Strengthening One Health Antimicrobial Resistance Surveillance in Bangladesh: Insights from the Fleming fund country grant.

چکیده اصلی

Antimicrobial resistance (AMR) is an escalating global public health concern, with particularly severe implications for low and middle-income countries such as Bangladesh. In Bangladesh context, fragmented surveillance systems and the extensive use of antimicrobials across human, animal, and aquaculture sectors contribute to the rapid emergence and spread of resistance. Strengthening integrated surveillance through a One Health approach is therefore crucial to support effective policy development and response strategies. This review outlines the policy, implementation, and key outcomes of the Fleming Fund Country Grant in Bangladesh between 2020 and 2025. It draws upon multiple data sources, including programme reports, routine AMR surveillance data, laboratory capacity-building initiatives, and stakeholder engagement activities across human, animal, aquaculture, and environmental sectors. Through this initiative, a coordinated national AMR surveillance network was established, comprising 20 laboratories across multiple sectors, including three designated national reference laboratories. The initiative strengthened surveillance through the introduction of standardized protocols and SOPs, improved diagnostic capacity, skilled workforce, and implementation of laboratory quality assurance systems, including EQA and NEQA. These measures enhanced the accuracy, consistency, and reliability of AMR surveillance data. In addition, the establishment of a national AMR data integration platform facilitated real time data sharing and evidence-based decision-making. A total of 208,346 bacterial isolates were analyzed, with AST results reported to the AMR dashboard across the human, and animal, health sectors. Overall, the Fleming Fund programme has made a substantial contribution to strengthening integrated AMR surveillance in Bangladesh by operationalizing a One Health framework. Continued political commitment, increased domestic investment, and the institutionalization of surveillance systems will be essential to sustain these gains and ensure long-term resilience against AMR.

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