BACKGROUND:
Mpox is an emerging health security threat in West Africa, where porous borders and high population mobility challenge outbreak containment. Strengthening preparedness at Points of Entry (PoEs) is critical to prevent regional spread.

METHODS:
In October 2025, we conducted a participatory, multi-method assessment across Liberia, Guinea, and Sierra Leone. Fifty stakeholders from health, immigration, veterinary, and border agencies engaged in a workshop that mapped ten strategic PoEs, applied SWOT and problem tree analyses, and used a Logical Framework Approach to co-develop actionable Joint Action Plans.

RESULTS:
Systemic vulnerabilities were stark: only 40% of PoEs had isolation capacity, 90% of sites lacked Mpox-specific training, and surveillance relied on fragmented paper-based systems with limited real-time reporting. Human resource shortages forced reliance on volunteers, and cross-border coordination was informal and unstructured. Three high-priority corridors were identified for immediate intervention: Bo Waterside (Liberia–Sierra Leone), Kardu (Sierra Leone–Guinea), and Pamelap (Guinea–Liberia). The participatory process yielded a costed Joint Action Plan addressing infrastructure, digital surveillance, workforce capacity, and formalized trilateral coordination.

CONCLUSIONS:
Current PoE capacities are critically inadequate to prevent cross-border Mpox spread. Targeted investments in priority corridors, combined with systemic health system strengthening and institutionalized regional cooperation, are urgently needed. This assessment demonstrates a replicable model for translating stakeholder-driven diagnostics into actionable policy, offering a blueprint for pandemic preparedness in West Africa and other high-risk regions.