Ethiopia’s One Health AMR surveillance: challenges, opportunities, and future prospects

Antimicrobial resistance (AMR) presents a critical challenge to public health, with significant threats to human, animal, and environmental health. Ethiopia’s efforts to establish a robust AMR surveillance system, which aligns with the One Health approach, have faced challenges, yet present notable opportunities for integration and improvement. 

Facing a global threat 

AMR poses a global threat by compromising the effectiveness of treatments against bacterial, viral, and fungal infections. For countries like Ethiopia, which carry a heavy burden of infectious diseases, developing an effective AMR surveillance system is critical for ensuring food safety and safeguarding livelihoods. However, limited resources present challenges in building such systems, including weak health infrastructures, limited laboratory capacity, and competing government priorities. 

The One Health approach is particularly relevant to AMR as it emphasizes the interconnectedness of human, animal, and environmental health. Through this lens, Ethiopia has begun integrating AMR surveillance systems across these sectors. This integrated approach allows for the monitoring of resistance patterns, enables a comprehensive data collection across the different heath sectors, improves resource allocation for the prevention effort  and early detection of emerging AMR threat, which can help in shaping effective public health responses. 

AMR surveillance in Ethiopia 

Ethiopia’s current AMR surveillance efforts are divided between human health and the agrifood system. While the human health sector benefits from more established laboratories and coordination mechanisms, surveillance in animal, plant and environmental health remains underdeveloped. Moreover, the surveillance of substandard and falsified medical products, and antimicrobial residues in food-producing animals is still evolving. 

Despite efforts, surveillance across sectors remains fragmented, with inconsistent data collection, reporting systems, and a lack of integration at the national level. The human health sector utilizes better-established coordination mechanisms and data management platforms like WHONET, while the animal health sector lags in its use of the SILAB system for surveillance. 

An assessment conducted by FAO and its partners sought to identify these gaps and provide recommendations for improvement. It revealed considerable variations in laboratory capacity, diagnostic capabilities, access to resources and funding and data management across sectors. The findings will help shape future strategies for the integration of AMR surveillance under a national One Health approach.

Like many low- and middle-income countries, Ethiopia’s AMR surveillance faces several challenges:

Inadequate laboratory infrastructure and input: A lack of advanced diagnostic equipment and regular supplies of testing the necessary laboratory reagents and supplies hinders the accuracy and efficiency of laboratories.

Training gaps: Despite capacity-building efforts, training and retaining skilled personnel, particularly microbiologists and technicians, remains a challenge. Training experts in laboratory equipment maintenance and calibration also remains essential to ensure reliable quality test results and effective implementation of Quality Management Systems.

Data collection and management: Inconsistent epidemiological data collection and a lack of integrated reporting platforms result in incomplete and unreliable AMR trend analysis.

National coordination: Coordination and standardization across different health sectors, especially in animal health, are weak, hampering efforts to achieve a unified One Health AMR data system.