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South Africa gets “PRET^[1]“. As part of South Africa’s ongoing efforts to prepare for future respiratory pathogen pandemics, the country is developing a ³Ô¹ÏÍøÕ¾ Respiratory Pathogen Pandemic Preparedness Plan. The Plan outlines key activities for preparedness, response and recovery, aligning with the World Health Organization’s (WHO) initiative.

From 19–21 August 2024, multidisciplinary and multilevel stakeholders convened in Johannesburg, South Africa, to participate in a tabletop simulation exercise aimed at testing and refining the draft ³Ô¹ÏÍøÕ¾ Respiratory Pathogen Pandemic Plan. This event was organized by the ³Ô¹ÏÍøÕ¾ Department of Health, in collaboration with the ³Ô¹ÏÍøÕ¾ Institute for Communicable Diseases, WHO, the International Organization for Migration, and Doctors Without Borders. Attendees included representatives from various sectors and organizations including The Office of the Presidency, the ³Ô¹ÏÍøÕ¾ Disaster Management Authority, South Africa Military Health Services, the Department of Agriculture, Land Reform and Rural Development, Clinton Health Access Initiative, Jhpiego and others.

Simulation exercises are essential tools for countries to test and validate their preparedness and response mechanisms for public health emergencies, including epidemics and pandemics. This tabletop simulation exercise, known as Exercise PanPRET-1, engaged stakeholders in a discussion-based setting where they responded to a fictional scenario. The scenario unfolded in four stages, beginning with the outbreak of a novel respiratory virus in another country, progressing to the declaration of a pandemic, and concluding with the end of the pandemic. At each stage, participants were presented with injects and accompanying questions designed to assess the functionality of preparedness and response systems based on the draft plan.

Several key learnings emerged from this exercise. The importance of strong multisectoral coordination and communication mechanisms, even during peacetime (the interpandemic period), was underscored. One of the notable outcomes was the development of actionable recommendations aligned with the and the Health Regulations core capacities. These recommendations will be integrated into the next iteration of South Africa’s pandemic preparedness plan.

The three-day event provided a valuable platform for participants to reacquaint themselves with the draft plan, share insights and expertise, and collaboratively develop actionable recommendations to finalize the ³Ô¹ÏÍøÕ¾ Respiratory Pathogen Pandemic Preparedness Plan. Employing a whole-of-government, whole-of-society approach, South Africa remains committed to proactively prepare for future respiratory pathogen pandemics.

Some reflections from the participants at the exercise:

The simulation exercise has been extremely valuable to ensure that pillar 10 of the Presidential Health Compact – Pandemic Prevention, Preparedness and Response (PPPR) results in adequate preparedness for the next pandemic. Stakeholders tabled recommendations to continue to refine the country’s PPPR strategy and strengthen health systems as an essential foundation. The Presidency remains committed to leading the country’s efforts and aligning with regional and global efforts.

• Dr Lwazi Manzi, Pillar 10 (Pandemic Prevention, Preparedness and Response) Lead of the Second Presidential Health Compact, Office of the Presidency, South Africa

The pandemic simulation exercise was a great opportunity to share South Africa’s progress in pandemic planning and to test and evaluate our country systems. The more than 100 participants are testament to the value placed on pandemic preparedness. The quality of discussions and outputs will strengthen and catapult the next draft of the country’s pandemic preparedness and response plan.

• Dr Wayne W. Ramkrishna, Deputy Director, Zoonotic Diseases, Communicable Diseases Directorate, ³Ô¹ÏÍøÕ¾ Department of Health, South Africa

An immense effort has been made by NDOH, supporting sectors and partner organizations to review the Pandemic Preparedness Plan for Respiratory Pathogens, to identify gaps and make recommendations for improvement. The knowledge, skill and energy in the room was incredible. MSF remain a committed partner on this journey toward preparedness.

• Ms Camren McAravey, Country Operational Representative, Doctors without Borders

Recent global and country reviews into the response to pandemics of influenza and COVID-19 and outbreaks like cholera have all underscored the need for countries to invest in strengthening capacities for pandemic preparedness. WHO commends the South Africa Government for leading efforts to strengthen national capabilities for pandemic preparedness and response. We remain committed as WHO to walk the talk in support of Government efforts in this regard.

• Dr Joseph Wamala, Epidemic Preparedness and Response Team Lead, WHO Country Office South Africa

The recent simulation exercise in South Africa is a clear example of how multisectoral engagement is cardinal in pandemic preparedness. By bringing together diverse stakeholders from across sectors, South Africa has set an example in the African region. It’s only through such collaborative efforts that we can build resilient systems capable of responding effectively to future pandemics.

• Dr Lionel Nizigama, Pandemic Influenza Preparedness Technical Officer, WHO Regional Office for Africa

[1] PRET is a French word which means “ready” in English. It is also the acronym for the Preparedness and Resilience for Emerging Threats initiative.