AMR Surveillance Pilot Study among chicken layering farmers within Kiambu County, Kenya. Photo Credit: ©FAO/Luis Tato

Nairobi - Antimicrobial resistance (AMR) is of growing global concern. AMR in human pathogens is forecast to cause an increasing number of deaths accompanied by rising costs in healthcare. Usage of antimicrobials in humans and animals leads to selection for resistance; furthermore, from a One Health perspective, the close connection between animals, food, people and the environment requires urgent action across sectors for reduced and more prudent use in both humans and animals.

The Antimicrobial Resistance (AMR) Network Meeting for East Africa was organized by the Food and Agriculture Organization of the United Nations (FAO) in collaboration with the World Organisation for Animal Health (OIE). The meeting brought together 37 participants drawn from the Ministries in charge of agriculture in Djibouti, Ethiopia, Eritrea, Kenya, Rwanda, South Sudan, Sudan and Uganda. Representatives from the following agencies attended OIE, ILRI, CDC-Kenya, University of Nairobi, KEMRI, World Animal Protection, and FAO (Rome, Sudan, Ethiopia, Zimbabwe and Kenya). The objectives of the meeting were to:

1. Share information on the progress made in the implementation of National Action Plan in the countries, challenges and lessons learnt.
2. Review progress made in countries in the development and implementation of AMR surveillance strategies, identify challenges, lessons learnt and potential solutions to address the gaps
3. Review the regional framework for AMR Surveillance and agree on whether countries aspire to have a regional surveillance approach, its scope, funding/resources and next steps to implement including priorities for the next year.
4. Review progress made in countries in the development and implementation of AMU monitoring and surveillance strategies, identify challenges, lessons learnt and potential solutions to address the gaps

Key highlights from country updates and subsequent discussions included:

• Kenya, Uganda, Ethiopia and Sudan have launched their multi-sectoral OH AMR National Action Plans and begun implementation.
• Rwanda, South Sudan, Eretria and Djibouti have either not started their NAP development process or are still in the planning phase, with a resultant low level of implementation of AMR specific activities.
• Significant awareness raising activities have been undertaken in Kenya, Ethiopia, Uganda, and Sudan especially during the annual World Antibiotic Awareness Week, targeting the media, general public and veterinarians. However, the focus of awareness should be extended to include more farmers and frontline staff who are primary users of antimicrobials
• Kenya, Uganda and Ethiopia have made progress in delineating their AMR surveillance strategies/plans, articulated objectives, priority pathogens and antimicrobials.
• Kenya, Ethiopia and Sudan have applied FAO’s Assessment Tool for Laboratories and Antimicrobial resistance Surveillance Systems (ATLASS), which assists in prioritizing capacity-building activities.
• Kenya has undertaken a mapping process to analyse end to end the national value chain of veterinary antimicrobial products,
• Kenya, Ethiopia and Sudan have undertaken mixed method participatory research in key animal production sectors (supported by UK Fleming Fund) to contextualize antimicrobial use, aimed at informing interventions to improve responsible use of antimicrobials
• In summary Ethiopia and Kenya had made significant progress on AMR activities in food and agriculture during the past two years. Sudan and Uganda are expected to follow the Kenya and Ethiopia as implementation of NAPs has just begun. However, it was acknowledged that there is a real need for additional support for national efforts

Countries agreed on to advance regional collaboration on surveillance through a number of key actions:

1. Further development of a regional surveillance framework setting out core criteria encompassing priority target sectors, bacterial species, antimicrobials, epidemiological approaches and standardization of laboratory methodologies, according to international standards.
2. Creation of a regional surveillance roadmap (operational plan) to support national implementation of surveillance programmes, drafted by FAO based on the activities identified by the East Africa network which will serve as a menu to channel support offered by international and regional bodies, investors etc.
3. Creation of a formal AMR sub-network, proposed to sit within the East Africa Animal Health Network (EAAH) under the existing laboratory and epidemiology networks. In parallel, the Inter-Agency Group on AMR (IAG) will be consulted by FAO and OIE on how to create a One Health regional AMR platform within one or more of the RECs, which will target decision makers.
4. A Technical Advisory Group in East Africa (TAG-EA) will be created to be responsible for finalization of the surveillance framework, as well as provision of technical support and development of template protocols, SOPs and methodologies. The group will be composed of national experts from each country, as well as regional experts (academia, industry) and international experts, (e.g. from AMR reference centres). FAO and OIE will initiate formation of the TAG-EA.

Overall, the participants from the various countries were very engaged and interactive, and having them all together was very important in order to build a firm foundation for a harmonized AMR and AMU surveillance approach and success.

For more information contact: [email protected]