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Publications

Journal Article Review Ppublish 4 citations

PubMed: 42895836 DOI: 10.1093/cid/ciag520

Surveillance Data Use Through the Fleming Fund: Informing Action on Antimicrobial Resistance in Low- and Middle-Income Countries.

Clin Infect Dis 83(Supplement_1):S25-S36

Authors: Archie Drake, Alesia Ofori, Amy Rahmadanti, Ankur Gupta-Wright, Areeya Disratthakit, Ayodele Majekodunmi, Benjamin Kissi Sasu, N Claire Gordon, Claudia Parry, Collins Mitambo, Deborah Nanjebe, Desrina Sitompul, Didem Torumkuney, Evelyn Wesangula, Freddy Eric Kitutu, Heidi Hopkins, Jacob Wildfire, Japheth A Opintan, Jennifer Armitage, Joseph Sam Kanu, Kate Macintyre, Kriti Khurana, Lamiaa Shehata, Manish Pathak, Megha Raj Banjara, Milena von Und Zur Mühlen, Muhammad Taimoor Kayani, Muhammad Usman Zaheer, Mwapu Ndahi, Nandini Shetty, Nicholas Feasey, Nigel French, Nimesh Poudyal, Nure Alam Siddiky, Paul Turner, Pem Chuki, Qadeer Ahsan, Rebecca Maudling, Ritu Amatya, Satyajit Sarkar, Syed Abbas, Tamalee Roberts, Tauqeer Mustafa, Tim Shorten, Titha Dzowela, Toby Leslie, Tochi Okwor, Yu Nandar Aung

Affiliations

  • Itad Ltd, Brighton, United Kingdom.
  • Independent Consultant, Dar es Salaam, Tanzania.
  • Independent Researcher, United Kingdom.
  • Directorate of Quality of Referral Health Service, Ministry of Health, South Jakarta, Indonesia.
  • Department of Infectious Disease, Imperial College London, London, United Kingdom.
  • Department of Infectious Diseases and Tropical Medicine, University of Heidelberg, Heidelberg, Germany.
  • Department of Infectious Diseases, Bristol NHS Trust, Bristol, United Kingdom.
  • MODRA, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
  • Ajisefini Consulting, Abuja, Nigeria.
  • National Food Safety Laboratory, Veterinary Services Department, Ministry of Food and Agriculture, Accra, Ghana.
  • Rare and Imported Pathogens Laboratory, UK Health Security Agency, Wiltshire, United Kingdom.
  • Fleming Fund Management Agent, Mott MacDonald, London, United Kingdom.
  • Antimicrobial Resistance Coordinating Centre, Ministry of Health, Lilongwe, Malawi.
  • Public Health Institute of Malawi, Lilongwe, Malawi.
  • ESA Regional Hub, Mott MacDonald, Kampala, Uganda.
  • Fleming Fund Country Grant to Indonesia, DAI, Jakarta, Indonesia.
  • Infectious Diseases Research Unit, GSK HQ, London, United Kingdom.
  • Family Health and Infectious Diseases, East Central and Southern Africa Health Community, Arusha, Tanzania.
  • Department of Pharmacy, Makerere University School of Health Sciences, Kampala, Uganda.
  • Department of Women's and Children's Health, International Child Health and Migration, Uppsala University, Uppsala, Sweden.
  • Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra, Ghana.
  • Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • LAMP Development Organisation, Edinburgh, United Kingdom.
  • College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
  • National Public Health Agency, Ministry of Health, Freetown, Sierra Leone.
  • Oxford Health Evaluations, Buckingham, United Kingdom.
  • Monitoring and Evaluation, South Asia, Mott MacDonald, New Delhi, India.
  • IDS, Mott MacDonald, Noida, India.
  • Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.
  • Department of Health and Social Care, London, United Kingdom.
  • Fleming Fund Country Grant to Pakistan, DAI, Islamabad, Pakistan.
  • Regional Office for Asia and the Pacific, Food and Agriculture Organization of the United Nations, Bangkok, Thailand.
  • Department of Veterinary Public Health and Epidemiology, Federal Ministry of Livestock Development, Abuja, Nigeria.
  • The School of Medicine, The University of St Andrews, St Andrews, United Kingdom.
  • Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
  • Tāwharau Ora, School of Veterinary Science, Massey University, Palmerston North, New Zealand.
  • Antimicrobial Resistance, International Vaccine Institute, Seoul, Republic of Korea.
  • Fleming Fund Country Grant to Bangladesh, DAI, Dhaka, Bangladesh.
  • Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.
  • Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Science, International Center of Antimicrobial Resistance Solutions, Copenhagen, Denmark.
  • Independent Consultant, United Kingdom.
  • STRIDES Nepal Project, Kathmandu, Nepal.
  • Policy & Economic Research, International Vaccine Institute, Seoul, Republic of Korea.
  • Institute of Development Studies, Brighton, United Kingdom.
  • Department of Microbiology, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao PDR.
  • Fleming Fund Country Grant, University of North Carolina Project Malawi, Lilongwe, Malawi.
  • Disease Prevention and Health Promotion, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria.
  • Community Medicine, Veritas University, Abuja, Nigeria.
  • Fleming Fund Management Agent, Mott MacDonald, Bangkok, Thailand.

Abstract

BACKGROUND

Drawing on the Fleming Fund's work to strengthen antimicrobial resistance (AMR) surveillance across Africa and Asia during 2018-2026, this article provides one of the first syntheses of AMR surveillance data use in low- and middle-income countries.

METHODS

A participatory synthesis for narrative review was conducted to summarize experience across administrative levels (facility, subnational, national, and regional).

RESULTS

Data use was most evident at the facility level, in human health systems where resistance patterns, antimicrobial use, and clinical data increasingly informed antimicrobial stewardship, infection prevention and control, and other quality improvement initiatives. Data use in other sectors required different approaches. At the national level, Fleming Fund investments were associated with revisions of treatment guidelines, updates of essential medicines lists, and regulatory measures, primarily through improved governance and policy communities. Regional platforms supported member country data use at the national level. Subnational data use was undertaken in countries with decentralized health systems. Across levels, data use pathways driven by local priorities helped surveillance inform action.

CONCLUSIONS

Fleming Fund experience suggests that surveillance is more likely to inform action when data use is built into system design. Continued investment will be needed if AMR surveillance is to improve policy and practice in low- and middle-income countries.

MeSH

Income, Investments