The African Union Member States (AU MS) face significant health threats, particularly infectious diseases, due to its overstretched public health systems and infrastructure. Despite Its remarkable improvements and growth in health sector service delivery in recent times, the African continent remains under-resourced. At the same time, the continent bears over 24% of the global disease burden while providing only 3% of the global health workforce and spending less than 1% of the world’s financial resources on health.Emerging and re-emerging infectious diseases, such as Ebola Virus Disease (EVD), Marburg, Rift Valley fever (RVF), Crimean-Congo Hemorrhagic Fever (CCHF), and COVID-19, alongside natural disasters and humanitarian crises, continue to pose substantial health, security, and economic challenges in Africa. The high mobility of people, animals, and goods across the continent in light of globalization exacerbates the spread of infectious diseases through formal and informal Points of Entry (PoEs), underlining the necessity for robust early detection of infectious diseases, emergency preparedness and response, infection control programs and enhanced capacity for healthcare workers at national and regional levels which will improve the early warning and response systems. Africa Centres for Disease Control and Prevention (Africa CDC), the public health institution of the African Union, recognizes the critical need to address health challenges and emergencies effectively across the continent. In response to these health challenges Africa CDC has developed a continental strategic framework to strengthen cross-border surveillance, coordination, and information sharing among AU MS. This continental strategic framework is designed to address the increasing frequency and magnitude of cross-border public health threats in Africa, which are driven by population movements, globalization, and human, animal and environmental interactions within the ecosystems. The framework aims to strengthen and improve cross-border surveillance, coordination, collaboration, and information sharing among AU MS, focusing on points of entry (PoE), including airports, seaports, land borders and adjoining communities.The key objectives of the framework include enhancing coordination and governance, building capacities at PoEs, improving data sharing mechanisms, strengthening risk communication, and monitoring population mobility patterns across AU MS. This Africa CDC strategic framework will also bolster the continent’s preparedness and response to health emergencies, contributing to the overall resilience and robustness of public health systems in the AU MS A review of existing cross-border surveillance, coordination, collaboration, and information sharing in Africa reveals a rather complex landscape shaped by various policy instruments, frameworks, plans, and initiatives and highlights associated challenges across the African continent.At the international level, the International Health Regulations (IHR) provide a foundation for detecting and responding to public health emergencies by strengthening and improving surveillance capacities at PoEs and fostering regional collaboration and international cooperation. It underscores the need for a continental strategic framework within the AU. In the same vein, the Global Framework for the Progressive Control of Transboundary Animal Diseases (GF-TADs) and the Performance of Veterinary Services (PVS) tools aim to strengthen veterinary services and control Trans-boundary Animal Diseases (TADs) and zoonosis through regional and international cooperation that emphasizes the One Health approach, which integrates human, animal, and environmental health globally.At the AU level, the African Union Agenda 2063, Africa Health Strategy 2016-2030, and Africa CDC Strategic Plan 2023-2027 provide overall vision, direction, and strategic priorities and aim to enhance public health systems, strength cross-border disease management, and improve health security on the continent.A SWOT analysis of the current situation highlighted strengths, including existing policies and strong civil society engagement, and opportunities for improvement, such as strengthening PoE infrastructure and training. The analysis also highlighted weaknesses, such as underfunding, inadequate cross-border reporting, and health threats from insecurity and climate emergencies. Addressing these issues through comprehensive policy implementation, capacity building, and robust international cooperation is essential for effective cross-border disease surveillance and public health security in Africa.
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