Abstract
The drivers causing spillovers of zoonotic diseases in Africa are multifaceted and include cultural and traditional wildlife practices, illegal trade channels, environmental factors driven by climate change, and human migration. These drivers have been assessed separately in various reviews, and no synthesis has integrated all four within a unified multistage zoonotic spillover framework in Southern Africa, West, and Central Africa. This narrative review explores how cultural practices, the trading of wildlife, climatic changes, and forced human migration contribute to the zoonotic spillover risks. The literature search was conducted with PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar databases between the years 1990 and 2026 using a structured search strategy. Bushmeat consumption, zootherapeutic practices, and wildlife trade create direct and sustained wildlife-human contact pathways, with zootherapeutic handling chains being the most poorly monitored exposure pathway. Climate-induced range shifts and habitat loss are increasing reservoir host distribution into human-adjacent environments, and climate-induced migration is moving reservoir populations to new areas without known exposure norms. Collectively, this evidence suggests that these drivers do not work in isolation at their intersections, creating compounding risks that cannot be solved by a single-domain intervention. We present this as an interpretive synthesis of the evidence reviewed, not a directly tested findings. Three documented areas highlight the need for strengthening the current implementation of One Health: enforcement measures that push trade into clandestine channels, underfunded wildlife surveillance, and the lack of community knowledge systems in the approach to designing surveillance. Women in urban bushmeat retail, a structurally high-exposure population, remain absent from formal serological surveillance programs. On the basis of these documented gaps, the review recommends redesigning surveillance for the prevention of zoonotic spillover, including sentinel systems in Sahelian and forest-margin areas linked to climate. Structural One Health governance reform will also be needed to implement these priorities, namely, incorporating community knowledge systems, climate, and migration data into national surveillance systems.