Mugerwa Ibrahimm, Nabadda Susan N, Midega Janet, Guma Consolata, Kalyesubula Simeon, Muwonge Adrian
National Health Laboratories and Diagnostic Services, Antimicrobial Resistance National Coordination Centre (AMR-NCC) for Human Health, Ministry of Health, Butabika, Kampala 10312, Uganda.
The Welcome Trust, 215 Euston, London NW1 2BE, UK.
Trop Med Infect Dis. 2021 Sep 29;6(4):178. doi: 10.3390/tropicalmed6040178.
Antibiotic resistance and its mechanisms have been known for over six decades, but global efforts to characterize its routine drivers have only gained momentum in the recent past. Drivers of clinical and community resistance go beyond just clinical practice, which is why one-health approaches offer the most realistic option for controlling antibiotic resistance. It is noteworthy that the emergence of resistance occurs naturally in the environment, but akin to climate change, the current accelerated emergence and spread bears hallmarks of anthropomorphic influence. If left unchecked, this can undo the medical and agricultural advancements of the last century. The WHO recommends that nations develop, adopt, and implement strategies that track the changing trends in antibiotic resistance levels to tackle this problem. This article examines efforts and progress in developing and implementing a human health antimicrobial resistance surveillance strategy in Uganda. We do so within the context of the National Action Plan for tackling antimicrobial resistance (AMR-NAP) launched in 2018. We discuss the technical milestones and progress in implementing surveillance of GLASS priority pathogens under this framework. The preliminary output of the framework examines the performance and compares AMR and AMU surveillance data to explain observed trends. We conclude that Uganda is making progress in developing and implementing a functional AMR surveillance strategy for human health.
抗生素耐药性及其机制已为人所知六十多年，但全球确定其常规驱动因素的努力直到最近才开始有进展。临床和社区耐药性的驱动因素不仅仅局限于临床实践，这就是为什么“同一健康”方法为控制抗生素耐药性提供了最现实的选择。值得注意的是，耐药性在环境中自然出现，但与气候变化类似，当前加速出现和传播具有人为影响的特征。如果不加以控制，这可能会使上个世纪的医学和农业进步付诸东流。世界卫生组织建议各国制定、采用和实施追踪抗生素耐药性水平变化趋势的战略来解决这个问题。本文探讨了乌干达在制定和实施人类健康抗菌药物耐药性监测战略方面所做的努力和取得的进展。我们是在2018年启动的应对抗菌药物耐药性国家行动计划（AMR-NAP）的背景下进行探讨的。我们讨论了在此框架下实施对全球抗菌药物耐药性和使用监测系统（GLASS）重点病原体监测的技术里程碑和进展。该框架的初步成果考察了性能，并对比了抗菌药物耐药性和抗菌药物使用监测数据，以解释观察到的趋势。我们得出结论，乌干达在为人类健康制定和实施有效的抗菌药物耐药性监测战略方面正在取得进展。
