Antimicrobial resistance preparedness in sub-Saharan African countries
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(2020) 9:145
RESEARCH
Open Access
Antimicrobial resistance preparedness in sub-Saharan African countries Linzy Elton1* , Margaret J. Thomason1, John Tembo2, Thirumalaisamy P. Velavan3,4, Srinivas Reddy Pallerla3, Liã Bárbara Arruda1, Francesco Vairo5, Chiara Montaldo5, Francine Ntoumi3,6, Muzamil M. Abdel Hamid7, Najmul Haider8, Richard Kock8, Giuseppe Ippolito5, Alimuddin Zumla1,9, Timothy D. McHugh1 and the PANDORA-ID-NET consortium
Abstract Background: Antimicrobial resistance (AMR) is of growing concern globally and AMR status in sub-Saharan Africa (SSA) is undefined due to a lack of real-time data recording, surveillance and regulation. World Health Organization (WHO) Joint External Evaluation (JEE) reports are voluntary, collaborative processes to assess country capacities and preparedness to prevent, detect and rapidly respond to public health risks, including AMR. The data from SSA JEE reports were analysed to gain an overview of how SSA is working towards AMR preparedness and where strengths and weaknesses lie. Methods: SSA country JEE AMR preparedness scores were analysed. A cumulative mean of all the SSA country AMR preparedness scores was calculated and compared to the overall mean SSA JEE score. AMR preparedness indicators were analysed, and data were weighted by region. Findings: The mean SSA AMR preparedness score was 53% less than the overall mean SSA JEE score. East Africa had the highest percentage of countries reporting having AMR National Action Plans in place, as well as human and animal pathogen AMR surveillance programmes. Southern Africa reported the highest percentage of countries with training programmes and antimicrobial stewardship. Conclusions: The low mean AMR preparedness score compared to overall JEE score, along with the majority of countries lacking implemented National Action Plans, suggests that until now AMR has not been a priority for most SSA countries. By identifying regional and One Health strengths, AMR preparedness can be fortified across SSA with a multisectoral approach. Keywords: Antimicrobial resistance, Joint external evaluation, One health
Key points identified ‘Infection Prevention and Control’ (specifically in a
clinical setting) was the strongest AMR category across SSA ‘Antimicrobial Stewardship’ was the weakest category across SSA Veterinary AMR surveillance and stewardship is less established than in clinical settings across SSA, so a * Correspondence: [email protected] 1 University College London, London, UK Full list of author information is available at the end of the article
multidisciplinary approach to improving these areas is needed to achieve One Health East Africa reported the strongest AMR response, thus lessons can be adapted from this region across the continent
Introduction The 68th session of the World Health Assembly in May 2015 [1] adopted the World Health Organization’s (WHO) global action plan on antimicrobial resistance (AMR), where AMR was included as a sustainable development goal to facilitate worldwide action to tackle
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