The after action review (AAR) that took place at Hotel San-Cristobal in Antananarivo, captured the lessons learned from the response to the Pneumonic Plague outbreak of August- November 2017 with the aim of improving future performance through the analysis of identified best practices and challenges. The AAR covered five defined areas: coordination and logistics; surveillance and laboratory; case management, infection prevention and control; communication, social mobilization and community engagement; vector and reservoir management. 

The meeting gathered over 80 participants from national, regional and sub-regional levels who had been involved in the response including health and other departments such as education, local government and environment. Private health care providers, NGOs, UN agencies and partners participated in the AAR.

The meeting included detailed discussions on the existing capacity of the health system to prevent, detect, and respond to Pneumonic Plague outbreak; timeline of response interventions; best practices and their enabling factors; along with challenges and their limiting factors. The resulting recommendations were converted into targeted activities for immediate implementation and those that require more resources or longer-term implementation and that should be incorporated into other planning processes such as the National Action Plan for Health Security (NAPHS) for Madagascar which is expected to be developed soon.

The feedback from participants was very positive, with many of them expressing their recognition on the importance of AAR to improve the planning and response to future Plague outbreaks. Over 80% of the participants said that the AAR tool is a very useful tool for reviewing response capacities. 

The AAR workshop concluded with an advocacy and resource mobilization meeting held on the last day and presided over by the Prime Minister of Madagascar and where the main technical and financial partners based in Madagascar made commitments to provide the needed support for the implementation of the AAR key findings.