Freetown—Sierra Leone has completed a two-day tabletop simulation exercise, held from 5–6 November 2025 at the Public Health Emergency Operations Centre (PHEOC) in Freetown. The exercise was led by the Ministry of Health through the National Public Health Agency, with technical support from the World Health Organization (WHO). Funding was provided by Gavi, the Vaccine Alliance, under the Joint Emergency Action Plan (JEAP), and the Foreign, Commonwealth & Development Office (FCDO).

The simulation brought together key actors from across the health system, including the National Public Health Agency, Ministry of Health, Ministry of Agriculture and Food Security, and Ministry of Environment and Climate Change. Facilitators, evaluators and observers were drawn from WHO, Africa CDC, HEADA, US CDC, GIZ and other partners who used the exercise to assess real-time decision-making and identify areas for improvement.

Over two days, participants engaged in a simulated outbreak scenario, “Disease X”, designed to test Sierra Leone’s ability to detect, coordinate, and respond to a rapidly evolving health emergency. The exercise assessed readiness across key functional areas including surveillance, vaccination logistics, coordination, and risk communication within the Incident Management System (IMS).

Facilitators guided participants through scenario phases that required real-time decision-making and coordination. Teams were tasked with activating the PHEOC, mobilizing responders, managing vaccine deployment, and communicating effectively with the public while countering misinformation - mirroring the complexities of a real outbreak.

During the opening the session, Robert Musoke, WHO’s Emergency Preparedness and Response (EPR) Cluster Lead, underscored the significance of such exercises in building both systems and confidence. “Simulation exercises are vital for assessing the strength of our preparedness systems and ensuring effective implementation of the International Health Regulations (IHR),” he said. “They give us an opportunity to showcase our capacity, identify bottlenecks, and apply lessons from past emergencies like Ebola, COVID-19, and Mpox.”

From the National Public Health Agency (NPHA), Dr. Momoh Vandi, Deputy Executive Director, described the exercise as a valuable opportunity to evaluate how existing systems function in practice. “We have strong teams and established procedures, but it is crucial to periodically test these systems to identify gaps and ensure we remain ready to respond swiftly and effectively to any outbreak,” he said.

Dr. Desmond Kangbai, Programme Manager for the Expanded Programme on Immunization (EPI) at the Ministry of Health, emphasized the importance of learning from the experience to improve coordination and delivery. “The real value lies in the feedback we generate,” he explained. “It helps us refine our response strategies, strengthen collaboration among partners, and ensure vaccines are delivered efficiently when and where they are needed most.”

The exercise concluded with a “hot-wash” session, where participants reflected on lessons learned and developed a national improvement plan for vaccine-preventable disease outbreak preparedness. Priority areas identified for strengthening included data-driven decision-making, rapid communication, and timely resource mobilization including for vaccines during emergencies.

Lessons from the simulation will strengthen Sierra Leone’s operational readiness for any vaccine preventable disease outbreak and enhance PHEOC operations - ensuring faster, smarter, and more effective outbreak response.

By fostering continuous learning and simulation-based training, WHO and partners are helping Sierra Leone, and the wider African region build a more resilient, agile, and responsive public health system capable of tackling emerging health threats.

As one participant aptly summarized: “Preparedness is not about waiting for the next outbreak - it’s about ensuring we are always ready when it comes.”