A surveillance programme is only useful while it can keep producing dependable information. Work undertaken through the Surveillance Partnership to Improve Data for Action on AMR, or SPIDAAR, examined how to build that continuity into antimicrobial resistance monitoring.
The scale behind the work
The original report cited estimates linking nearly five million deaths worldwide to bacterial AMR in 2019, with 1.3 million directly attributable to it. It also highlighted a mortality rate of 27.3 per 100,000 in sub-Saharan Africa and limited laboratory capacity: bacteriology testing was reported in only 1.3% of 50,000 laboratories across 14 African countries.
Building a testing network
Pfizer, Wellcome Trust and health ministries in Ghana, Kenya, Malawi and Uganda worked together through SPIDAAR. Training covered clinical and microbiological staff at eight hospitals. Sites were asked to test 100 bacterial isolates from selected pathogens, with confirmation provided by South Africa's National Institute for Communicable Diseases.
Planning for continuity
In May 2021, Pfizer brought in Innovations in Healthcare to support longer-term planning. Over two years, the organisation worked with ministry and hospital teams on a sustainability framework, a supporting checklist and ways to assess progress. Peer learning gave participants opportunities to discuss obstacles and exchange practical responses.
Learning from local experience
Case studies from Ghana, Kenya and Uganda drew on interviews and desk research. Progress differed between settings, making local circumstances an important part of the findings. The wider lesson was that equipment and initial training need to sit within systems that can maintain skills, quality and institutional ownership after the first phase of a project.
