Generating Actionable Data From Antimicrobial Resistance Surveillance: Insights From the Fleming Fund's International Experience.

Authors

Ankur Gupta-Wright, Suliat Yetunde Adeleke, Victoria Adetunji, Qadeer Ahsan, Ritu Amatya, Ben Amos, Brian Asare, Sorie I O Bangura, Cyril Buhler, Nicholas Feasey, N Claire Gordon, Heidi Hopkins, Freddy Eric Kitutu, Toby Leslie, Ibrahima Lo, Seynabou Lo, Ayodele Majekodunmi, Rebecca Maudling, Ntombi B Mudenda, Victor Moses Musyoki, Deborah Nanjebe, Tessa Oakley, Manish Pathak, Tamalee Roberts, Lamiaa Shehata, Tim Shorten, Nure Alam Siddiky, John Stelling, Muhammad Taimoor, May Soe Thwe, Shawn Ting, Didem Torumkuney, Paul Turner, Jacob Wildfire, Timothy David Worth

Published in

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. Volume 83. Issue Supplement_1. Pages S13-S24. Oct 19, 2026.

Abstract

Antimicrobial resistance (AMR) is a major global health threat, with the greatest burden falling on low- and middle-income countries (LMICs) also challenged with limited surveillance capacity. The UK Government's Fleming Fund was established in 2015 to strengthen AMR surveillance across Africa and Asia through a One Health approach. This paper draws on program experience, country implementation evidence, and published literature to describe how the Fleming Fund operationalized AMR surveillance, assess its contribution to the quantity and quality of surveillance data, identify key implementation challenges, and consider implications for future global surveillance strategies. The Fleming Fund combined investments in laboratory infrastructure, workforce development, quality assurance, data systems, governance, and data use. Across supported countries, these investments enabled substantial growth in routine bacteriology and antimicrobial susceptibility testing, strengthened reference and surveillance laboratory capacity, increased participation in external quality assessment, and expanded reporting to the World Health Organization's Global Antimicrobial Resistance and Use Surveillance System. The program also supported complementary surveillance approaches, including antimicrobial use and consumption data and, in some settings, burden-of-disease and genomic surveillance. Progress, however, has been uneven and remains vulnerable to fragile infrastructure, procurement and supply chain bottlenecks, workforce turnover, fragmented data systems, weak clinical-laboratory interfaces, limited representativeness, and uncertain long-term financing. The Fleming Fund experience shows that strengthening AMR surveillance in LMICs is feasible, but requires sustained, system-wide investment. Future strategies should prioritize integration with clinical care, stronger digital and analytical capacity, broader diagnostic access, and domestic financing to ensure that high-quality AMR data are generated, shared, and translated into action.

PMID:
42895838
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

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