Strengthening Libya's pandemic preparedness using the National Bridging Workshop One Health Roadmap

Libya faces recurrent and emerging health threats at the human, animal, and environment interface, compounded by prolonged instability and fragmented health systems. The National Bridging Workshop (NBW) is a structured approach to identify multisectoral collaboration gaps and develop a joint One Health Roadmap aligned with international health security frameworks. This study aimed to describe Libya's first NBW and evaluate its effect on increasing participants' One Healthknowledge.

We conducted a quasi-experimental study using a single-group longitudinal design with pre-intervention, immediate post-intervention, and three-month follow-up assessments of One Health knowledge. The intervention was to deliver the NBW in Tripoli from 23 to 25 February 2025. Over three days, multisectoral stakeholders assessed collaboration across 16 technical areas using four locally adapted hazard scenarios (rabies, leishmaniasis, salmonellosis, and antimicrobial resistance [AMR]), mapped priority gaps to relevant International Health Regulations and Performance of Veterinary Services (PVS) indicators and co-developed a One Health Roadmap.

Seventy participants from human health, animal health, environmental health, food and drug control, and academia attended. Collaboration gaps were most consistently observed in technical-level coordination, sustainable financing, laboratory systems, education and training, and emergency funding across scenarios. Participants developed a joint roadmap comprising 11 objectives and 26 activities, with sustainable financing and the integration of One Health into legislation identified as the key priorities. Knowledge scores differed significantly across the three assessments time points (Friedman test, p < 0.001; Kendall's W = 0.44), indicating a moderate overall effect. Pairwise comparisons showed significantly higher scores immediately after the workshop than at baseline (median, 19 (18-20) vs. 16; p < 0.001; rank-biserial correlation, r = 0.64) and at three months than at baseline (median, 18.5 (15-20) vs. 16 (13-18); p = 0.015; r = 0.40).

The NBW was successfully implemented in a fragile setting and generated a prioritized One Health Roadmap. Knowledge gains that persisted at three months suggest that NBW may contribute to capacity building beyond planning outputs, supporting the longer-term operationalization of One Health and strengthening preparedness and response.