INTRODUCTION:
Genomic surveillance is critical for early detection of outbreaks, monitoring pathogen evolution, and guiding effective public health responses. In The Gambia, efforts to operationalise genomic surveillance face systemic, technical, and resource-related challenges, but also present unique opportunities to strengthen the public health system.

METHODS:
A mixed approach was used, including a review of national policies, key informant interviews with stakeholders at the Ministry of Health, laboratories, and regional health directorates, and an assessment of available infrastructure and human resource capacity. Findings were analysed to identify gaps, opportunities, and potential strategies for scaling up genomic surveillance.

RESULTS:
Key challenges included limited laboratory capacity for sequencing, inadequate bioinformatics expertise, irregular funding, and fragmented coordination between national and regional health actors. Weak sample transport systems and the absence of a sustainable workforce plan further constrained implementation. Despite these challenges, opportunities were evident. Existing laboratory infrastructure could be upgraded to accommodate genomic technologies, while regional collaboration with institutions such as the Africa CDC and WHO provided technical and financial support. Capacity-building initiatives and training programs were already underway, creating momentum for workforce development. Strong political commitment towards health security and integration of genomic data into disease surveillance platforms highlighted the feasibility of long-term operationalisation.

CONCLUSIONS:
Operationalising genomic surveillance in The Gambia requires a comprehensive strategy that addresses infrastructure, workforce, and governance gaps. Leveraging regional and global partnerships, ensuring sustainable financing, and strengthening policy frameworks will be crucial. While challenges remain significant, the opportunities provide a foundation for building a resilient genomic surveillance system that can enhance outbreak preparedness and response in The Gambia and serve as a model for similar low-resource settings.