Iterative Co-Development of the Tripartite Joint Risk Assessment Operational Process and Tool Through Incorporating Information From Pilots in Indonesia, the United Republic of Tanzania, and Georgia.

Introduction: Zoonotic diseases pose risks to human, animal, and ecosystem health; effective management relies on coordinated actions across sectors. Although One Health principles promote collaboration across sectors, operational tools for multisectoral risk assessment (RA) are lacking. Therefore, the Tripartite (FAO, WHO, and WOAH) developed the first-ever One Health operational tool for Joint Risk Assessment (JRA-OT), with inputs from 15 pilot countries and international experts. This article describes how information from pilots in Indonesia, the United Republic of Tanzania, and Georgia contributed to informing co-development of the final JRA process and tool. Methods: Three in-person meetings with international RA and zoonotic disease experts with a One Health background were convened in Rome, Italy, to co-develop the methodology (November 2017, September 2018) and incorporate pilot feedback (February 2020). Development criteria included a standard, systematic, qualitative, and multisectoral RA process, facilitating incorporation of expert opinion and sector-specific RA results. The pilot workshops described here were conducted in Indonesia (March 2018), the United Republic of Tanzania (March 2019), and Georgia (July 2019), and feedback was incorporated iteratively into the JRA-OT by a Tripartite Secretariat. Results: These pilot workshops demonstrated JRA's utility and provided critical information for improvements. Key findings included the (1) value of policy-level risk framing, (2) importance of political will, (3) need for subnational engagement, (4) importance of including all relevant sectors, and (5) necessity of clear, stepwise guidance to facilitate efficient collaboration and support training of national trainers. Conclusions: Co-development of the JRA using country pilots and expert consultations allowed for field-testing and iterative improvement of the tool, ensuring incorporation of user requirements, robust methodology for the joint, multisectoral assessment of national zoonotic disease risks, and ownership by the different sectors. The process serves as a model for co-development of other multisectoral operational tools.