Strengthening infectious disease surveillance and control through long-term international collaboration: Insights from the Ghana- Japan partnership.

West Africa remains a global epicenter for emerging and re-emerging infectious diseases, yet data on pathogen diversity and transmission dynamics remain fragmented. This communication summarizes 21 years of longitudinal research collaboration between the Institute of Science Tokyo (formerly Tokyo Medical and Dental University) and the Noguchi Memorial Institute for Medical Research (NMIMR) in Ghana. Our integrated surveillance framework encompasses: i) defining environmental virulence factors for Mycobacterium ulcerans to refine Buruli ulcer risk assessment; ii) uncovering the "masked" circulation of Dengue and SARS-CoV-2 through molecular epidemiology; iii) investigating biological determinants, including gut microbiome profiles, of reduced Rotavirus vaccine efficacy in low-income settings; iv) characterizing the environmental reservoirs and fitness costs of carbapenemase-producing Enterobacteriaceae; and v) analysis of the interaction of malaria parasites between symbionts in vector mosquitoes and vaccine development. By aligning basic research on infectious diseases with clinical data and human resource development, this partnership provides a scalable model for strengthening global health security and addressing the unique infectious disease challenges of the "post-viral" era.