Abstract
Research, collaboration, and knowledge exchange are critical to global efforts to tackle antimicrobial resistance (AMR). Different healthcare economies are faced with different challenges in implementing effective strategies to address AMR. Building effective capacity for research to inform AMR-related strategies and policies is recognised as an important contributor to success. Interdisciplinary, intersector, as well as international collaborations are needed to span global to local efforts to tackle AMR. The development of reciprocal, long-term partnerships between collaborators in high-income and in low- and middle-income countries (LMICs) needs to be built on principles of capacity building. Using case studies spanning local and international research collaborations to codesign, implement, and evaluate strategies to tackle AMR, we have evaluated and build upon the ESSENCE criteria for capacity building in LMICs. The first case study describes the local codesign and implementation of antimicrobial stewardship (AMS) in the state of Kerala in India. The second case study describes an international research collaboration investigating AMR surgical patient pathways in India, the UK, and South Africa. We describe the steps undertaken to develop robust, agile, and flexible AMS research and implementation teams. Notably, investing in capacity building ensured that the programmes described in these case studies were sustained through the current severe acute respiratory syndrome coronavirus pandemic. Describing the strategies adopted by a local and an international collaboration to tackle AMR, we provide a model for capacity building in LMICs that can support sustainable and agile AMS programmes.
Highlights
Antimicrobial resistance (AMR), leading to a decrease in effectiveness of antibiotics, is a major global health threat (Holmes et al, 2015)
The 2014 ‘Review on antimicrobial resistance’, Chaired by Jim O’Neill, estimated that 10 million deaths could be attributed to AMR by 2050, with the majority of these deaths predicted to be in low- and middle-income countries (LMICs) (O’Neill, 2016)
Where there is access to diagnostic laboratories, incidences of unnecessary testing as well as antibiotic prescribing in the absence of any microbiology tests results remain high (Skodvin et al, 2019; Charani et al, 2019c). Solutions to overcome these challenges have been reported in LMICs, an example being in Vietnam where an internationally funded and established research collaboration has been successful in delivering a sustainable antimicrobial stewardship (AMS) programme, including enhanced laboratory capacity (Wertheim et al, 2013)
Summary
Antimicrobial resistance (AMR), leading to a decrease in effectiveness of antibiotics, is a major global health threat (Holmes et al, 2015). Solutions to overcome these challenges have been reported in LMICs, an example being in Vietnam where an internationally funded and established research collaboration has been successful in delivering a sustainable AMS programme, including enhanced laboratory capacity (Wertheim et al, 2013).
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