Ebola preparedness in Sierra Leone during the 2026 Bundibugyo virus emergency: institutional findings and introduction of the Architectural and Operational Readiness Gap (AORG) framework.
- 1National Public Health Agency, 42A Main Motor Road, Wilberforce, Freetown, Sierra Leone.
- 2Foothills Community-Based Interventions, Kentucky, United States of America.
Abstract
the World Health Organization (WHO) declared the Bundibugyo Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) and Uganda a Public Health Emergency of International Concern (PHEIC) on May 17, 2026; no licensed vaccine or specific therapeutic exists. Rapid preparedness assessments tend to capture plans more reliably than operational functionality. We propose the Architectural and Operational Readiness Gap (AORG) framework as an exploratory analytic lens, applied here in Sierra Leone. cross-sectional, convergent parallel mixed-methods design. In May 2026, the Emergency Preparedness and Response team at the National Public Health Agency of Sierra Leone, led by the manager, completed the Economic Community of West African States (ECOWAS) rapid assessment questionnaire. Two reviewers classified the 35 binary indicators as architectural or operational. Domain AORG was the percentage-point difference between scores. Open-text responses were analysed using rapid qualitative content analysis. Reporting follows the STROBE cross-sectional checklist, with GRAMMS and SRQR additionally applied to the mixed-methods and qualitative elements. twelve of 15 architectural (80%) and 10 of 20 operational (50%) indicators were reported as in place; exploratory national AORG +30 percentage points. Largest positive AORGs: infection prevention and control (+100 pp; 0/5) and points of entry (+100 pp; 0/1). Risk communication showed inverse AORG (-67 pp). National laboratory capacity covered only Zaire ebolavirus. Four qualitative themes emerged: training; supplies and supply-chain fragility; non-functional infrastructure; decentralised local-language preparedness. Sierra Leone reported substantial preparedness architecture but a notable operational gap, concentrated in Bundibugyo diagnostics, infection prevention, isolation infrastructure and operationalisation of an existing emergency financing trust fund. Findings reflect one institutional position, not an independent audit. The AORG framework may support rapid mixed-methods preparedness measurement.
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BibTeX
@article{ikoona2026ebola,
title = {{Ebola preparedness in Sierra Leone during the 2026 Bundibugyo virus emergency: institutional findings and introduction of the Architectural and Operational Readiness Gap (AORG) framework.}},
author = {Eric Nzirakaindi Ikoona and Lucy Namulemo and Mary Magdalene Sinnah and Mohamed Alex Vandi and Foday Sahr},
journal = {The Pan African medical journal},
year = {2026},
month = jun,
doi = {10.11604/pamj.2026.54.39.53501},
url = {https://europepmc.org/article/MED/42953108},
note = {CC BY},
}
RIS
TY - JOUR
TI - Ebola preparedness in Sierra Leone during the 2026 Bundibugyo virus emergency: institutional findings and introduction of the Architectural and Operational Readiness Gap (AORG) framework.
AU - Eric Nzirakaindi Ikoona
AU - Lucy Namulemo
AU - Mary Magdalene Sinnah
AU - Mohamed Alex Vandi
AU - Foday Sahr
PY - 2026
DA - 2026/06/09
JO - The Pan African medical journal
DO - 10.11604/pamj.2026.54.39.53501
UR - https://europepmc.org/article/MED/42953108
AB - the World Health Organization (WHO) declared the Bundibugyo Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) and Uganda a Public Health Emergency of International Concern (PHEIC) on May 17, 2026; no licensed vaccine or specific therapeutic exists. Rapid preparedness assessments tend to capture plans more reliably than operational functionality. We propose the Architectural and Operational Readiness Gap (AORG) framework as an exploratory analytic lens, applied here in Sierra Leone. cross-sectional, convergent parallel mixed-methods design. In May 2026, the Emergency Preparedness and Response team at the National Public Health Agency of Sierra Leone, led by the manager, completed the Economic Community of West African States (ECOWAS) rapid assessment questionnaire. Two reviewers classified the 35 binary indicators as architectural or operational. Domain AORG was the percentage-point difference between scores. Open-text responses were analysed using rapid qualitative content analysis. Reporting follows the STROBE cross-sectional checklist, with GRAMMS and SRQR additionally applied to the mixed-methods and qualitative elements. twelve of 15 architectural (80%) and 10 of 20 operational (50%) indicators were reported as in place; exploratory national AORG +30 percentage points. Largest positive AORGs: infection prevention and control (+100 pp; 0/5) and points of entry (+100 pp; 0/1). Risk communication showed inverse AORG (-67 pp). National laboratory capacity covered only Zaire ebolavirus. Four qualitative themes emerged: training; supplies and supply-chain fragility; non-functional infrastructure; decentralised local-language preparedness. Sierra Leone reported substantial preparedness architecture but a notable operational gap, concentrated in Bundibugyo diagnostics, infection prevention, isolation infrastructure and operationalisation of an existing emergency financing trust fund. Findings reflect one institutional position, not an independent audit. The AORG framework may support rapid mixed-methods preparedness measurement.
SN - 1937-8688
ER -