Work

Strategies and challenges in containing antimicrobial resistance in East Africa: a focus on laboratory-based surveillance

Year: 2025

Type: article

Abstract: BACKGROUND: Antimicrobial resistance (AMR) is increasing worldwide, undermining strides in public health and the economy, particularly in low- and middle-income countries. Africa is the continent with the highest death rate attributed to antimicrobial-resistant infections. There is a lack of information on AMR mitigation strategies and their implementation in the region. The aim of this study was to analyze national strategies to tackle AMR with focus on AMR surveillance in the East African Community (EAC) and their implementation status including the analysis of strengths, weaknesses, opportunities, and threats. METHODS: Within our expert group (composed of representatives from the National Public Health Laboratories (NPHL), Ministries of Health of Burundi, Kenya, Rwanda, South Sudan, Tanzania, and Uganda) we used a qualitative approach to analyze AMR National Action Plans (NAPs), AMR surveillance programs, publications and reports on the AMR situation and strategies in the EAC. RESULTS: We found varying levels of implementation of antimicrobial resistance (AMR) strategies among East African Community (EAC) Partner States. For example, progress in key steps for the sustainable implementation of National Action Plans on AMR (AMR-NAPs) ranged from 7% in Burundi to 94% in Kenya. The overall accomplishment of the WHO checklist for AMR surveillance also varied: 44% in South Sudan, 61% in Burundi, 89% in Rwanda, 94% in Tanzania, and 100% in both Uganda and Kenya. Within EAC Partner States, the detection of bacterial pathogens and their antimicrobial susceptibility profiles is coordinated by national reference laboratories. Most EAC countries have established AMR surveillance systems. However, challenges such as limited laboratory testing capacity, low representativeness of surveillance data, lack of integration among existing systems, and financial constraints undermine efforts to curb AMR. CONCLUSIONS: Regional collaboration among EAC Partner States is essential for an effective and sustainable response to antimicrobial resistance. Strengthening joint efforts will enable countries to share resources, harmonize surveillance systems, and address common challenges more efficiently. The EAC Regional Network of Reference Laboratories is one example of a regional mechanism that can support such collaboration. The findings of this study will inform the development of a regional AMR strategy focused on laboratory-based surveillance and help guide the prioritization of technical and financial support across the EAC region.

Source: Antimicrobial Resistance and Infection Control

DOI: 10.1186/s13756-025-01662-y