ALERTO in Five Countries of the SICA Region—Activating Local Epidemic Readiness in Transborder territories under a One Health Approach

Background

Belize, Costa Rica, El Salvador, Guatemala, and Honduras were awarded US$22.44 million from the Pandemic Fund to establish integrated prevention, preparedness, and response (PPR) capabilities across the Central American Integration System (SICA) region. The grant catalyzed an additional US$14.4 million in co-financing from international organizations, as well as US$17.2 million in co-investment provided by the project’s five governments. The multi-country project, called ALERTO, brought together a wide range of partners across sectors, from the International Civil Aviation Organization to the Regional League of Civil Society for the Fight Against Malaria, among others.

Central America encompasses numerous national borders, across which there is a steady flow of people, animals, and goods. The region also hosts rich biodiversity and multiple forest corridors, which are increasingly threatened by deforestation. This degradation and frequent interactions between people and wildlife amplify the risk of zoonotic disease spread. Central America is also frequently hit by natural disasters, which puts additional strain on underfunded health and emergency systems. Among SICA countries, health spending remains below 4% of gross domestic product.

In response to the region’s challenges, and in keeping with the spirit of the Pandemic Fund, the ALERTO project emphasizes cross-border and cross-sectoral cooperation. It is led by the five countries’ Ministries of Health, with support from the Inter-American Development Bank (IDB) as its Implementing Entity.

Project objectives

By focusing on strategic border areas, ALERTO aims to reduce the risk and impact of public health threats. It also seeks to position SICA as a model of effective regional PPR.

Implementation arrangements and key components

ALERTO emphasizes the Pandemic Fund’s priorities -- surveillance, laboratory systems, and workforce development—as well as the efficient and transparent use of resources. Detail on all project components follows.

Strengthening early detection and response. This part of the project focuses on national and cross-border efforts to prevent, detect, confirm, notify, and respond to outbreaks with pandemic potential. Activities include conducting multisectoral risk evaluations, upgrading laboratories, and procuring diagnostics and biosafety tools. They also include establishing or strengthening Public Health Emergency Operations Centers (PHEOCs) in all countries, developing and testing multi-hazard contingency plans and standard operating procedures, and deploying multidisciplinary rapid response teams. At the community level, additional activities include establishing or enhancing community-based surveillance and updating risk communication and community engagement strategies.

Improving multisectoral coordination. With a focus on coordination at the national, binational, and regional levels, all project countries intend to improve their policy and governance frameworks, operationalize national One Health platforms, fortify the Regional One Health Technical Committee, and harmonize their alert and data-sharing protocols.

Reinforcing sustainable financing. This part of the project aims to enhance the strategic, efficient use of national, regional, and external investments in PPR. Activities include developing national investment plans based on International Health Regulations (IHR) and SICA priorities, as well as building a regional framework to align pooled and external financing.

Ensuring transparent resource management. Activities here focus on strengthening administrative and financial systems aligned with the IHR Monitoring and Evaluation Framework and reinforcing oversight and reporting systems for Pandemic Fund resources.