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Antimicrobial resistance preparedness in sub-Saharan African countries

Elton, Linzy; Thomason, Margaret J.; Tembo, John; Velavan, Thirumalaisamy P.; Pallerla, Srinivas Reddy; Arruda, Liã Bárbara; Vairo, Francesco; Montaldo, Chiara; Ntoumi, Francine; Abdel Hamid, Muzamil M.; Haider, Najmul; Kock, Richard; Ippolito, Giuseppe; Zumla, Alimuddin; McHugh, Timothy D.


Linzy Elton

Margaret J. Thomason

John Tembo

Thirumalaisamy P. Velavan

Srinivas Reddy Pallerla

Liã Bárbara Arruda

Francesco Vairo

Chiara Montaldo

Francine Ntoumi

Muzamil M. Abdel Hamid

Najmul Haider

Richard Kock

Giuseppe Ippolito

Alimuddin Zumla

Timothy D. McHugh


Background: Antimicrobial resistance (AMR) is of growing concern globally and AMR status in sub-Saharan Africa (SSA) is undefined due to a lack of real-time data recording, surveillance and regulation. World Health Organization (WHO) Joint External Evaluation (JEE) reports are voluntary, collaborative processes to assess country capacities and preparedness to prevent, detect and rapidly respond to public health risks, including AMR. The data from SSA JEE reports were analysed to gain an overview of how SSA is working towards AMR preparedness and where strengths and weaknesses lie.
Methods: SSA country JEE AMR preparedness scores were analysed. A cumulative mean of all the SSA country AMR preparedness scores was calculated and compared to the overall mean SSA JEE score. AMR preparedness indicators were analysed, and data were weighted by region.
Findings: The mean SSA AMR preparedness score was 53% less than the overall mean SSA JEE score. East Africa had the highest percentage of countries reporting having AMR National Action Plans in place, as well as human and animal pathogen AMR surveillance programmes. Southern Africa reported the highest percentage of countries with training programmes and antimicrobial stewardship.
Conclusions: The low mean AMR preparedness score compared to overall JEE score, along with the majority of countries lacking implemented National Action Plans, suggests that until now AMR has not been a priority for most SSA countries. By identifying regional and One Health strengths, AMR preparedness can be fortified across SSA with a multisectoral approach.


Elton, L., Thomason, M. J., Tembo, J., Velavan, T. P., Pallerla, S. R., Arruda, L. B., …McHugh, T. D. (2020). Antimicrobial resistance preparedness in sub-Saharan African countries. Antimicrobial Resistance and Infection Control, 9(1),

Journal Article Type Article
Acceptance Date Aug 6, 2020
Publication Date Aug 28, 2020
Deposit Date Sep 3, 2020
Publicly Available Date Sep 3, 2020
Journal Antimicrobial Resistance & Infection Control
Print ISSN 2047-2994
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 9
Issue 1
Public URL
Publisher URL


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