Towards One Health Institutionalization in Libya: leveraging stakeholders' network for health security strengthening

Abdulaziz Zorgani^1,2*Asma Saidouni³Omar Elahmer^1,2Diyaeddin Natuh³Ramadhan Mohamed Osman³Abdelaziz El Halafi³Ahmed Zouiten³

• ¹National Center for Disease Control, Tripoli, Libya
• ²University of Tripoli, Tripoli, Libya
• ³World Health Organization Country Office for Libya, Tripoli, Libya

Background: The institutionalization of the One Health approach is critical for addressing complex health threats at the human-animal-environment interface. In Libya—a state affected by prolonged political conflict, growing impact of climate change and weak intersectoral coordination—such an approach is critical to address zoonotic diseases, antimicrobial resistance (AMR), and climate-related health threats. This study aimed to map and analyze stakeholder networks to inform the development of a national One Health governance framework in Libya. Methods: We employed a mixed-methods approach integrating participatory Net-Map stakeholder mapping, social network analysis (SNA), and SWOT analysis during a national consultation workshop (September 2024) with 42 multisectoral experts. SNA metrics (degree, betweenness, eigenvector centrality, modularity) were computed using R software to analyze a network of 11 core institutions and 102 directed ties across four interaction modalities: coordination, collaboration, capacity building, and advocacy. Results: The network is structurally cohesive (reciprocity = 0.857; average path length = 2.05) but functionally siloed into three clusters: (1) an Operational One Health Interface comprising the National Centre for Disease Control (NCDC), National Centre for Animal Health (NCAH), Environmental Sanitation Affairs (ESA), and Ministry of Environment (MoE); (2) an Agricultural and Livestock Governance Cluster including the Ministry of Agriculture (MoA), Food and Agriculture Organization of the United Nations (FAO), Ministry of Local Government(MoLG), and World Organisation for Animal Health (WOAH); and (3) a Public Health and Regulatory Cluster consisting of the Ministry of Health (MoH), Food and Drug Control Center (FDCC), and World Health Organization (WHO). NCAH and NCDC emerged as central hubs, while MoA served as the key broker (betweenness centrality = 0.334). SWOT analysis identified technical expertise as key strengths, but highlighted fragmented coordination, and political instability as major constraints. Conclusion: These evidence-based insights directly informed Libya’s first national One Health Memorandum of Understanding (MoU), establishing a formal governance framework signed by the MoH, MoA, MoLG, MoE, and FDCC and endorsed by NCDC, the NCAH, and ESA. The study demonstrates that even in fragile contexts, network-informed stakeholder engagement act as a catalyst for health security underscoring how integrated governance can enhance prevention, preparedness, response and resilience against future threats.