Over more than a decade, Morocco has strengthened its influenza laboratory and surveillance capacities through sustained support from the Pandemic Influenza Preparedness (PIP) Framework. These investments have delivered measurable improvements in diagnostic coverage, timely and complete data generation, and reporting, supporting more effective detection of and response to influenza and other respiratory threats.
Since 2014, PIP partnership contribution (PC) funds have supported a series of coordinated activities, including training, mentorship, field assessments, and internal and external quality assurance. These efforts have been implemented through close coordination between the World Health Organization (WHO) and the Ministry of Health and Social Protection of Morocco, with the active involvement of representatives leading each PIP component, namely epidemiological surveillance, laboratory systems, and preparedness and response to epidemics and pandemics.
Together, these efforts strengthened the capacity of the National Influenza Centre (NIC) and expanded influenza surveillance to ten sentinel sites across nine of the country’s twelve administrative regions. This work contributes to broader global efforts to strengthen pandemic influenza preparedness, aligning with the Global Influenza Strategy 2019–2030 and the Influenza Pandemic Preparedness Framework, while also supporting the implementation of the International Health Regulations (2005) (IHR).
This expansion has also significantly increased laboratory and surveillance capacity across the country. In 2014, only two administrative regions had molecular diagnostic capability. By 2026, all sentinel sites were able to perform real-time reverse transcription-polymerase chain (RT-PCR) reaction testing for influenza using GeneXpert.
During the COVID-19 pandemic, this system was rapidly repurposed, enabling national testing capacity to reach 287 173 tests in one week at peak. This demonstrates the added value of PIP investments in strengthening surveillance and laboratory capacities for pandemic preparedness, enabling timely detection and response to respiratory threats.
Genomic surveillance has also been strengthened. In line with WHO guidance on integrated influenza surveillance, a representative subset of influenza-positive specimens—up to 10% where feasible—is selected for sequencing. The resulting genomic data are shared on global platforms such as Global Initiative of Sharing All Influenza Data (GISAID) enabling the rapid detection and characterization of changes in influenza viruses, and supporting global risk assessment and informed decision-making.
In addition to sharing these data, the NIC also shares circulating viruses each season with WHO collaborating centers to support monitoring of circulating strains and the development of influenza vaccines.
Respiratory virus surveillance systems have transitioned from a single pathogen–influenza virus–to an integrated approach. Since 2022, Morocco has conducted surveillance of influenza alongside respiratory syncytial virus (RSV) and SARS-CoV-2 within a unified framework. This approach, aligned with WHO recommendations, supports improved analysis of seasonal trends and strengthens preparedness for influenza pandemics and other respiratory pathogens.
PIP supported capacity-building also extended beyond the public sector. In late 2021, a national training programme reached 204 laboratory professionals across eight regions, including staff from 183 private laboratories. Three rounds of external quality assessment helped standardize testing procedures and reporting, strengthening reliability across the national network.
Morocco’s experience shows how sustained PIP PC support can deliver tangible improvements in influenza surveillance systems. Continued efforts will focus on maintaining quality, expanding genomic surveillance and strengthening coordination, in line with global strategies and evolving public health priorities.