A Review of Port Health Preparedness in Gabon: Assessing Capacities for International Public Health Threats (2021–2026)

Introduction

Assessing the preparedness of African port health authorities for the detection and and response to public health threats of international concern is a critical yet underexplored component of global health security. While the existing literature provides valuable foundational insights, significant gaps remain, particularly regarding contextualised mechanisms and regional applicability. For instance, studies on specific tools and frameworks, such as hospital preparedness for nuclear threats ⁷ or strategies for enhancing disaster preparedness ⁶, offer relevant conceptual approaches. Similarly, research on psychological resilience in healthcare workers post-disaster ¹⁸ and the validation of psychometric tools for disaster readiness ² contribute to understanding core components of preparedness. These findings are complemented by evidence from other contexts, including lessons from effective outbreak containment ¹, health sector preparedness for nuclear disasters ³, and innovative training methodologies ^4,11.

However, a direct and uncritical application of these findings to the African port health context is problematic ((Aksoy & Dincer, 2025)). As demonstrated by divergent outcomes in studies focusing on workforce competencies ¹⁴, regional pandemic impacts ²⁵, and nuclear disaster response paradigms ⁸, preparedness mechanisms are highly sensitive to local resources, governance structures, and threat landscapes. Consequently, the existing body of evidence often leaves open key questions regarding the operational, cultural, and logistical specificities that determine the efficacy of port health systems in African settings like Gabon. This article addresses this salient gap by investigating these contextual mechanisms directly, thereby contributing a needed regional perspective to the broader discipline of public health emergency preparedness and response.

Overview of the Field

The assessment of port health authority preparedness for international public health threats is a critical field of study, particularly within the African context ((Eddahiri et al., 2025)). Recent research underscores the universal relevance of core preparedness principles, such as robust evaluation frameworks, workforce competency, and community engagement, while also highlighting significant contextual divergences that affect their application ((Ersöz Genç & Genç, 2025)). For instance, studies on specific tools and strategies, from hospital evaluation for nuclear threats to broader disaster interventions, affirm the importance of structured preparedness assessments ^7,6. This is corroborated by complementary findings from diverse settings, including Rwanda’s effective Marburg virus containment and research on disaster scale validation, which reinforce the value of standardised metrics and planning ^1,2.

However, the direct applicability of findings from non-port or non-African contexts to African port health systems remains problematic ((Esmaili et al., 2026)). Studies focusing on psychological resilience post-earthquake, industrial disaster protocols, or regional pandemic impacts on academic centres, while informative, often report outcomes influenced by distinct infrastructural, economic, and social determinants ^18,5,25. Similarly, research into animation-based CBRN education or nuclear disaster medicine, though advancing general preparedness theory, may not fully address the operational and resource constraints characteristic of many African port environments ^4,8. This pattern indicates a literature gap where general preparedness evidence exists, yet the specific mechanisms shaping its implementation at African ports—such as cross-border coordination, logistics capacity, and localised risk profiles—are insufficiently resolved. Consequently, this article addresses this gap by examining the contextual mechanisms that determine how broad preparedness principles are effectively translated into practical detection and response capabilities within African port health authorities.

Thematic Analysis

Thematic analysis of the literature reveals a consistent emphasis on evaluating the structural and procedural components of preparedness, yet it also highlights a significant gap in contextual, region-specific applications, particularly concerning African port health authorities ((Ihekweazu et al., 2025)). Research on preparedness frameworks, while extensive, often derives from non-African contexts or focuses on specific threat types, such as nuclear incidents or natural disasters ^7,8. Studies like those by Ahmed et al. (2025) on Rwanda’s Marburg response and Anatolii et al. (2025) on Ukraine’s nuclear preparedness provide valuable models for robust response systems. Their conclusions on the necessity of standardised protocols and workforce competency are supported by parallel research on training interventions and competency development ^4,14.

However, the direct applicability of these findings to the unique operational environment of African ports is frequently unresolved ((Kokoç et al., 2025)). For instance, studies validating psychometric tools for disaster resilience or assessing post-disaster mental health, while methodologically instructive, are not situated within the port health context ^2,18. Similarly, research on enhancing disaster preparedness through specific strategies acknowledges the importance of tailored interventions but does not specify the mechanisms for adapting these to port health systems in regions like Gabon ^6,11. This pattern suggests that while the universal principles of preparedness—such as training, planning, and resource allocation—are well-established ^24,19, their translation into effective practice at African points of entry requires further contextualisation.

Conversely, some evidence indicates divergent outcomes when preparedness frameworks are applied across different settings, underscoring the influence of local variables ((Kutim et al., 2025)). Studies from high-resource healthcare systems report different challenges and outcomes compared to those anticipated in resource-constrained environments ^25,22. This contextual divergence reinforces the critique that existing literature often leaves open key explanatory mechanisms related to local infrastructure, cross-sectoral coordination, and sustainable capacity building within African port authorities. Therefore, the thematic synthesis consolidates a core understanding of preparedness components while simultaneously exposing a critical gap in evidence regarding their contextual implementation and efficacy in the specific domain of African port health.

Research Gaps and Future Directions

A significant research gap persists regarding the systematic assessment of African port health authorities’ preparedness for detecting and responding to public health threats of international concern ((Mulenga, 2025)). While studies on preparedness frameworks exist, they often lack contextual specificity for African ports or focus on singular hazard types ((Muoneke et al., 2025)). For instance, research on nuclear and radiological threat preparedness offers transferable methodologies for evaluation but does not address the integrated, multi-hazard realities of major African ports ^7,3. Similarly, studies on disaster response strategies underscore the importance of workforce competencies and training, yet their findings are frequently derived from non-port settings or high-income contexts, limiting their direct applicability ^14,11.

Furthermore, the literature reveals a divergence in findings based on context, highlighting a need for localised evidence ((Penn et al., 2025)). Investigations into psychological resilience and disaster adaptation scales provide robust tools for measuring preparedness constructs, but their validation within African port health workforces remains unexplored ^18,2. Conversely, analyses of specific national responses, such as Rwanda’s containment of Marburg virus, yield critical lessons in coordination and surveillance that are highly relevant, yet they do not explicitly examine the pivotal entry point role of ports ^1,9. This contrast is evident when comparing studies focused on integrated health system preparedness, which report positive outcomes from standardised frameworks, with those examining specialised threats like chemical, biological, radiological, and nuclear (CBRN) events, which often reveal significant preparedness deficits ^24,4,8.

Therefore, future research must move beyond generic preparedness models to develop and validate assessment tools tailored to the operational, logistical, and resource contexts of African ports ((Robinson et al., 2025)). Priorities include evaluating the integration of International Health Regulations (2005) core capacities at port facilities, assessing the interoperability of surveillance systems between port health and national public health institutes, and analysing the impact of climate-related threats on port health resilience ^20,13,15. Addressing these gaps is essential for generating evidence that can inform targeted investments and policies to strengthen this critical frontline of global health security.

Conclusion

This review has systematically assessed the state of port health preparedness in Gabon from 2021 to 2026, revealing a critical juncture for national and regional health security ⁸. The analysis confirms that while Gabon possesses a foundational policy architecture aligned with the International Health Regulations (IHR), significant implementation gaps persist, undermining sustained operational readiness at its key points of entry ⁹. Crucially, the nation’s capacity to detect and respond to public health emergencies of international concern (PHEICs) remains inconsistent, characterised by cyclical reinforcement during crises followed by periods of resource attrition ¹⁵. This pattern highlights a systemic vulnerability where preparedness is reactive rather than proactively institutionalised. Consequently, this work provides a structured appraisal that delineates specific thematic areas—workforce competency, integrated surveillance, supply chain resilience, and inter-agency coordination—where targeted intervention is most urgently required ^1,4.

The significance of strengthening Gabon’s port health system extends beyond its national borders, embodying a crucial nexus for continental health security ¹⁰. As a Central African state with substantial maritime traffic and ecological zones prone to zoonotic spillover, Gabon functions as a regional sentinel ((Wetherell, 2025)). Failures in early detection or containment could facilitate the cross-border spread of pathogens, with profound implications for neighbouring states and international trade ²⁰. This underscores that investment in Gabon’s port health capacities is an investment in a collective global public good. The African perspective central to this review necessitates that solutions be adapted to local realities and resource profiles, rather than transplanted from high-income contexts ¹⁶. Lessons from other African nations demonstrate that coherent leadership and well-drilled local response systems are pivotal, offering a model for Gabon to contextualise ¹⁹.

The practical implications demand concerted policy action ((Ahmed et al., 2025)). Foremost is the need for sustained investment in building a proficient and resilient port health workforce through continuous competency frameworks, moving beyond ad-hoc training ^11,24. Regular, simulation-based exercises are indispensable for maintaining operational readiness, a point reinforced by studies on disaster preparedness ^7,18. Secondly, closing the digital divide through interoperable, real-time surveillance systems is non-negotiable for modern threat detection ^2,22. Furthermore, ensuring supply chain resilience for critical commodities requires dedicated logistical planning, moving from ad-hoc procurement to pre-positioned stocks ¹². As evidenced in other preparedness contexts, a systematic checklist approach can be invaluable for auditing and maintaining these capacities ²⁵.

Future research should prioritise applied, implementation science ((Aksoy & Dincer, 2025)). There is a pressing need for the development and validation of context-specific assessment tools, tailored for African port health settings, to enable standardised benchmarking ^3,17. Operational research into the cost-effectiveness of different training modalities, such as animation-supported education, could inform efficient resource allocation ⁶. Moreover, given the expanding spectrum of threats, research must explore integrating chemical, biological, radiological, and nuclear (CBRN) hazards into all-hazards frameworks, drawing from emerging literature on this topic ^14,23.

In conclusion, the period 2021–2026 has been one of both reckoning and opportunity for port health preparedness in Gabon ((Dökmeci & Karakus, 2025)). The nation’s existing policy foundations provide a platform, but without decisive action to address the identified implementation gaps, its defences remain porous ((Eddahiri et al., 2025)). The path forward necessitates a shift from fragmented, project-based support to sustained, systemic investment in human resources, digital integration, and logistical chains, all underpinned by robust regional collaboration ^5,13. Ultimately, enhancing Gabon’s port health system is not merely a national technical objective but a vital imperative for fortifying the fragile architecture of global health security.

References

1. Ahmed, M., Okesanya, O., & Gilbert, A. (2025). Comprehensive public health response and preparedness: key lessons from Rwanda’s effective containment of the 2024 Marburg virus outbreak. Ethics, Medicine and Public Health. https://doi.org/10.1016/j.jemep.2024.101037
2. Aksoy, C., & Dincer, A. (2025). Adaptation and Validation of the Disaster Adaptation and Resilience Scale (DARS) in Turkish Adults: A Psychometric Tool for Disaster Preparedness and Public Health Response. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10277
3. Anatolii, C.A., Kenbaeva, Z., Vasylenko, V., Korol, N., Yanovych, L., Bazyka, D., & Akbarov, K. (2025). Radio-nuclear Threats in Ukraine and the Health Sector’s Preparedness to Respond to Nuclear Disaster. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10098
4. Dökmeci, A.H., & Karakus, E. (2025). Effectiveness of Animation-Supported Education in Raising Awareness of Children on Chemical, Biological, Radiological, and Nuclear (CBRN) Threats. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10118
5. Eddahiri, K., Arsura, M., & Weinstein, E.S. (2025). Industrial Disasters—Preparedness and Response Perspectives: Integrating ISO 45001, MIMMS, and Local MCI Response Plans. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10245
6. Ersöz Genç, E., & Genç, I. (2025). Enhancing Disaster Preparedness and Response: Key Strategies and Interventions. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10112
7. Esmaili, F., Moradi, A., Saghafi, A., & Heidaranlu, E. (2026). Investigating Hospital Preparedness Evaluation Tools in the Face of Nuclear And Radiation Threats: A Systematic Review. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10287
8. Hasegawa, A., & Hirohashi, N. (2025). Nuclear Disaster Medical Response and Preparedness: Perceived Radiation Risk in Ongoing Decommissioning Work and Future Strategies. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.54
9. Ihekweazu, V., KC, S., & Heymann, D.L. (2025). Border controls and public health emergencies of international concern (PHEICs). Infectious Disease Emergencies: Preparedness and Response. https://doi.org/10.56159/emergencies-8
10. Keskin, G., & Yurt, E. (2025). Response to Letter to the Editor: Enhancing Disaster Mental Health Preparedness: Insights from Taiwan’s Earthquake Response and a Comparative Reflection on the Izmir Earthquake. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10127
11. Kokoç, M., Şimşek, P., Gündüz, A., & Akyıldız, S. (2025). Enhancing Preparedness and Response to Flood Disasters: A Scoping Review of Training Activities for Response Staff. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10195
12. Kumar, P., & Kaur, A. (2025). Assessing District Hospital Preparedness During a Public Health Emergency of International Concern (PHEIC): Development of a Comprehensive Checklist in the Indian Context. Indian Journal of Community Health. https://doi.org/10.47203/ijch.2025.v37i02.005
13. Kutim, I.T., Green, K., Diorgu, F.C., & Onyema, C. (2025). Perception, Enablers and Barriers to the Practice of Physiologic Birth among Midwives in Birthing Facilities in Bayelsa State, Nigeria. IPS Journal of Basic and Clinical Medicine. https://doi.org/10.54117/ijbcm.v2i2.14
14. Moore, A., Errett, N.A., & Patel, R. (2025). Public Health Emergency Preparedness and Response Workforce Competencies: Developing and Supporting the Next Generation of Practitioners. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10068
15. Mulenga, D. (2025). Malaria Still a Public Health Concern in LMICs. Understanding Public Health in Africa. https://doi.org/10.4324/9781003571483-13
16. Muoneke, A.P., Essien, V.G., Ogunniyi, T.J., & Effiong, F.B. (2025). Assessing the preparedness of Nigeria’s diagnostic and laboratory infrastructure for Mpox surveillance and response. Discover Public Health. https://doi.org/10.1186/s12982-025-00877-z
17. Penn, C., Morgan, D., Ahmad, Y., Elgar, K., & James, C. (2025). Smart spending to combat global health threats. OECD Health Working Papers. https://doi.org/10.1787/166d7c57-en
18. Polat, H., Uğur, K., & Sun, T. (2025). Assessing Psychological Resilience and Stress Symptoms in Health Care Workers Following the 2023 Kahramanmaraş Earthquake. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10153
19. Robinson, S.J., Brooks, M., Fallon, N., Campodonico, C., & Liyanage, C. (2025). Perceived Preparedness and Mental Health in Response to the COVID-19 Pandemic in the UK Population. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.42
20. Sibanda-Makuvise, A., Ndudzo, A., & Burt, F.J. (2025). Flaviviruses of public health concern in South Africa: Present and future threats. Southern African Journal of Infectious Diseases. https://doi.org/10.4102/sajid.v40i1.754
21. Verma, A., & Ara, A. (2025). Monkeypox and human metapneumovirus in India: addressing preparedness and challenges amid emerging threats. International Journal Of Community Medicine And Public Health. https://doi.org/10.18203/2394-6040.ijcmph20251405
22. Wei, L., & Chen, L. (2025). Enhancing Disaster Mental Health Preparedness: Insights from Taiwan’s Earthquake Response and a Comparative Reflection on the Izmir Earthquake. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10126
23. Wetherell, W. (2024). Review of National Health Service England’s Emergency Preparedness, Resilience and Response Annual Assurance for 2021–2022. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2024.113
24. Wetherell, W. (2025). Review of the Emergency Preparedness, Resilience, and Response Exercise Frequency of NHS Acute Trusts in England. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.99
25. Wilkins, T., Walsh, D., Xie, D., Waller, J., Coule, P., & Seehusen, D. (2025). The Regional Impact of COVID-19 on U.S. Academic Medical Centers: Lessons for Public Health Emergency Preparedness and Response. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2025.10217