Agenda for action
DIAGNOSTICS CENTRAL TO TACKLING RISING AMR BURDEN ACROSS AFRICA
Regional stakeholders discuss AMR + Africa + Diagnostics in South Africa
Research and development, systems strengthening and community engagement around diagnostics are essential to mitigate the growing threat of antimicrobial resistance (AMR), according to leading specialists at a regional stakeholders’ summit co-hosted by FIND and the South African Medical Research Council (SAMRC). AMR + Africa + Diagnostics, held on 30 January 2018 in Cape Town, South Africa, was the first international conference ever to be held in Khayelitsha, a community profoundly affected by HIV and TB – both diseases with particular significance to AMR.
The meeting highlighted important issues for policymakers on the eve of the Prince Mahidol Award Conference 2018, on “Making the World Safe from the Threats of Emerging Infectious Diseases”, taking place in Bangkok. It also feeds into an ongoing analysis by the International Agency Coordinating Group (IACG) on innovation and access priorities.
Speakers from across Africa, including senior representatives from the South African Department of Health, Africa Centers for Disease Control, Right to Care, Médécins Sans Frontieres, top clinicians and academics, patients and community representatives, and industry, discussed critical diagnostic needs and solutions that will help prevent and better treat drug-resistant infection to a wide range of diseases. Significant data presented at the event highlighted the burden of drug-resistant HIV, TB, STIs that threaten people around the world.
Patients and clinicians described their personal experiences, particularly at a community or primary health care level, in tackling drug-resistant forms of common bacterial infections such as TB, cystitis, pneumonia and meningitis, gastrointestinal infections, UTI, and post-operative complications.
Diagnostics available in Europe and the US are not available or affordable in low- and middle-income countries. Many countries now have a national strategy in place, but lack of diagnostic capacity impedes antibiotic stewardship.
Overall conclusions reinforced the newly launched AMR strategy from FIND – the non-profit Foundation for Innovative New Diagnostics. It stresses the role of diagnostics to optimize the use of antibiotics, protect new drugs and empower surveillance – key areas of concern for SAMRC and other regional and international partners.
There was a clear consensus on three research and development priorities, alongside concrete actions that must be taken to strengthen systems and engage the community.
Research and development
- Simple rapid tests for community and primary health workers to distinguish viral from bacterial infections (including mycobacterial and mycotic), and identify key pathogens to enable targeted treatment
- Diagnostic tests for resistance profiling, to facilitate surveillance and ensure appropriate treatment
- Software, such as connectivity tools, to create interconnected diagnostic networks, and decision aid tools to optimize patient management and rational use of antibiotics
- Improved access to quality-assured testing
- Expedited, simpler approval process for diagnostics that reflect the risks and benefits of tests in different regions
- Rapidly implement Essential Diagnostics Lists (EDLs) in line with WHO recommendations
Advocacy and education
- Build on the successes and experience of community coalitions around HIV and TB to engage patient groups and civil society to build awareness of the impact of AMR and the value of diagnostics in saving patients and drugs
- Develop AMR-specific education tools for health workers and laboratory technicians
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- Press release: FIND launches strategy to accelerate diagnostics use to prevent antimicrobial resistance, alongside four forthcoming AMR collaboration agreement
- Meeting brochure
- FIND’s AMR strategy: Accelerating Diagnostics Use to Prevent AMR
- Antimicrobial resistance and diagnostics: One pager
- Quotes provided in support of this meeting
- FIND’s work in AMR – Snapshot
- Tadesse BT et al., Antimicrobial resistance in Africa: A systematic review, BMC Infect Dis, 2017.
- Musicha P et al., Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998-2016): a surveillance study, Lancet Infect Dis, 2017.
- Brink AJ et al., The role of appropriate diagnostic testing in acute respiratory tract infections:
An antibiotic stewardship strategy to minimise diagnostic uncertainty in primary care, SAMJ, 2016.