Surveillance Data Use Through the Fleming Fund: Informing Action on Antimicrobial Resistance in Low- and Middle-Income Countries

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ID: 332999
2026
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Ranked #612 of 619 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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Abstract
Abstract Background Drawing on the Fleming Fund's work to strengthen antimicrobial resistance (AMR) surveillance across Africa and Asia during 2018–2026, this article provides one of the first syntheses of AMR surveillance data use in low- and middle-income countries. Methods A participatory synthesis for narrative review was conducted to summarize experience across administrative levels (facility, subnational, national, and regional). Results Data use was most evident at the facility level, in human health systems where resistance patterns, antimicrobial use, and clinical data increasingly informed antimicrobial stewardship, infection prevention and control, and other quality improvement initiatives. Data use in other sectors required different approaches. At the national level, Fleming Fund investments were associated with revisions of treatment guidelines, updates of essential medicines lists, and regulatory measures, primarily through improved governance and policy communities. Regional platforms supported member country data use at the national level. Subnational data use was undertaken in countries with decentralized health systems. Across levels, data use pathways driven by local priorities helped surveillance inform action. Conclusions Fleming Fund experience suggests that surveillance is more likely to inform action when data use is built into system design. Continued investment will be needed if AMR surveillance is to improve policy and practice in low- and middle-income countries.
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Authors Archie Drake, Alesia Dedaa Ofori, Amy Rahmadanti, Ankur Gupta‐Wright, Areeya Disratthakit, Ayodele Oluwakemi Majekodunmi, Benjamin Kissi Sasu, Nicola Claire Gordon, Claudia Parry, Collins Mitambo, Deborah Nanjebe, Desrina Sitompul, Didem Törümküney, Evelyn Wesangula, Freddy Eric Kitutu, Heidi Hopkins, Jacob Wildfire, Japheth A. Opintan, Jack Armitage, Joseph Sam Kanu, Kate Macintyre, Kriti Khurana, Lamiaa Shehata, Manish Pathak, Megha Raj Banjara, Milena L. von und zur Muhlen, Muhammad Taimoor Kayani, Muhammad Usman Zaheer, Mwapu Dika Ndahi, Nandini Shetty, Nicholas Feasey, Nigel Peter French, Nimesh Poudyal, Nure Alam Siddiky, Paul Turner, Pem Chuki, Qadeer Ahsan, Rebecca Maudling, Ritu Amatya, Satyajit Sarkar, Syed Shahid Abbas, Tamalee Roberts, Tauqeer Mustafa, Tim Shorten, Titha Dzowela, Toby J Leslie, Tochi Joy Okwor, Yu Nandar Aung
Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2026
DOI
10.1093/cid/ciag520
URL
https://doi.org/10.1093/cid/ciag520
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