Anthrax outbreak surveillance and response in Arba Minch, Ethiopia: After-action review

Background: Anthrax is a serious infectious disease affecting animals and humans and remains a public health issue in developing countries. Aim: This study assessed the overall anthrax outbreak response and identified strengths, challenges, and best practices during surveillance, preparedness, and response in Ethiopia from May 2022 to July 2022. Setting: Conducted in Arba Minch Town, Gamo Zone, Southern Ethiopia. Methods: An after-action review (AAR) using qualitative methods was performed. Experts included clinicians, public health professionals, and government officials were involved in the outbreak response. Data were collected via focus group discussions, key informant interviews, and observations, recorded digitally. Thematic analysis was used. Results: Strong stakeholder engagement and coordination were evident, with mass vaccinations aiding control. However, gaps included unprepared logistics, poor communication, and insufficient training. Despite anthrax being immediately notifiable, weaknesses in surveillance detection and reporting were found. Coordination was effective with intersectoral collaboration and commitment, leading to a commendable, lifesaving response once initiated. Conclusion: The study revealed effective engagement and coordination but identified gaps in preparedness and communication. Addressing these through capacity-building and stronger preparedness is crucial for future outbreak management. Contribution: This study provides valuable evidence-based insights to improve health preparedness and response in the African context.