Laboratory tools from the Fleming Fund antimicrobial resistance surveillance programme.

PROBLEM: Current laboratory assessment tools aimed at improving bacteriology and testing for antimicrobial resistance focus on quality of laboratory services. No guidance exists for establishing bacteriology services necessary for diagnosis and surveillance of antimicrobial resistance in low- and middle-income countries.

APPROACH: Comprehensive laboratory needs assessment tools and procurement catalogues were developed, piloted and used by the Fleming Fund programme. These tools were designed to support the strengthening of bacteriology testing capacity within national antimicrobial resistance surveillance systems receiving Fleming Fund support.

SETTING

The tools were used in reference laboratories and surveillance sites for antimicrobial resistance in 24 countries in the African, South-East Asia and Western Pacific regions, comprising 341 clinical, veterinary, aquaculture, food safety and environmental laboratories.

RELEVANT CHANGES: The needs assessment tool provides a structured framework for laboratory renovation and installation of bacteriology testing equipment. The procurement catalogues list reagents and consumables for antimicrobial resistance surveillance of priority pathogens in humans in the World Health Organization Global Antimicrobial Resistance and Use Surveillance System and selected bacteria in terrestrial and aquatic food-producing animals. Combined with training and capacity-building initiatives supported through other Fleming Fund investments, these efforts have substantially enhanced diagnostic capacity for bacterial infections and antimicrobial resistance surveillance in the laboratories.

LESSONS LEARNT: These tools were instrumental in identifying gaps to enhance bacteriology laboratory capacity and capabilities and became an essential resource for procurement, tracking supplies and asset management. The tools are adaptable and can strengthen laboratory capacity in settings and health programmes beyond bacteriology and antimicrobial resistance surveillance.