Strengthening AMR Surveillance in Africa

By Crystal Lubbe

November 13, 2024

The article from Africa CDC titled “New Guidance Sets Path to Strengthen AMR Surveillance” focuses on the critical need to address the growing threat of Antimicrobial Resistance (AMR) in Africa. This guidance is essential given that AMR poses a significant public health threat, with more fatalities than HIV, TB, and malaria combined. The comprehensive approach outlined in this article presents key strategies for improving AMR surveillance in the region.

AMR as a Public Health Threat

Antimicrobial Resistance (AMR) has rapidly escalated into one of the leading threats to public health in Africa. It occurs when microorganisms become resistant to antimicrobial treatments, making infections harder to treat. This phenomenon not only increases disease transmission but also heightens illness severity and mortality rates.

New Guidance and Collaboration

The AMR Surveillance Guidance for the African Region was launched in September 2024, resulting from collaborative efforts between African countries, Africa CDC, the African Society for Laboratory Medicine (ASLM), the East, Central and Southern Africa Health Community (ECSA-HC), the West African Health Organization (WAHO), and the Fleming Fund. This guidance aligns national strategies with regional and global approaches to improve AMR surveillance.

One Health Approach

The guidance underscores a One Health approach, which integrates human, animal, plant, and environmental health to address AMR effectively. This holistic strategy aligns with the African Union AMR Landmark Report: Voicing African Priorities on the Active Pandemic.

Key Recommendations

The guidance recommends integrating AMR surveillance data into existing health information systems to enhance sustainability and efficiency. It also advises the establishment of National Central Coordinating Units (NCCUs) to oversee AMR surveillance activities. Furthermore, national and sub-national AMR steering committees are recommended to align national efforts with broader public health priorities.

Surveillance Challenges and Solutions

Conducting AMR surveillance in Africa faces considerable challenges, such as limited bacteriology services and inadequate laboratory infrastructure. To address these issues, the guidance suggests diverse surveillance sites, including both rural and urban healthcare facilities, to ensure the collection of representative data. Furthermore, it highlights the need for comprehensive data management systems to centralize information on patient demographics, clinical profiles, laboratory results, and antimicrobial use.

Quality Assurance and Capacity Building

The guidance emphasizes the importance of quality assurance measures, such as External Quality Assessment (EQA) programs, to maintain the accuracy of AMR surveillance data. It also highlights the necessity for capacity building, urging governments to invest in training healthcare workers and laboratory technicians on AMR testing and data management practices.

Overcoming Barriers

Despite facing barriers like limited funding and outdated data management systems, the guidance provides a roadmap for overcoming these challenges. Key focuses include improving governance, developing infrastructure, and building capacity. Partnerships with organizations like WHO, FAO, and WOAH are crucial for standardizing surveillance methods and facilitating data sharing.

Regional and International Support

Regional organizations such as ASLM and the Antimicrobial Resistance Surveillance Network (AMRSNET) are pivotal in supporting national surveillance efforts and promoting knowledge exchange. Initiatives like the international exchange program between Ethiopia and South Africa aim to share best practices for implementing effective AMR surveillance systems.

In summary, the new guidance is a vital step toward strengthening AMR surveillance in Africa, highlighting the need for collaboration, a One Health approach, and robust data management systems to tackle the significant public health threat posed by AMR. By focusing on quality assurance and capacity building, Africa can make substantial progress in the fight against Antimicrobial Resistance.

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