Gaps in AMR surveillance data across Africa to drive shape health policy reform

New reports published provide a detailed account of drug resistance surveillance capacity across the continent to reduce AMR burden

Addis Ababa, Ethiopia 24 July 2023 – The Mapping AMR and AMU Partnership (MAAP) consortium, led by the Africa Centres for Disease Control and Prevention (Africa CDC) and the African Society for Laboratory Medicine (ASLM) – supported by the UK Aid Fleming Fund -publish 14 new individual country reports providing a detailed study representation of the AMR situation across the continent.

The 14 African Union Member States in the first phase of MAAP at the end of 2022, include Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Kenya, Tanzania, Uganda, Malawi, Eswatini, Zambia, and Zimbabwe.

MAAP was launched in 2019 to help assist the participating Member States to measure and monitor their antimicrobial resistance (AMR) and antimicrobial use (AMU) status and to identify gaps for data improvement, through a Fleming Fund regional grant managed by Mott MacDonald.

Containing over 819,500 AMR data records, between 2016 to 2019, from 205 laboratories, the AMR surveillance data analysed for the new reports from each Member State provides a unique source of information to feed into the national AMR action plan, national laboratory strategic plan, and other relevant policies in Africa.

‘MAAP has collaborated with African Union Member States and put AMR on the map of Africa for the first time. A critical step to address the threat of AMR on the continent,’ said Dr Yewande Alimi, Africa CDC AMR Programme Coordinator.

The study’s findings from the 14 Member States in the first phase of MAAP indicate that only five (5) out of the 15 antibiotic – pathogens combinations prioritised by the WHO (GLASS) are being consistently tested and demonstrate a high rate of AMR.

Researchers also found that most laboratories across Africa are not ready for AMR testing. Just over 1% of the 50,000 medical laboratories forming the tiered laboratory networks of the participating Member States conduct bacteriology testing and even fewer are capable of conducting the scientific process of determining AMR. This underlies the importance of further investment in laboratory capacity, including microbial systems, equipment and training – supported by the Fleming Fund, working with grantees and national partners.

‘The lack of bacteriology and AMR testing capacity documented by MAAP has been an eye-opener. The reports published today constitute a unique resource for national, regional and global stakeholders working at reducing the burden of AMR,’ said Pascale Ondoa, Director of Science and New Initiatives at ASLM.

MAAP also documented an alarming picture of AMC with a combined lack of access and erratic use of antimicrobials. Only four drugs comprised more than two-thirds (67%) of all the antibiotics used in the healthcare setting, while reserve-category antibiotics were found in only six of the 14 MAAP countries. Unregulated antibiotic fixed combinations represented 3.4% of all consumed antibiotics.

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 over 27 deaths per 100,000.

Without data information on the rates, drivers, and trends of AMR on both AMU and antimicrobial consumption (AMC), health experts are ‘flying blind’ and cannot develop and deploy policies to limit or curtail AMR. Interventions in Africa mostly remain generic since no baseline information on the magnitude of the problem is available at national or regional levels.

Given the threat of the rise of drug-resistant organisms, African Union (AU) Heads of State and Government have committed to urgently addressing the threat of AMR across multiple sectors, especially human health, animal health, and agriculture.

The Africa Union Framework for Antimicrobial Resistance Control, 2020-2025 details strategies for Africa CDC to improve data surveillance, delay AMR emergence and limit transmission and mitigate harm from resistant pathogens.

Based on the findings, Africa CDC and ASLM will continue to engage Member States on AMR surveillance and increase the quality and quantity of AMR and AMC data being collected across Africa, along with revised AMR control strategies and research priorities.

Visit the Africa CDC and ASLM websites to access the reports.

ENDS

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About MAAP

MAAP is a consortium of partners, led by ASLM and Africa CDC, alongside, the One Health Trust, the West African Health Organization (WAHO), the East, Central and Southern Africa Health Community (ECSA-HC), Innovative Support to Emergencies, Diseases and Disasters (inSTEDD), and IQVIA.

About Africa CDC

Africa CDC is an autonomous health agency of the African Union which supports Member States in their efforts to strengthen health systems and improve surveillance, emergency response, prevention and control of diseases. Learn more at: http://www.africacdc.org

About the African Society for Laboratory Medicine (ASLM)

ASLM is an independent, international, not-for-profit organisation founded in March 2011 in Addis Ababa that coordinates, galvanises and mobilises relevant stakeholders at the local, national, and international levels to improve local access to world-class diagnostic services and ensure healthy African communities now and for the long-term. ASLM is the first pan-African society for laboratory professionals, endorsed by the African Union (AU) and supported by multiple African Ministers of Health through its Ministerial Call for Action. https://aslm.org

About the Fleming Fund

The Department of Health and Social Care (DHSC)’s Fleming Fund is a UK aid programme supporting up to 25 countries across Africa and Asia to tackle antimicrobial resistance (AMR), a leading contributor to deaths from infectious diseases worldwide.

The Fleming Fund invests in strengthening AMR surveillance systems through a portfolio of country grants, regional grants and fellowships managed by Mott MacDonald, and global projects managed by DHSC. Flemingfund.org / @FlemingFund