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Publications

Journal Article Review Ppublish 4 citations

PubMed: 42895838 DOI: 10.1093/cid/ciag497

Generating Actionable Data From Antimicrobial Resistance Surveillance: Insights From the Fleming Fund's International Experience.

Clin Infect Dis 83(Supplement_1):S13-S24

Authors: Ankur Gupta-Wright, Suliat Yetunde Adeleke, Victoria Adetunji, Qadeer Ahsan, Ritu Amatya, Ben Amos, Brian Asare, Sorie I O Bangura, Cyril Buhler, Nicholas Feasey, N Claire Gordon, Heidi Hopkins, Freddy Eric Kitutu, Toby Leslie, Ibrahima Lo, Seynabou Lo, Ayodele Majekodunmi, Rebecca Maudling, Ntombi B Mudenda, Victor Moses Musyoki, Deborah Nanjebe, Tessa Oakley, Manish Pathak, Tamalee Roberts, Lamiaa Shehata, Tim Shorten, Nure Alam Siddiky, John Stelling, Muhammad Taimoor, May Soe Thwe, Shawn Ting, Didem Torumkuney, Paul Turner, Jacob Wildfire, Timothy David Worth

Affiliations

  • Department of Infectious Disease, Imperial College London, London, United Kingdom.
  • Department of Infectious Diseases and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.
  • Department of Infectious Diseases, Bristol NHS Foundation Trust, Bristol, United Kingdom.
  • Itad Ltd, Brighton, United Kingdom.
  • Federal Ministry of Livestock Development, Abuja, Nigeria.
  • Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan, Nigeria.
  • DAI Global LLC, Bethesda, Maryland, USA.
  • FHI 360, Kathmandu, Nepal.
  • Independent consultant.
  • Pharmacy Directorate, Ministry of Health, Accra, Ghana.
  • Ministry of Health and Sanitation, Freetown, Sierra Leone.
  • ORDiagnostics, France.
  • The School of Medicine, University of St Andrews, St Andrews, United Kingdom.
  • Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
  • UK Health Security Agency, Porton Down, Salisbury, United Kingdom.
  • Fleming Fund , International Development Sector, Mott MacDonald, London, United Kingdom.
  • Department of Pharmacy, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
  • Department of Women's and Children's Health, International Child Health and Migration, Uppsala University, Uppsala, Sweden.
  • Food and Agriculture Organization of the United Nations, Dakar, Senegal.
  • UFR des Sciences de la Santé, Université Gaston Berger de Saint-Louis, Saint-Louis, Senegal.
  • Ajisefini Consulting, London, United Kingdom.
  • Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
  • Burnet Institute, Melbourne, Victoria, Australia.
  • Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People's Democratic Republic.
  • Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Fondation Mérieux, Vientiane, Lao People's Democratic Republic.
  • GSK, London, United Kingdom.
  • Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.

Abstract

Antimicrobial resistance (AMR) is a major global health threat, with the greatest burden falling on low- and middle-income countries (LMICs) also challenged with limited surveillance capacity. The UK Government's Fleming Fund was established in 2015 to strengthen AMR surveillance across Africa and Asia through a One Health approach. This paper draws on program experience, country implementation evidence, and published literature to describe how the Fleming Fund operationalized AMR surveillance, assess its contribution to the quantity and quality of surveillance data, identify key implementation challenges, and consider implications for future global surveillance strategies. The Fleming Fund combined investments in laboratory infrastructure, workforce development, quality assurance, data systems, governance, and data use. Across supported countries, these investments enabled substantial growth in routine bacteriology and antimicrobial susceptibility testing, strengthened reference and surveillance laboratory capacity, increased participation in external quality assessment, and expanded reporting to the World Health Organization's Global Antimicrobial Resistance and Use Surveillance System. The program also supported complementary surveillance approaches, including antimicrobial use and consumption data and, in some settings, burden-of-disease and genomic surveillance. Progress, however, has been uneven and remains vulnerable to fragile infrastructure, procurement and supply chain bottlenecks, workforce turnover, fragmented data systems, weak clinical-laboratory interfaces, limited representativeness, and uncertain long-term financing. The Fleming Fund experience shows that strengthening AMR surveillance in LMICs is feasible, but requires sustained, system-wide investment. Future strategies should prioritize integration with clinical care, stronger digital and analytical capacity, broader diagnostic access, and domestic financing to ensure that high-quality AMR data are generated, shared, and translated into action.

MeSH

Laboratories, Data Systems, Investments, Workforce