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Annual review 2022

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Fighting drug-resistant microbes

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Overuse of antimicrobial drugs is endangering human health and agriculture by producing resistant microbes. Combatting this threat demands global cooperation and surveillance data. As the Fleming Fund’s management agent, we are playing a key role.

Project

Fleming Fund

Client

UK Department of Health and Social Care (DHSC)

Location

22 priority countries across Africa and Asia

Expertise

Programme and fund management; human, animal, and environmental health; international development; capacity building; programme sustainability.

Project value

£265M

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A broad strategy

The success of the programme depends on the quality and quantity of data that flows from each country’s laboratories into national and global surveillance systems. We work with governments to identify and fill gaps in national AMR capacity, ensuring that funding is distributed where it can achieve most value and in countries with the highest vulnerabilities.

The Fleming Fund’s grants have enabled governments with overstretched health budgets to strengthen laboratory and diagnostic capacity at 240 sites and improve biosafety and biosecurity to ensure bacterial samples are collected, handled, processed, and stored safely.

Taking a multidisciplinary One Health approach to combating AMR is an integral part of the programme. Some drug-resistant viruses, bacteria, fungi, and parasites move freely between humans, animals, and the environment; therefore, they cannot be effectively controlled without cross-sectoral collaboration.

Advanced equipment

Advanced lab equipment, including bacterial culture and antimicrobial susceptibility testing instruments and mass spectrometers, has been delivered to human and animal health laboratories to improve AMR testing accuracy and increase AMR testing capacity. Funding has also been used to upgrade information management and quality assurance systems and provide training to ensure data is collected, monitored, interpreted and shared effectively.

The Fleming Fund also has a fellowship programme, which has created a global network of multidisciplinary AMR experts and advocates. We have supported 184 fellows across 22 countries, providing peer-to-peer mentoring and training. These experts are forging strong links across the human, animal, and environmental health sectors, sharing knowledge, furthering collaboration, and pushing for greater alignment in policy and strategy.

240

laboratory sites received investment

184

fellows supported across 22 countries

Equipping laboratories and creating a global network of experts

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Nurturing expertise and connections

Alongside the numerous technical challenges in tackling AMR, there are a huge range of policy implications that cut across the One Health sectors – human, animal, and the environment. The Fleming Fund fellowships support the professional development of AMR practitioners and influencers. We partner with universities and other institutions across the world to provide high quality mentorship and training.

In Kenya, the programme has sparked collaboration and friendship between two policy fellows – Dr Evelyn Wesangula, patient safety unit lead at the Ministry of Health in Kenya with over 15 years’ experience as a pharmacist, and Dr Romona Ndanyi, head of Kenya’s National Veterinary reference laboratory for AMR in animal health as a veterinarian for more than 20 years.

The duo say they benefited from compassionate leadership training, communication tutorials, mentoring and lectures on policy issues provided by the University of Edinburgh. “Policy discussions with members of the Scottish government were a useful way to learn about how human and animal health staff in Scotland work together to deal with AMR challenges that we also face in Kenya,” says Dr Ndanyi.

Coaching and mentoring have helped them to work more effectively in multisector AMR teams with colleagues across the Ministries for Health, Agriculture and the Environment, with the ministries now sharing resources and collaborating more closely. The pair have also built open communication through an active WhatsApp group with members from each ministry.

“We are equal players with equal responsibility when we plan and chair AMR meetings, and we speak with one voice on AMR issues,” says Dr Wesangula, who is also a senior AMR Project Officer at the WHO, supporting east, central and southern African countries to implement NAPs on AMR. “We all own the problem and the actions, which makes a big difference when it comes to implementing interventions.”

Thanks to Fleming Fund support, AMR data on humans, animals and the environment is now available in Kenya. The data findings have encouraged the various sectors to act on AMR. “If there wasn’t national data available then people m