Antimicrobial resistance situational analysis 2019–2020: Design and performance for human health surveillance in Uganda

Abstract

Antibiotic resistance and its mechanisms have been known for over six decades, but global efforts to characterize its routine drivers have only gained momentum in the recent past. Drivers of clinical and community resistance go beyond just clinical practice, which is why one-health approaches offer the most realistic option for controlling antibiotic resistance. It is noteworthy that emergence of resistance occurs naturally in the environment, but akin to climate change, the current accelerated emergence and spread bears hallmarks of anthropomorphic influence. If left unchecked, this has the potential to undo medical and agricultural advancements of the last century. To tackle this problem, the WHO recommends that nations develop, adopt and implement strategies that track the changing trends in antibiotic resistance levels. In this article, we examine efforts and progress in developing and implementing a human health antimicrobial resistance surveillance strategy in Uganda. We do so within context of the National Action Plan for tackling antimicrobial resistance (AMR-NAP) launched in 2018. We discuss the technical milestones and progress in implementing surveillance of GLASS priority pathogens under this framework. The preliminary output of the framework is used to examine the performance as well as compare AMR and AMU surveillance data to explain observed trends. We conclude that Uganda is making progress in developing and implementing a functional AMR surveillance strategy for human health.