Surveillance Data Use Through the Fleming Fund: Informing Action on Antimicrobial Resistance in Low- and Middle-Income Countries
Year: 2026
Type: review
Abstract: BACKGROUND: Drawing on the Fleming Fund's work to strengthen antimicrobial resistance (AMR) surveillance across Africa and Asia during 2018-2026, this article provides one of the first syntheses of AMR surveillance data use in low- and middle-income countries. METHODS: A participatory synthesis for narrative review was conducted to summarize experience across administrative levels (facility, subnational, national, and regional). RESULTS: Data use was most evident at the facility level, in human health systems where resistance patterns, antimicrobial use, and clinical data increasingly informed antimicrobial stewardship, infection prevention and control, and other quality improvement initiatives. Data use in other sectors required different approaches. At the national level, Fleming Fund investments were associated with revisions of treatment guidelines, updates of essential medicines lists, and regulatory measures, primarily through improved governance and policy communities. Regional platforms supported member country data use at the national level. Subnational data use was undertaken in countries with decentralized health systems. Across levels, data use pathways driven by local priorities helped surveillance inform action. CONCLUSIONS: Fleming Fund experience suggests that surveillance is more likely to inform action when data use is built into system design. Continued investment will be needed if AMR surveillance is to improve policy and practice in low- and middle-income countries.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciag520
Authors: Archie Drake, Alesia Ofori, Amy Rahmadanti, Ankur Gupta-Wright, Areeya Disratthakit, Ayodele Majekodunmi, Benjamin Kissi Sasu, N Claire Gordon, Claudia Parry, Collins Mitambo, Deborah Nanjebe, Desrina Sitompul, Didem Torumkuney, Evelyn Wesangula, Freddy Eric Kitutu, Heidi Hopkins, Jacob Wildfire, Japheth A Opintan, Jennifer Armitage, Joseph Sam Kanu, Kate Macintyre, Kriti Khurana, Lamiaa Shehata, Manish Pathak, Megha Raj Banjara, Milena von und zur Mühlen, Muhammad Taimoor Kayani, Muhammad Usman Zaheer, Mwapu Ndahi, Nandini Shetty, Nicholas Feasey, Nigel French, Nimesh Poudyal, Nure Alam Siddiky, Paul Turner, Pem Chuki, Qadeer Ahsan, Rebecca Maudling, Ritu Amatya, Satyajit Sarkar, Syed Abbas, Tamalee Roberts, Tauqeer Mustafa, Tim Shorten, Titha Dzowela, Toby Leslie, Tochi Okwor, Yu Nandar Aung
Institutions: Kementerian Kesehatan Republik Indonesia, Heidelberg University, Imperial College London, Mahidol Oxford Tropical Medicine Research Unit, Ministry of Food and Agriculture, UK Health Security Agency, Mott MacDonald (United Kingdom), Public Health Institute of Malawi, Ministry of Health, GlaxoSmithKline Research & Development Limited (United Kingdom), East, Central and Southern Africa Health Community, Uppsala University, Makerere University, University of Ghana, Vrije Universiteit Amsterdam, University of Sierra Leone, Tribhuvan University, Department of Health and Social Care, Food and Agriculture Organization of the United Nations, Federal Ministry of Livestock Development, University of St Andrews, Liverpool School of Tropical Medicine, Massey University, International Vaccine Institute, Angkor Hospital for Children, University of Oxford, Cambodia-Oxford Medical Research Unit, International Centre for Antimicrobial Resistance Solutions, Institute of Development Studies, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Veritas University, Nigeria Centre for Disease Control
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,763
Award: Training Award
OpenAlex ID: W7222931340