Assessing the implementation of the disease surveillance and response strategy in Togo

The surveillance of infectious diseases has gained importance with the rise of (re)emerging pathogens and growing antimicrobial resistance. In many low- and middle-income countries (LMICs), surveillance systems remain insufficiently structured to support timely detection and response. To address these gaps, the World Health Organization Regional Office for Africa recommends the Integrated Disease Surveillance and Response (IDSR) strategy, implemented across 47 Member States. Regular evaluation of IDSR systems is encouraged to guide national reforms and strengthen preparedness. This study assesses the level of IDSR implementation in Togo and identifies key challenges affecting its performance. A qualitative study was conducted through a review of national strategic documents and focus group discussions with 21 actors involved in IDSR, including national surveillance specialists, Public Health Emergency Operations Center staff, decentralized health authorities, health facility managers, community health workers, and community leaders. Data were collected using tailored interview guides and analyzed through content analysis structured around the nine components of the WHO IDSR Technical Guide. IDSR is only partially implemented in Togo. While some opportunities and technological tools are in place, major weaknesses in the health system limit the effectiveness of surveillance. Significant gaps remain in coordination, resource mobilization, health system effectiveness, data quality and reporting, preparedness, and response capacities. Significant gaps hinder the full implementation of the IDSR in Togo. Addressing these challenges presents opportunities to strengthen surveillance, improve early detection, and enhance public health response across the country.