Improving risk analysis of environmentally driven zoonotic biological threats as a primary pandemic prevention approach: A case study of the Tripartite Joint Risk Assessment Operational Tool operationalization in Kenya.

Kenya faces a heightened risk of emerging and/or reemerging infectious disease (EID) outbreaks of zoonotic origins due to climate-induced extreme weather events and other environmental drivers. We aimed to obtain the perspectives of stakeholders on the development of a newly conceptualized integrated risk analysis (IRA) framework to address environmentally driven EIDs. We addressed the study aim by learning from stakeholders' experiences with the operationalization of the Joint Risk Assessment Operational Tool (JRA OT) in Kenya. We conducted an exploratory and explanatory qualitative study using a constructivist approach. National- and county-level government representatives, representatives from the Quadripartite institutions (FAO/UNEP/WHO/WOAH), and other partner institutions related to One Health (OH) in Kenya were recruited to participate in semi-structured key informant interviews from 22/02/2024 to 30/03/2024. A total of twenty-eight interviews were conducted, transcribed verbatim and analyzed using a thematic framework analysis. Study participant pool comprised sixteen, five, and seven county-level, national-level, and partner institution representatives respectively. Four major themes emerged from the study data as essential components of an IRA framework: (i) Improving cross-sectoral data sharing and integration; (ii) Early stakeholder inclusion and holistic engagement; (iii) Proactive cross-sectoral resource mobilization and allocation; and (iv) Policies and legislation for addressing OH governance challenges. Improving IRA processes to ensure integration of the environment sector into the OH approach will enhance preparedness for and response to environmentally driven zoonotic biological threats. National and sub-national OH policies are needed to enable routine operationalization of risk-based OH activities like Joint Risk Assessments (JRAs) and other aspects of risk analysis to inform cross-sectoral decision making for pandemic prevention.