Evaluating the 7-1-7 Outbreak Response Metric: Modelling and Implementation Insights for Ebola, Measles, and Anthrax in Central and Eastern Uganda, 2025

Introduction Uganda’s recent progress in public health emergency preparedness underscores the relevance of the 7–1-7 framework (detection within 7 days, notification within 1 day, response within 7 days). Evidence on the incremental benefits of meeting these targets in resource-constrained settings remains limited. We modelled cases averted and cost-effectiveness of achieving 7–1-7 timelines for Sudan virus disease (SVD), measles, and anthrax in Uganda, and additionally explored more ambitious targets (3–1-4 and 1–1-1). Methods We used stochastic compartmental models to compare observed response time lines with hypothetical scenarios that meet 7–1-7 targets. Surveillance data from recent outbreaks informed the models. Cost-effectiveness was assessed using Disability-Adjusted Life Years (DALYs) averted and Incremental Cost-Effectiveness Ratios (ICERs). Additional simulations tested the impact of compressing timelines to 3–1-4 and 1–1-1 while keeping all other intervention parameters identical. Results Under the modelled 7–1-7 scenario, 133 SVD cases (47 deaths) and 1,409 DALYs would be averted, with an ICER of −17.46 USD/DALY (cost-saving). For measles, 81 cases and one death would be averted (ICER 83 USD/DALY). For anthrax, the framework would prevent three human cases (one death) and 50 animal cases (45 animal deaths), averting 734 DALYs, but would require an additional US$651,811 for livestock vaccination and carcass disposal. All ICERs fell below Uganda’s willingness-to-pay threshold (1,300 USD/DALY). Moving beyond 7–1-7 to 1–1-1 would avert an additional 55 SVD cases and 21 deaths, and 13 measles cases, at negligible incremental cost, demonstrating that even faster response yields substantial extra health gains. For anthrax, faster timelines beyond 7–1-7 produced only marginal benefits, confirming that vaccination coverage – not timeliness – is the dominant driver. Conclusion The 7–1-7 framework substantially reduces cases, deaths, and costs across three diverse diseases. Accelerating to 1–1-1 further amplifies these benefits for fast-spreading pathogens like Ebola and measles, but for slow zoonoses like anthrax, improving vaccination coverage remains paramount. Achieving these targets requires investments in rapid detection, contact tracing, vaccination, referral systems, and sustainable multi-sector financing.