Abstract
IntroductionAntimicrobial resistance (AMR) poses a global threat. High levels of AMR to commonly used antibiotics have been reported in East Africa. A situation analysis of AMR in Ethiopia also indicated high resistance levels. To prevent and contain AMR, Ethiopia established a national surveillance network.ObjectivesThis article describes the steps taken to prioritise AMR and establish the National Antimicrobial Resistance Surveillance System in Ethiopia, as well as present the challenges and lessons learned through implementation.MethodsIn April 2017, Ethiopia had developed and approved the National AMR Surveillance Plan for laboratory-based AMR surveillance. The World Health Organization recommendations and Ethiopias’s current microbiology capacity were used to prioritise organisms for reporting. The surveillance system is comprised of a network linking the national reference laboratory with surveillance sentinel sites. Roll-out of the AMR surveillance network occurred in three phases in order to ensure successful implementation.ResultsElectronic capture and transmission of data, supply chain for the microbiology laboratory and communication problems were challenges observed after implementation started. Support from Ethiopian Public Health Institute focal persons for data entry, regular scheduled communication establishment and procurement of supplies by the American Society for Microbiology were some of the measures taken to address the challenges.ConclusionEthiopia has demonstrated that setting up AMR surveillance in lower resource settings is possible with strong leadership and stakeholder engagement.
Highlights
Antimicrobial resistance (AMR) poses a global threat
It is estimated that 700 000 people die every year from drug resistance in common bacterial infections, HIV and malaria
The development and implementation of the Ethiopia antimicrobial resistance (AMR) Surveillance Plan was a national effort led by the Ethiopian Public Health Institute (EPHI) under the Federal Ministry of Health and supported by Centers for Disease Control and Prevention (CDC), the American Society for Microbiology (ASM) as well as Ohio State University’s Global One Health initiative
Summary
The emergence of antimicrobial resistance (AMR) is threatening the effective and successful treatment of infectious diseases. The development and implementation of the Ethiopia AMR Surveillance Plan was a national effort led by the Ethiopian Public Health Institute (EPHI) under the Federal Ministry of Health and supported by CDC, the American Society for Microbiology (ASM) as well as Ohio State University’s Global One Health initiative. Staff from EPHI, stakeholders and other decision-makers used guidance materials from the World Health Organization’s (WHO) Global AMR Surveillance System (GLASS) to inform discussions and decision-making around the selection of sites, organisms and specimens to prioritise for reporting and data management methods.[12]. ASM supported EPHI to train laboratory staff from the initial four surveillance sites in basic microbiology, antibiotic susceptibility testing and data management. For long-term sustainability, EPHI has begun working with the Pharmaceutical Fund and Supplies Agency, Ethiopia’s central procurement agency, to ensure adequate, quality supplies are available in future
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