At Sierra Leone’s Kenema Government Hospital (KGH), which houses the country’s only dedicated Lassa fever treatment unit and a biosafety level-3 laboratory, the battle against the deadly virus is a daily reality.
The facility doubles as Sierra Leone’s national reference centre for the disease, yet its resources are constantly stretched thin.
Mrs Mariatu Kamara, a nurse at the hospital, recalled one particularly harrowing night when three suspected Lassa fever patients were rushed in within just a few hours.
“Supplies were scarce, the isolation ward was already full, and protective gear was running low.
“It is not just the virus we fight, it is the fear, the mistrust, and the helplessness when families cannot afford care or do not believe in the disease until it is too late,” Kamara said.
Her story is not unique; it mirrors experiences across West Africa, where Lassa fever, a rodent-borne viral haemorrhagic disease, infects an estimated 300,000 people each year and claims around 5,000 lives.
In spite of decades of research, no licensed vaccine or universally effective treatment exists.
But a growing coalition of scientists, policymakers, and communities believes that a combined strategy of enhanced surveillance, clinical research, and community engagement could finally tilt the balance.
Experts say that surveillance systems are being upgraded across West Africa to enable early outbreak detection and rapid containment.
Health workers are now trained not only to recognise symptoms but also to integrate environmental and meteorological data into risk forecasting.
Nigeria’s Coordinating Minister of Health, Prof. Muhammad Ali Pate, underscored this at the recent second ECOWAS International Conference on Lassa fever in Abidjan, Côte d’Ivoire, saying that the solution was not going to primarily come from the global North.
Pate said the disease was local to the region, and the solutions must be led by it.
He added that surveillance was expanding into genomic monitoring, with laboratories sequencing viral lineages across countries to anticipate shifts and hotspots.
Dr Jide Idris, Director-General of the Nigeria Centre for Disease Control and Prevention (NCDC), reinforced this point, stating viruses did not respect borders.
“Our surveillance and our responses must therefore also transcend borders.
“We need an ECOWAS health pact that guarantees data sharing, joint preparedness, and pooled resources to fight these threats,” Idris said.
Renowned virologist Prof. Oyewale Tomori, warned against over-prioritising vaccines without first strengthening surveillance.
“If the region gets surveillance right, early detection and containment become possible.
“Then, when vaccines arrive, they can do their work more effectively,” Tomori said.
The virologist has long argued that Africa must build homegrown, sustainable surveillance systems, not donor-driven ones that collapse when funding ends.
Across West Africa, scientists and global partners are advancing clinical trials for vaccines, antivirals, and diagnostics.
Dr Katrin Ramsauer, who leads CEPI’s Lassa Fever Disease Programme, explained why cross-country partnerships were critical,
“Trials often require testing multiple drugs simultaneously, so adaptation is key.
“Communities must be informed, consulted, and carried along continuously.
“Without harmonised clinical management across sites, multi-country trials become extremely difficult.”
She linked this to CEPI’s 100-day mission, a vision to develop a vaccine within 100 days of identifying a new pathogen.
“In Nigeria and Liberia, new platforms are bringing regulators, research centres, and treatment facilities together to prepare trial sites and governance systems before the next epidemic strikes,” she said.
Dr Ifedayo Adetifa, Chief Transformation Officer at FIND, highlighted Nigeria’s transformation in diagnostics.
“We moved from three labs to more than 40 through deliberate decentralisation.
But it is not just about availability, quality, trust, integrated data systems are essential,” Adetifa said.
He also called for regional genomic surveillance, noting that different lineages of the Lassa virus circulated across borders, challenging both diagnostics and vaccine design.
Speakers at the conference repeatedly stressed that communities were not the “last mile” of epidemic response, but the first line of defence.
From safe food storage and rodent control to overcoming stigma, trust-building is essential.
Dr Marie Jaspard, an infectious disease specialist at the Saint-Antoine APHP hospital in Paris, emphasised African-led training for clinical trial managers and researchers, to ensure knowledge and expertise remain on the continent.
“Preparedness must be holistic, from supportive care in isolation centres to harmonised Standard Operating Procedures that can be rapidly deployed in outbreaks,” Jaspard said.
Stakeholders say this view aligns with One Health’s approach, linking human, animal, and environmental health.
By empowering communities, the aim is not just to respond to outbreaks but to build resilience that prevents them from escalating.
The Abidjan conference revealed both progress and persistent gaps. Knowledge gaps remain in understanding Lassa fever’s impact on vulnerable groups such as pregnant women and children.
Funding constraints also limit clinical trials, with the NCDC acknowledging the urgent need for resources to move from Phase 2A to Phase 2B trials. Regional solidarity is further tested by conflicts, insecurity, and weak health systems.
Tomori stressed that without strong surveillance, vaccines would fail to reach their potential, urging the region to stop depending on emergency donor responses and instead invest in long-term capacity.
Yet most experts agreed that institutionalised coordination, political commitment, and community-driven approaches are already showing results.
For too long, Africa’s pandemic preparedness story has been framed by deficits, imported vaccines, weak health systems, and external dependency.
However, progress is underway.
The Partnership for African Vaccine Manufacturing (PAVM) is scaling up regional production hubs, while the African Medicines Agency (AMA) is being operationalised to harmonise regulation.
In addition, countries such as Nigeria, Liberia, and Côte d’Ivoire are taking the lead in establishing cross-border preparedness platforms.
Dr Yahya Disu, Executive Director of Afrihealth for Social Development and Impact, made a succinct submission.
“If we only talk about what’s missing, we risk reinforcing outdated dependency narratives; the real story is how Africa is building solutions,” Disu said.
For Kamara and countless health workers in the region, the hope is that these combined efforts will mean fewer nights of helplessness.
The Abidjan conference made clear that ending Lassa fever will not be achieved in laboratories alone; it will be won in communities, clinics, and coordinated regional action.
The path forward demands surveillance that transcends borders, clinical trials rooted in West African leadership, and communities at the centre of preparedness.
Dr Mark Feinberg of IAVI provided further insights.
“If the Lassa fever vaccine programme is advanced with African leadership and ownership, it would set a powerful precedent for how future health priorities on the continent can be addressed,” he said.
The fight against Lassa fever is far from over; but the momentum is shifting from dependency to resilience, from fragmented responses to regional solidarity.
In that shift, experts say, lies the hope of finally ending a disease that has haunted West Africa for decades.