A multisectoral effort against Crimean-Congo hemorrhagic fever: Towards One Health approach implementation in the Balkans and Black Sea region

Crimean-Congo Hemorrhagic Fever (CCHF) is a notifiable zoonotic disease found also in the Balkans and adjacent regions, transmitted primarily through <i>Hyalomma marginatum</i> ticks and contact with infected animals and humans. This study investigates the implementation of the One Health (OH) approach in addressing CCHF in the Balkans and Black Sea area, highlighting the collaboration among human, animal, and environmental health sectors. We assessed the integration of OH principles in CCHF surveillance and response by comparing the information collected during the exercises implemented in the context of the European Project MediLabsecure in 2016 and 2023, and interviews with representatives from Serbia, Turkiye, and Georgia. Key findings reveal advancements in surveillance systems, with most countries now employing active or passive surveillance strategies. Prevention efforts include robust data collection, multisectoral governance, cross-border collaborations, and capacity building. Response strategies focus on developing standard operating procedures, public awareness campaigns, and seroprevalence studies. However, challenges persist, including insufficient community engagement, lack of integrated electronic data-sharing systems, inadequate funding, and limited cross-border cooperation. To enhance OH implementation, we recommend collaborative funding initiatives, the establishment of governmental policies for data sharing, interdisciplinary training programs, standardized evaluation frameworks, and sustainable tick control strategies. This study underscores the necessity of a comprehensive OH approach to effectively manage CCHF and other zoonotic diseases, highlighting the importance of integrated strategies that address human, animal, and environmental health.