10 lO lO lO across different sectors subnational levels held/Total number of meetings by 2026 planned # of Acts of Parliament # of Acts of Parliament reviewed/ Reports Annua l ZNPHI 0 l 0 0 0 reviewed the for creation of out of the planned landscape ana lysis for OHA Availabi lity of policy The indicator asses the availability Reports Annua l ZNPH I 0 0 l 0 0 framework for OHA of OHA Policy Framework in place coordination Avai lability of legislation on Legislation in place Legislation Annua l ZNPH I 0 0 0 l 0 OHA Availabi lity of Lega l Legal Framework implementation Plan and Annua l ZNPH I 0 l 0 0 0 Framework Operational plan in place Reports Plan on OHA in place and implemented 56 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK "~ a :t,. ~ ~ ~~ ~.--1~ 'l.U'""~ ~ L • & ·4 ~ ~ 2022 2023 2024 2025 2026 To operationa li se the # of line ministries with a # of One Health focal points or Reports of Quarterly ZNPH I 3 5 6 8 9 national One Health One Health focal point or OH desks established in Line the One coordinating mechanism One health desk ministries/ total number of OH Health by2026 line ministries steering committee # National One Health # of National One Health Steering Reports of once ZNPH I 0 l l l l Steering Committee (OHSC) Committee (OHSTC) estab lished/ the One estab lished total planned Health National One Health steering committee # One Health coordination # of One Health coordination Reports once ZNPH I 0 l 0 0 0 committee (OHCC) committee (OHCP) established/ ofthe established Total number of planned National One Health 57 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK "~ a :t,. ~ ~ ~~ ~.--1~ 'l.U'""~ ~ L • & ·4 ~ ~ 2022 2023 2024 2025 2026 # of one Health Technical number of OH TWGs estab lished/ Reports of Once ZNPH I 5 0 0 0 0 workings groups (OH -TWG) Total planned the One estab lished Health TWGs # of Workshop held to # of workshops held/Total Activity quarterly ZNPH I 0 6 4 4 4 develop terms of Reference planned reports for OHSC, O HCP and O HTWG To mobilize operationa l # of OH advocacy meetings # of meetings conducted/ resources in order to for government budget support the activities of allocation conducted the national One Health strategic plan Tota l number of meetings Activity reports quarterly ZNP HI 0 4 4 4 4 planned # of advocacy meetings for # of meetings conducted/Total Activity quarterly ZNPHI 0 4 4 4 4 increased partner funding number of meetings planned reports to support OH activities conducted # of O H financing concept # of OH financing concept notes notes and proposals and proposals developed/ developed # of Planned concept Developed financing Annua l/Once ZNP HI 0 4 4 4 0 notes and proposals concept note and proposal 58 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ,Qi ,~, ~ a ;~ OUtpUt lnqi~t J111~lqat0,t ,itefinitiM s .a,,.u r 11; .e ~,/ ~r:tt.:N Lead 'liAROET$ .MQV 2022 2023 2024 2025 2026 Theme: One Health Surveillance Cioal: A Functional One Health Surveillance System to contribute to the reduction of Zoonotic Diseases and other public health events To achieve one health # of survei llance system Number of sector survei ll ance Assessment Annua l Ministry 0 4 0 0 0 surveillance among key Assessments Conducted system assessments conducted/ reports of stakeholders for early across all the sectors Total number of assessments Fisheries detection of zoonotic planned and diseases and other public Li vestock health events by the end of 2024. # of workshops with Number of workshops conducted Workshop Annually Ministry 0 l l 0 0 stakeholders to identify the with stakeholders/Total number reports of data needs for an integrated of workshops planned Fisheries survei ll ance system and Livestock Availability of Functional Assesses the availability of an Consultancy Annually Ministry 0 l l 0 0 integrated OH surveillance integrated OH Surveillance Reports of system for Zoonotic diseases System for priority zoonotic Fisheries and other public health diseases and public health threats and events Livestock 59 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ~ ~~ ~.--1~ "~ •f f -~\!Jf~•~t ~ ~ a: - Lill ;;s ·d , _~ ~ 2022 2023 2024 2025 2026 # of meetings held with Number of meetings held with Meeting Annually ZNPH I 0 2 2 2 2 policy and decision makers policy and decision makers/Total reports on OH Surveillance number of meetings planned # of data quality audits Number of data quality audits Data quality Annually ZNPH I 0 l l l l conducted conducted/Number of data audit reports quality audits planned # of stakeholder workshops Number of stakeholder Stakeho lder Annually ZNPH I 0 2 2 2 2 on OH policy and guidelines workshops conducted on Workshop conducted OH policy and guidelines/ reports on Total number of stakeholder OH policy and workshops planned guidelines # of workshops conducted Number of workshop conducted Workshop Annua lly ZNPHI 0 2 0 0 0 to develop a One health list to develop a One health list of reports of priority Zoonotic Diseases priority Zoonotic Diseases/Total number of planned workshops to develop a One health list of priority Zoonotic Diseases 60 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ~ ~~ ~.--1~ "~ •f f -~\!Jf~•~t ~ ~ a: - Lill ;;s ·d , _~ ~ 2022 2023 2024 2025 2026 # of Training Needs NumberofTraining needs Training Annually ZNPH I 0 l l l l Assessment conducted on assessments conducted on OH Needs O H surveillance survei ll ance/Total number of Assessment Training Needs assessments reports on O H planned on OH survei llance survei llance #of trainings on OH Number of trainings on OH Training Bi-Annual ZNPH I 0 2 2 2 2 surveillance conducted at surveill ance conducted at all Reports all levels levels/Total Number of trainings on OH Planned on O H survei llance at all Surveillance levels at all Levels # of Surveys conducted Number of Surveys conducted to OH Status Annua lly ZNPHI l 2 2 2 2 to determine O H status in determine OH status in Zambia/ Survey Zambia Total Number of Surveys Planned Reports to determine OH status in Zambia # of Mapping and capac ity Number of Mapping and Mapping Annually ZNPH I 0 l l l 0 assessments of existing capacity assessments of and capacity Laboratories across the existing Laboratories across assessment sectors conducted the sectors conducted/Tota l reports Number of Mapping and capacity assessments of existing Laboratories Planned across the sectors. 61 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ,Qi ,~, ~ a ;~ OUtpUt lnqi~t J111~lqat0,t ,itefinitiM s .a,,.u r 11; .e ~,/ ~r:tt.:N L ead 'liAROET$ .MQV 2022 2023 2024 2025 2026 # of laboratories linked to Number of laboratories linked to Consultancy Annually ZNPH I 0 0 0 l l create a network create a network/Total number of report/ A laboratories planned to be linked functional laboratory network Availability of a multi-sector Laboratory Courier System A Functional Annually ZNPH I 0 0 l l l laboratory courier system Established multi-sector laboratory courier system To strengthen and # of personnel trained in Number of laboratory personne l Training Bi-Annual National 0 l l l l establish laboratory specific diagnostics at all trained in specific diagnostics/ reports on Food capacity to diagnose levels Total number of lab personnel specific priority zoonotic diseases p lanned to be trained Diagnostics and public health events Number of SOPs developed, Number of SOPs developed, SOPs Annually Ministry 0 4 4 4 4 at all provincial levels by harmonized and reviewed harmonized and reviewed for Ava ilable of 2026 across all OH sect ors zoonotic diseases/Total Number Fisheries of SOPs Planned to be developed, and harmonized and reviewed for Livestock zoonotic diseases 62 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ~ ~~ ~.--1~ "~ •f f -~\!Jf~•~t ~ ~ a: - Lill ;;s ·d , _~ ~ 2022 2023 2024 2025 2026 # of laboratories equipped Number of laboratories equipped/ Inventory Annually ZNPH I 0 l l l l with equipment and Total number of laboratories of lab supp lies Planned to be equipped equipment # of Laboratories Number of laboratories renovated Infrastructure Annually ZNPHI 0 l l l l Infrastructure renovated or or constructed/Tota l number reports Constructed of laboratories Planned to be renovated or constructed # of Laboratory Diagnostic Number of Laboratory Laboratory Bi-annual ZNPHI 0 0 2 2 2 Mentorship trainings mentorship trainings conducted/ Mentorship conducted at all levels Total number of Laboratory Training Diagnostics mentorship trainings reports planned # of trainings conducted Number of QMS trainings QMS training Bi-annual ZNPHI 0 0 0 0 2 in quality management conducted/Total number of reports system at all levels planned QMS trainings # of proficiency testings Number of Proficiency testing Proficiency Annua lly National 0 0 2 2 2 conducted conducted/Tota l number of Testing Food planned Proficiency testings reports 63 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK D a t a Objective Output Indicator lndiQator definition sources/ Frequency L e ad TARGETS MoV 2022 2023 2024 2025 2026 Theme: Preparedness and Response Cioal: A Functional One Health Surveillance System to contribute to the reduction of Zoonotic Diseases and other public health events To strengthen capacity for # of multi-disciplinary number of emergency response Meeting Annually ZNPH I 0 l lO 58 58 preparedness to respond emergency response teams teams created /planned minutes and to Zoonotic diseases, at all levels with TORS reports public health events of # OH HR surge activities Number of OH HR surge strategic Meeting Annually ZNPH I 0 l l l l known and unknown for emergency response activities conducted/Total minutes and etiology at all levels by conducted number planned reports for the 2026 OH HR surge strategic plan Proportion of emergency funds used to respond to Contingency Annual ly ZNPH I l 4 4 4 4 funds accessed by al l sectors outbreaks/ Total funds available plan and sectora l reports proportion of EPR and RRT Number of EPR and RRT teams # of tabletop Bi- annually ZNPHI 0 200 200 120 90 teams trained using OH trained/Total# of EPR and RRT Training approach at the subnational teams reports level simulation exercises Number of tabletop # of field Reports Quarterly ZNPHI 0 4 4 4 4 conducted simulations conducted/ planned 64 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ~ ~~ ~.--1~ "~ •f f -~\!Jf~•~t ~ ~ a: - Lill ;;s ·d , _~ ~ 2022 2023 2024 2025 2026 simulation exercises Number of field simu lation Reports Annually ZNPHI 0 l l l l conducted exercises conducted/ planned To strengthen Availabi lity of guidelines, # of guidelines, SOPs and Reports Annually ZNPHI 0 l l l l coordination of SOPs and contingency plans contingency plans/#planned emergency preparedness and response to public health events among relevant ministries and agencies by 2026 65 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ,Qi ,~, ~ a ;~ OUtpUt lnqi~t J111~lqat0,t ,itefinitiM s .a,,.u r 11; .e ~,/ ~r:tt.:N L ead 'liAROET$ .MQV 2022 2023 2024 2025 2026 # of contingency plans number of contingency plans/ Meeting Quarterly DMMU 0 4 4 4 4 reviewed and updated Total number of contingency minutes and plans available reports Availabi lity of PHEOC This indicator assesses the Inventory Annually ZNPH I 0 l 0 0 0 equipment (software, avai lability of PHEOC equipment reports furniture, TV monitors, etc) at provincial levels. Number of provinces and # of provinces and Districts Sensitization Annually ZNPH I 5 63 58 0 0 Districts Sensitized on the Sensitized on the creation of reports creation of PHEOCS for PH EOCS for emergency response emergency response # of provinces with PHEOCS # of Provincial PHEOCS Presence Annua lly ZNPHI 0 l 0 0 0 established/Total number of of PHEOCS provinces structures Proportion of staff trained in # of staff trained/Total# of Training Annually ZNPH I 0 l l l PHEOC SOPS and guidelines PHEOC staff reports Availability of Data base on This indicator assesses the Data base of Annually ZNPHI 0 l 0 0 subject matter expert Avai lability of the database for experts subject matter expertise Ensure effective # of training held for # of trainings conducted/# Training Annually ZNPHI 0 l l l l multisectoral EPR stakeholders on multi- planned reports committee and RRT at all sectoral EPR committee and levels by 2026 RRT at all levels # of Risk assessment of # of risk assessments Risk Bi- annually DMMU 0 2 2 2 2 potential hazard conducted conducted/# planned assessment reports 66 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ,Qi ,~, ~ a ;~ OUtpUt lnqi~t J111~lqat0,t ,itefinitiM s .a,,.u r 11; .e ~,/ ~r:tt.:N Lead 'liAROET$ .MQV 2022 2023 2024 2025 2026 Theme: Advocacy Communication and Training Cioal: Enhance awareness on One Health for professionals, policy-makers and the, community To develop capacity # of meetings held to review # of meetings held/# of meetings meeting Annually MoH/ 0 2 0 0 2 for OH advocacy and the health communication planned reports and ZNPH I communication programs strategy for incorporation minutes at all levels of government of OH communication and and among stakeholders advocacy principles by June 2026 # of workshops held to #of workshops held/# planned Annually MoH/ 0 2 2 2 2 disseminate the updated ZNPHI communication and Advocacy strategy # of meetings held to develop One health advocacy and communication packages. 67 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ~ ~~ ~.--1~ "~ •f f -~\!Jf~•~t ~ ~ a: - Lill ;;s ·d , _~ ~ 2022 2023 2024 2025 2026 # of meetings held/# of meeting reports and minutes Bi- annual MoH/ZNPHI 0 2 2 2 2 meetings planned # of meetings held to # of meetings held/# of meetings meeting Annually MoH/ 0 2 2 2 2 develop sensitization planned to develop and #of reports, ZNPHI materials (print, social materials developed/#planned minutes and media, mass media) materials developed # of One health advocacy #of printed and published materials Annua lly MoH/ 0 3 3 3 3 and communication materials/planned printed and ZNPH I materials printed and published published # of dissemination and #of meetings held/#planned meeting Bi- annua l MoH/ 0 2 2 2 2 sensitization including reports and ZNPHI media houses conducted minutes To increase the # of desk review meetings # of desk reviews conducted/# Desk review Annually MoH/ 0 l 0 l 0 knowledge base by conducted (including planned report ZNPHI incorporating focused co ll ecting preliminary data) on One Hea lth initiatives of preservice and in service by incorporating in pre- curricular to examine One service health content 68 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ~ ~~ ~.--1~ "~ •f f -~\!Jf~•~t ~ ~ a: - Lill ;;s ·d , _~ ~ 2022 2023 2024 2025 2026 # of meetings held # of meetings held to develop reports and Annually MoH/ 0 2 0 2 0 to develop One materials/# planned minutes ZNPHI Health advocacy and communication training materials including on line materials # of curricular review # of review workshops held/# reports and Annually MoH/ 0 l 0 l 0 workshops to integrate One planned minutes ZNPHI health held To in crease awareness on # of meeting held to # of training institutions that have meeting annually MoH/ 0 l l l l One Health to policy and conduct One Health same curricu la/# of common reports and ZNPHI decision makers by July sensitization for policy and training materials developed for minutes 2026 decision makers their trainees # of knowledge baseline # of institutions and tutors meeting annually MoH/ 0 l l l l survey conducted for trained/# planned reports and ZNPH I selected staff minutes # of One health ToT # ofToTs/# planned meeting annua lly Mo H/ 0 l l l l conducted reports and ZNPHI minutes # of dissemination meetings # of meetings held/# planned meeting annually MoH/ 0 l l l l held for policy makers on reports and ZNPHI One Health components minutes 69 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ,Qi ,~, ~ a ;~ OUtpUt lnqi~t J111~lqat0,t ,itefinitiM s .a,,.u r 11; .e ~,/ ~r:tt.:N Lead 'liAROET$ .MQV 2022 2023 2024 2025 2026 Theme: Research Cioal: Optimize the health of human, animal and environment through evidence based OH research To align In stitutional # of MoUs, MTA & DTAs Number of MoUs, MTAs & DTAs, Current MoUs, Bi-annual ZNPH I 0 2 2 2 2 collaborative Research on developed and signed developed and signed/Tota l MTAs/DTAs, One Health among research institutions number of MOU planned research materials & Records of MoUs, MTAs, DTAs available Availabi lity of data-base The indicator assess the Actual Annua lly ZNPHI 0 l l l l of inventory on existing availabi lity of data base of databases institutional research institutional research capacity of each capacity co ll aborating institution 70 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK Availabi lity of lab equipment The indicator assess the Stock Bi -annual ZNPH I/ 0 2 2 2 2 and supplies equipment- Inventory and registers UNZA Inventory for Consumables as from each planned col laborating Number of training report on types, modules and names Number of training reports, Training Materials from Quarterly UNZA 0 4 4 4 4 modules and personnel co llaborating In stitutions trained as planned Availability of harmonized This indicator assess the Policy and Annually ZNPH I 0 l l l l research policies and avai lability of Harmonized policies legislative regulations and regulations in research documents in place To coordinate the # of consultative meetings establishment of One held and National O H Health research themes among all institutions by 2026 71 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK Number of Consultative Inventory of Research Th emes Monthly ZNPHI 7 72 72 72 72 Meetings Held /Tota l within each collaborative number of meetings In stitution # of co llaborative One Number of O H research proposals Existing Annually ZNPH I 0 7 7 l l Health research proposals developed & submitted/ Tota l Grants & among institutions number planned Fully funded developed proposals # of O H research workshops held Number of Workshops held/ Workshop Reports Quarterly UNZA 0 4 4 4 4 Total number of workshop planned # of Joint One Hea lth Number of joint One Hea lth Reports on Bi-annual ZNPHI 0 2 2 2 2 Research activities research activities held/ Tota l O H Research number of research planned activities To develop and enhance # of conference proceedings Number of Conference Published Bi-annual UNZA 0 2 2 2 2 existin g communication held proceedings Published/ Tota l Conference channels between One number conferences planned proceedings Health researchers and & Published policy makers by 2026 Research Reports 72 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK # of publications of One Number of O H Research O H research Quarter ly UNZA 0 4 4 4 4 Health research findings in published / Tota l number of O H findings/ local and international open research conducted websites # of O H Meetings, Number of meetings, workshops Policy Briefs, Annua lly ZNPHI 0 l l l l workshops and and presentations held / Tota l Reports, presentations organized for number of meetings planned Presentations policy makers 73 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK

5.1 Two-Year Implementation Plan The implementation plan will cover a period of two years Two-Year Implementation Plan ObjectiVes Activities Yeer:2022 Ve;ilr: 2023 Year: 2024 - 2026 QTR4 QTRl QTR2 QTR3 QTR4 2024 2025 2026 Theme: Governance and Coordination Cioal: To have a functional and well-coordinated One Health national program To strengthen legal framework ( policy Conduct orientation meetings 0 X X X X X and legislation) on One Health across at national level on OHA different sectors by 2026 Conduct orientation meetings 0 X X X X at sub national levels on OHA Conduct a review of Acts of X different pieces of Legis lature Draft a policy framework for X OHA coordination Drafting of legislation and X regulations on O HA Legal Framework Operationa l X Plan on O HA in p lace and implemented To ope rationalise the national One Establish One Health focal X X X X X X X Health coord inatin g mechanism by point or O H desks in line 2026 ministries 74 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • ,-,_,," ~-· Meeting t o nominate and ~-- QTR4 ·, ~--~~ QTRl X - ·~ ·•. ,- QTR2 X QTR3 X QTR4 X ~~ - ~ 2024 2025 2026 designate members of the OHSC Meeting to nominate and X X X X designate members of the OHCP Meetin g to nominate and X designate members of the OHTWG Workshop to develop terms of X X X X X X X reference for the OHSC, O HCP, and O HTWG To mobilize operationa l resources in Conduct O H advocacy X X X X X X X order to support the activities of the meetings for government national One Hea lth strategic plan budget allocation Conduct advocacy meetings for X X X X X X X increased partner funding to support O H activities Develop OH financing concept X X X X X X X note and proposals 75 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ;~ ~- ~2f4D. ~ rl02J QTR4 QTRl QTR2 QTR3 QTR4 \fan2024-~ 2024 2025 2026 Theme: Surveillance Cioal: A Functional One Health Surveillance System to contribute to the reduction of Zoonotic Diseases and other Public Health Events To achieve one health surveillance Assessment of the existing X X X X among key stakeholders for early surveillance systems across all detection of public health events by the sectors the end of 2026 Conduct Workshops with X X X stakeholders to identify the data needs for integrated surveillance system Develop an integrated X X X X X survei llan ce system for the highest priority zoonotic diseases and public health threats Review of the OH survei llance X X System 76 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • ,-,_,," ~-· Advocacy meetings with policy ~-- QTR4 ·, ~--~~ QTRl X - ·~ ·•. ,- QTR2 QTR3 X QTR4 ~~ - ~ 2024 X 2025 X 2026 X and decision makers on O H Surveillance Stakeholders engagement X X X X X Workshops on OH Surveillance policy and guidelines Workshop to develop One X X health li st for priority zoonotic diseases Tr aining Needs Assessments on X X X X OH survei llan ce Trainin g Workshops on OH X X X X X Surveillance at all levels Cond uct a baseline and end line X X X X survey on OH implementation in Zambia To strengthen and estab li sh laboratory Mapping of existing laboratory X X capacity to diagnose priority zoonotic facilities and capacities across diseases and public health even t s at all the sectors provincial levels by 2026 Establish a laboratory network X X Establish a laboratory courier X X system for samples Tr aining of laboratory personnel X X X in specific diagnostics 77 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • ,-,_,," ~-· Works hops to develop, ~-- QTR4 ·, ~--~~ QTRl - ·~ ·•. ,- QTR2 QTR3 QTR4 ~~ - ~ 2024 X 2025 X 2026 X harmonize and review SOPs for priority zoonotic diseases across all sectors Equipping of laboratories X X X Infrastructure development X X X X Laboratory Diagnostic X X X Mentorsh ip trainings Trainings in quality X X X management system Implementation of proficiency X X X testing 78 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK Q~~ -~- -~-=~ -~~~ r.t.~ ~#):~ QTR4 QTRl QTR2 QTR3 QTR4 2024 2025 2026 Preparedness and Response Cioal: To strengthen preparedness planning and improve the ability to respond to public health threats through the One health approach at all levels (community, district, provincial and national) To strengthen capacity for Establish a coordinated and X X X X preparedness to respond to Zoonotic functional multi-disciplinary diseases, public health events of known EPR teams with TORS and unknown etiology at all levels by Operationalize access to X X X X 2026 emergence funds to support all relevant sectors to carry out immediate in vestigations in public health events Conduct trainings in EPR and X X X X X RRTteams using OH approach at sub-national level To conduct tabletops X X X X X X X simulation exercises To conduct field simulation X X X X exercises 79 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • To strengthen the coordination ,-,_,," ~-· Develop integrated guidelines ~-- QTR4 ·, ~--~~ QTRl X - ·~ ·•. ,- QTR2 QTR3 QTR4 ~~ - ~ 2024 2025 2026 of emergency preparedness and SOPs and contingence plans response to public health events for coordinated emergency among relevant ministries and preparedness and response of agencies by 2026 public health events Review the contingence plans X X X X developed Procure equipment and X software for PHEOC, develop and install PHEOC dashboard for response tracker Conduct sensitization of X X X X X X X X Provinces and districts in PHEOC Establishment of Provincial X PHEOC Trained PHEOC staff in X X X X established plans and procedures Create a data base for subject X matter experts on priority zoonotic diseases and other public health threats 80 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • Ensure an effective multisectoral EPR ,-,_,," ~-· Conduct training of ~-- QTR4 ·, ~--~~ QTRl X - ·~ ·•. ,- QTR2 QTR3 QTR4 ~~ - ~ 2024 X 2025 X 2026 X committee and RRT at all levels by 2026 stakeholders into multisectoral EPR committee and RRT at all levels Conduct risk assessment in X X X X potential hazard areas Develop risk communication X X X X plans based on priority Zoonotic diseases Preposition of emergency X X X X supplies 81 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ;~ ~- ~2f4D. ~ rl02J QTR4 QTRl QTR2 QTR3 QTR4 \fan2024-~ 2024 2025 2026 Theme: Advocacy, Communication and Training Cioal: Enhance awareness on One Health for professionals, policy-makers and the community To develop capacity for OH advocacy Hold meetings to review X X X X X X and communication programs at the health communication all levels of government and among strategy for incorporation of O H stakeholders by June 2026 commun ication and advocacy principles (the meetings can bring together a group of multi- sectoral and muti -deciplinary professionals) Hold workshops to disseminate X X X X X X X the updated communication and Advocacy strategy 82 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • ,-,_,," ~-· Hold meetings to develop ~-- QTR4 X ·, ~--~~ QTRl - ·~ · •. ,- QTR2 X QTR3 QTR4 X ~~ - ~ 2024 X 2025 X 2026 One health advocacy and commun ication packages Hold meetings to develop X X X X X X X sensitization materials (print, socia l media, mass media Print and publish One health X X X X X X X advocacy and communication materials Conduct dissemination X X X X X and sensitization meetings including for media houses To increase the knowledge base by conduct a desk review X X X X X incorporating focused on One Health (including collecting initiatives by incorporating in pre - preliminary data) of preservice service. and in-service curricular to examine One health content 83 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • ,-,_,," ~-· Hold a meeting to develop ~-- QTR4 ·, ~--~~ QTRl - ·~ · •. ,- QTR2 X QTR3 QTR4 X ~~ - ~ 2024 X 2025 X 2026 X One Health advocacy and commun ication training materials inc ludin g on lin e materials curricu lar review workshops to X X X X X integrate One health held knowledge baseline survey for X X X X X selected staff conducted hold a meeting to conduct One X X X X X X X health ToTs 84 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK Ob~ves ActMties year-:~~ y~r.202l Year: 2024 - ~26 QTR 4 QTRl QTR 2 QTR3 QTR 4 2024 2025 2026 To increase awareness on One Hea lth Ho ld a meeting to conduct One X X X X X X X to po licy and decision makers by Ju ly Hea lth sensitization for po licy 2026 and decision makers Hold a dissemination meeting X X X X X X X for po licy makers on One Hea lth components Objectives Activities Vear: 2022· ¥eart2023 Vear: 2.024 - 2026 QTR 4 QTRl IQTR 2 IQTR 3 IQTR 4 2024 I2025 I2026 Theme: Research Cioal: Optimize the health of human, animal and environment through evidence based OH research 85 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • To align In stitutional co ll aborative ,-,_,," ~-· Develop, review and revise ~-- QTR4 ·, ~--~~ QTRl X - ·~ ·•. ,- QTR2 QTR3 X QTR4 ~~ - ~ 2024 X 2025 X 2026 X Research on One Health MoUs and MTAs/DTAs to include One Health among relevant research institutions and laboratories services Assess inventory on existing X X X X capacity and develop databases Procure laboratory requisites based on research needs X X Training of research teams in X X X X X X X One Health themes Hold meetings to Harmonize In stitutional policy and regulations on utilization of laboratory X X X X services towards One Health research To coordinate the establishment of Hold workshops and Trainings X X X X X X X One Health research themes among all to Streamline co ll aborative One institutions Health research themes Develop co llaborative joint OH X X X X research proposals Quarterly OH coordination X X X X X X X workshops Conduct One Health Research X X X X X X X 86 / / / 5. MONITORINGAND EVALUATION IM&EI FRAMEWORK ' •• • • To develop and enhance existing ,-,_,," ~-· Participate and present One ~-- QTR4 ·, ~--~~ QTRl X - ·~ ·•. ,- QTR2 QTR3 QTR4 X ~~ - ~ 2024 X 2025 X 2026 X communication channels between Health research findings in One Health researchers and policy existing fora (NRIS, NSTC-SRF, makers ZHRC, ASVMSS etc.) Utilize socia l media and conventional media agencies/ websites to disseminate One Health research findings to the genera l public Organize policy dialogue and X X X X discussions among policy makers on policy briefs 87 / / / LIST OF CONTRIBUTORS List of contributors Workshop Attendance list NAME POSITION CONTACT 1 Prof Roma Chilengi DG, ZNPHI ZNPHI roma .chilengi@znphi.co.zm 2 Dr Geoffrey Mainda AMR Animal Health Coordinator AMRCC/FAO gmainda@hotmail.com 3 Dr Christine lnambao Senior Veterinary Officer. MFL namukoloim@gmail.com 4 Dr Chizimu Joseph AMR focal person & Coordinator ZNPHI chizimuyjoseph@yahoo.com 5 Dr Raymond Hamoonga One Health Lead, ZNPHI ZNPHI raymond .hamoonga@znphi.co.zm 6 Dr Geoffrey Mainda AMR Animal Health Coordinator AMRCC/FAO gmainda@hotmail.com 7 Ms Willingness Zyambo A.g . Quality Manager FDCL zwillingness@gamil.com 8 Ms Ngala Florence Chief.EHO MOH ngalaflo@gmail.com 9 Ms Regina Lubasi Chief.EHO MOH regina.lubasi@gmail.com 10 Dr Paul M.Zulu Infectious Disease Specialist ZNPHI drzulup@gamail.com 11 Mr Chazya Simumba Medical Laboratory scientists ZNPHRL chaksomnet@gmail.com 12 Dr Chilufiya Mulenga FETP-Resident ZNPHI chilufyam2007@gmail.com 13 Ms Namundi Siwale IMO ZNPHI stephaniesiwale@gmail.com 14 Dr.Muzala Kapina Head, SDI ZNPHI muzalakapina@gmail.com 15 Prof Musso Munyeme Lecturer -UNZA UNZA mussomunyeme@gmail.com 16 Dr Walter Muleya Lecturer -UNZA UNZA muleyawalter@gmail.com 17 Dr.Boster Dearson Siwla Director-RPA RPA boster.siwila@rpa.gov.zm 18 Ms Kabukabu Akufuna Snr. Environmental Officer ZNPHI kabuakufuma@gmail.com 19 Ms Evidence Chooka PA ZNPHI el iza bethchooka@ga mi I.com 20 Mr Mushaukwa Kabuku Director RPA mushaukwakl@yahoo.com 21 Dr Christine lnambao Senior Veterinary Officer. MFL namukoloim@gmail.com 22 Dr Ricky Chazya Epidemiologist MFL rchazya@yahoo.com 23 Ms Carol Mufana Workforce develop-Advisor UKHSA carol.mufana@ukhsa.gov.uk 24 Mr Brian Siakabeya PSWMO MLGRD bsiakabeya@yahoo.com 88 / / / LIST OF CONTRIBUTORS 25 Ms Chipo Mwela Surveillance & IPC WHO cmwela @who.int 26 Dr Theodora Knight - Jones COHESA Lead ILRI T.Knight-Jones @cgiar.org 27 Ms Shikaseba Euniverse M&E officer ZNPHI eunichindongo@gmail.com 28 Mr Wesley Mwambazi Governance Specialist ZNPHI - 29 Dr Jonas Hines USCDC 30 Mr Yahya Kand eh ACDC 31 Ms Nachombe Kandila MLGRD 32 Ms Elizabeth Nyemba Musa MLGRD 33 Dr Joseph Pett Country Lead, UKHSA UKHSA Joseph.pett@ukhsa.gov.uk 34 Ms Hillary Chibiya FDL 35 Mr Rodwell Chandipo ZEMA 36 Ms Albertina Ngoma Moraes Knowledge Translation Officer ZNPHI 37 Ms Juanita Ntemba Mumba MoH 38 Dr Davie Simwaba Public Health Specialist, EBS ZNPHI 39 Ms Otridah Kapona ZNPHIRL Lead ZNPHI 40 Mr Obrie Chewe Epidemiologist ZNPHI 41 Dr Jackson Katampi Wildlife Veterinarian DNPW 42 Dr Bengu Said UKHSA Healthy animals UN (~) (~~\ World Health ((cj~D World Organisation for Animal Health environment ~~J Organization ~ Foundeda,OIE programme THE UK Health tfiJa. ofFoodtheandUnitedAgriculture WORLC Security \JI Nations Organization BANK Agency ~ ~ p ILRI Z N PH I ZAMBIA NATIONAL INTERNATIONAL LIVESTOCK RESEARCH INSTITUTE PUBLIC HEALTH INSTITUTE