Epidemic and pandemic preparedness in the MENA region: A descriptive analysis of stakeholder distribution, patterns, and regional variation

Epidemic and pandemic preparedness relies on multi-sectoral coordination, a competent workforce, and well-defined preparedness functions. In the Middle East and North Africa (MENA) region, preparedness is shaped by diverse health system capacities, political contexts and recurrent crises. Despite recurrent outbreaks in the region, limited regional-level evidence exists on who is involved in preparedness and how different roles are distributed across preparedness domains, as well as countries and income settings. This cross-sectional stakeholder mapping study identified stakeholder roles, affiliations, and organizations involved in epidemic and pandemic preparedness across 22 MENA countries. Using publicly available online sources, stakeholder roles were systematically identified and categorized according to the European Centre for Disease Prevention and Control (ECDC) public health emergency preparedness framework. Records were analyzed by preparedness domain, workforce category, organizational affiliation, country, income level, and gender. A total of 3555 stakeholder roles were identified across the region. Roles were predominantly classified under coordination and communication (38.4%) and health services (32.0%), while emergency risk communication (4.1%) and policy development, adaptation, and implementation (6.6%) were the least represented domains. Emergency management roles constituted the largest workforce group (42.6%), followed by public health professionals (28.3%) and clinicians (19.4%). Significant variation was observed across country income levels, including differences in preparedness domains, workforce categories, organizational affiliation, and gender distribution. Records associated with women accounted for 31.5% of the total roles, with their representation varying across income groups. Preparedness-related roles were identified across the MENA region but vary in their distribution across domains, workforce categories, and countries. The greater representation of records in operational roles, alongside limited representation in policy development and emergency risk communication, highlights differences in the publicly identifiable preparedness landscape across functions. These findings provide a regional descriptive overview that can inform future validation, stakeholder engagement, and capacity-building efforts across the MENA region.