Using One Health assessments to leverage endemic disease frameworks for emerging zoonotic disease threats in Libya

Abstract

Continued emergence, re-emergence and spread of zoonotic diseases demonstrates the imperative need for multisectoral communication and joint coordination of disease detection and response. While there are existing international frameworks underpinning One Health capacity building for pandemic prevention and response, often guidance does not account for challenges faced by countries undergoing long-term conflict and sociopolitical instability. The purpose of this research was to identify Libya’s laboratory and surveillance networks and routes of inter- and multisectoral communication and coordination for priority zoonotic diseases. The One Health Systems Assessment for Priority Zoonoses (OH-SAPZ) tool is an established methodology that was adapted and applied to the Libyan context to support prioritization of zoonotic diseases, development of systems map schematics outlining networks of communication and coordination, and analysis of operations for targeted capacity building efforts. Five zoonotic diseases were selected to undergo assessment: highly pathogenic avian influenza, brucellosis, Rift Valley fever, leishmaniasis and rabies. Through decisive acknowledgement of Libya’s unique health setting, we mapped how patient and sample information is both communicated within and between the human, animal and environmental health sectors, spanning from local index case identification to international notification. Through our assessment we found strong communication within the public and animal health sectors, as well as existing multisectoral coordination on zoonotic disease response. However, local-level communication between the sectors is currently lacking. Due to the ongoing conflict, resources (financial and human) and access have been severely impacted, resulting in limited laboratory diagnostic capacity and discontinued disease prevention and control measures. We sought to identify opportunities to leverage existing operations for endemic diseases like brucellosis for emerging zoonotic threats, such as Rift Valley fever. Analysis of these operations and capabilities supports the development of targeted recommendations that address gaps and may be used as an implementation guide for future One Health capacity building efforts.

Assessing One Health capacities for transboundary zoonotic diseases at the Libya-Tunisia border

“…The development of the One Health Transboundary Assessment for Priority Zoonoses (OHTAPZ) derived from the well-tested OHSAPZ methodology and accompanying papers [ 7 – 10 , 15 ]. As such, the previously established three-phased approach of prioritization, systems mapping, and analysis and recommendations was adapted and applied to a transboundary context.…”

“…Competing health priorities, funding limitations, resource inadequacies and interdisciplinary silos can all impact the effectiveness and sustainability of national and regional One Health strategies [ 1 , 2 ]. A number of national One Health disease prioritization and assessment tools and resources have been developed and used by national governments, international organizations and other relevant stakeholders to support interdisciplinary approaches to outbreak preparedness and response [ 3 – 10 ]. Nevertheless, the dynamic nature of zoonotic emergence, spillover and spread necessitates multisectoral coordination beyond national borders to encompass cross-boundary and regional cooperation.…”

“…The One Health Systems Assessment for Priority Zoonoses (OHSAPZ) tool utilizes a phased methodology to map existing nodes of communication and coordination between multisectoral stakeholders for prevention, detection, response and recovery to national priority zoonoses [ 7 , 15 ]. Since 2015, this assessment methodology has been applied in a variety of country settings spanning from the Middle East to North and West Africa, successfully adapted to accommodate in-country contexts, and completed wholly remotely using facilitated videoconference technologies [ 8 – 10 ]. In collaboration with One Health stakeholders in Libya and Tunisia, we adapted the OHSAPZ methodology to a transboundary setting, focusing the approach on existing multisectoral and bilateral One Health capacities and coordination for priority TZDs at POEs.…”