International Exchange Study Visit for improved and Strengthened Antimicrobial Resistance Surveillance System in Africa
Antimicrobial resistance (AMR) poses a growing and urgent threat in Africa. With nearly 1.3 million deaths attributed to AMR in 2019, Inadequate monitoring and control measures by governments have worsened the situation, hindering the prevention of resistant micro-organisms. If immediate action is not taken, millions of Africans are estimated to lose their lives to antimicrobial resistance by 2050.
AMR stands as one of the leading public health challenges of the 21st century, with Africa having the world’s highest mortality rate from AMR infections, resulting in 27.3 deaths per 100,000 attributable to AMR.
The Africa Union Framework for Antimicrobial Resistance Control, 2020-2025 describes strategies for Africa CDC to improve surveillance, delay emergence, limit transmission, and mitigate harm from AMR pathogens.
Recent findings paints the dire reality of the AMR surveillance situation across the continent and the urgent need for improved AMR surveillance in AU member states. The findings of the multi-country study are particularly concerning as most laboratories across Africa do not have the resources for AMR testing and surveillance. The continuous lack of surveillance data has hindered our understanding of Antimicrobial Resistance, antimicrobial use (AMU), and drivers of resistance on the continent. In response to this growing public health threat, Africa CDC has launched an international exchange study visit between Africa Union Member States for sharing knowledge and best practices on Antimicrobial Resistance surveillance system implementation and AMR control in May 2023.
This initiative kicked off with an exchange visit between Ethiopia and South Africa, convening public health experts from the Ethiopian Public Health Institute (EPHI) and South Africa National Institute of Communicable Diseases (NICD), Centre for Health-Associated Infections, Antimicrobial Resistance and Mycoses (CHARM) for a collaborative learning experience on AMR surveillance implementation.
Participants shared their best practices for establishing and operationalising functional laboratory-based Antimicrobial Resistance Surveillance systems, particularly in resource-limited settings. This meeting took place in Johannesburg, South Africa from 22 – 26 May 2023.
Both countries have documented remarkable progress in AMR Surveillance, the Ethiopian National Public Health Institute began its laboratory-based AMR surveillance system in 2017 and has expanded the participating sentinel sites by strengthening the detection and response capacity of priority pathogens guided by WHO/GLASS AMR data reporting, national AMR prevention and containment strategy, EPHI laboratory-based AMR surveillance system guide.
Speaking at the meeting, Deputy Director General of the Ethiopian Public Health Institute (EPHI), Dr. Getachew Tollera highlighted the criticality and timeliness of the exercise, stating, “We need standardized approaches to address regional and global shared threats such as Antimicrobial Resistance. Collaboration, partnerships, and networking with institutions like NICD are crucial for EPHI to be prepared and respond effectively to emerging threats.”
South Africa’s leadership in AMR surveillance across the continent is commendable. The country’s participation in key initiatives led by Africa CDC holds great promise. Initiatives such as continental genomic sequencing through the Pathogen Genomics Institute (PGI) and the EQAFRICA regional project, funded by the Fleming Fund, have already made significant contributions to AMR surveillance in 14 African Union countries, with the NICD leading regional EQA reference capacity to enhance laboratory capabilities in detecting and monitoring AMR. In collaboration with Africa CDC, NICD aims to support AMR surveillance capacity-building efforts across the continent. Collaborative efforts such as this, have great potential for advancing AMR surveillance and laboratory improvement in the continent.
“It is a great opportunity for any country on the African continent to get an understanding of how surveillance of AMR surveillance is performed and how we can learn from each other in different settings on implementation of surveillance as the global AMR surveillance system is changing”, says Professor Olga Perovic,, Principal Pathologist, Antimicrobial Resistance Laboratory and Culture Collection Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses (CHARM) during the international exchange visit.
Africa CDC will continue to engage Member States on AMR surveillance and support similar learning opportunities for other countries with the aim of promoting and advocating for excellence in AMR prevention and containment intervention strategies in Africa.
The international exchange visits are part of Africa CDC’s effort to strengthen AMR surveillance in Africa by building capacity and providing technical assistance to support the development and implementation of surveillance systems while leveraging existing resources in AU Member States.