{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:56:56Z","timestamp":1781614616721,"version":"3.54.5"},"reference-count":23,"publisher":"BMJ","issue":"Suppl 1","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":76,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,6,1]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antimicrobial resistance (AMR) is a major global health threat, and African countries are disproportionately affected due to limited diagnostic capacity, weak surveillance and inadequate monitoring of antimicrobial consumption (AMC). This study analysed regional trends using the Tracking Antimicrobial Resistance Country Self-Assessment Survey (TrACSS), a standardised tool for monitoring national progress in AMR response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an analysis of the TrACSS database covering 47 African countries (2017\u20132024). Indicators included national AMC monitoring systems, national AMR surveillance systems and laboratory capacity focusing on public and private bacteriology coverage and antimicrobial susceptibility testing (AST) for WHO-priority bacteria and critical fungi. Descriptive and trend analyses were performed, and the association between AMC and AMR system maturity was examined using logistic regression and correlation tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between 2017 and 2024, the proportion of countries with advanced AMC monitoring more than doubled (13%\u201330%), while advanced AMR surveillance quadrupled (13%\u201357%). From 2022 to 2024, public-sector bacteriology coverage rose from 80%\u201394%\u2009and private sector coverage from 60%\u201375%. Nearly all countries (95.7% in 2024) reported at least one reference laboratory performing AST for priority bacteria, though pathogen-specific reporting remained limited, with the lowest capacity for\n                      <jats:italic>Campylobacter spp.<\/jats:italic>\n                      (reported by a maximum of 12.2% of countries annually). Dual Candida and Aspergillus testing increased from 23% to 30%, but nearly half (46.8%) of countries still lacked a national mycology reference laboratory. Countries with advanced AMC systems were significantly more likely to also have advanced AMR surveillance (OR 8.1; p&lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The WHO African Region has made measurable progress in AMR response over the past 8 years, though gains remain uneven. Strengthening mycology services, expanding bacteriology coverage and integrating AMC and AMR data systems are critical next steps towards achieving resilient, evidence-driven surveillance networks that can better guide stewardship and investment decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004532","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:20:16Z","timestamp":1781612416000},"page":"e004532","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["8 years of strengthening AMR response capacity in the WHO African region (2017\u20132024): progress in antimicrobial consumption monitoring, surveillance and laboratory capacity"],"prefix":"10.1136","volume":"4","author":[{"given":"Laetitia","family":"Gahimbare","sequence":"first","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0765-7497","authenticated-orcid":false,"given":"Chinwe","family":"Iwu-Jaja","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yidnekachew Degefaw","family":"Mazengiya","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheick O","family":"Coulibaly","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lubaju R Z","family":"Lugor","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambele Judith","family":"Mwamelo","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Medicine, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6832-873X","authenticated-orcid":false,"given":"Olushayo Oluseun","family":"Olu","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Ahmed","family":"Yahaya","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"2026061605201030000_4.Suppl_1.e004532.1","unstructured":"World Health Organization . Antimicrobial resistance. 2020."},{"key":"2026061605201030000_4.Suppl_1.e004532.2","unstructured":"O\u2019Neill J . Review on antimicrobial resistance. Tackling drug-resistant infections globally. 2016."},{"key":"2026061605201030000_4.Suppl_1.e004532.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01867-1"},{"key":"2026061605201030000_4.Suppl_1.e004532.4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4081\/jphia.2023.2392","article-title":"Monitoring progress on antimicrobial resistance response in the WHO African Region: insights from the TrACSS 2021. Results for the Human Health Sector","volume":"14","author":"Gahimbare","year":"2023","journal-title":"J Public Health Afr"},{"key":"2026061605201030000_4.Suppl_1.e004532.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-017-2713-1","article-title":"Antimicrobial resistance in Africa: a systematic review","volume":"17","author":"Tadesse","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2026061605201030000_4.Suppl_1.e004532.6","doi-asserted-by":"crossref","DOI":"10.2471\/BLT.17.191890","article-title":"Antimicrobial resistance: translating political commitment into national action","volume":"95","author":"Inoue","year":"2017","journal-title":"Bull World Health Organ"},{"key":"2026061605201030000_4.Suppl_1.e004532.7","unstructured":"World Health Organization . Global action plan on antimicrobial resistance. Microbe mag. 2015.1. Available: https:\/\/iris.who.int\/bitstream\/handle\/10665\/193736\/9789241509763_eng.pdf?sequence=1 [accessed 12 Apr 2024]"},{"key":"2026061605201030000_4.Suppl_1.e004532.8","doi-asserted-by":"crossref","DOI":"10.12688\/wellcomeopenres.12523.1","article-title":"Supporting surveillance capacity for antimicrobial resistance: Laboratory capacity strengthening for drug resistant infections in low and middle income countries","volume":"2","author":"Seale","year":"2017","journal-title":"Wellcome Open Res"},{"key":"2026061605201030000_4.Suppl_1.e004532.9","first-page":"S76","article-title":"A Cross-Cutting Approach to Surveillance and Laboratory Capacity as a Platform to Improve Health Security in Uganda","volume":"16","author":"Lamorde","year":"2018","journal-title":"Health Secur"},{"key":"2026061605201030000_4.Suppl_1.e004532.10","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.3390\/antibiotics12081313","article-title":"Laboratory Surveillance, Quality Management, and Its Role in Addressing Antimicrobial Resistance in Africa: A Narrative Review","volume":"12","author":"Musa","year":"2023","journal-title":"Antibiotics (Basel)"},{"key":"2026061605201030000_4.Suppl_1.e004532.11","article-title":"Antimicrobial resistance in the WHO African region: current status and roadmap for action","volume":"39","author":"Essack","year":"2017","journal-title":"J Public Health"},{"key":"2026061605201030000_4.Suppl_1.e004532.12","unstructured":"World Health Organization . Global database for tracking antimicrobial resistance (AMR) country self- assessment survey (TrACSS). 2023."},{"key":"2026061605201030000_4.Suppl_1.e004532.13","unstructured":"World Health Organization . Global antimicrobial resistance and use surveillance system (GLASS) report: antibiotic use data for 2022. Geneva World Health Organization; 2025."},{"key":"2026061605201030000_4.Suppl_1.e004532.14","unstructured":"World Health Organization . Global antibiotic resistance surveillance report 2025. WHO global antimicrobial resistance and use surveillance system (GLASS). Geneva World Health Organization; 2025."},{"key":"2026061605201030000_4.Suppl_1.e004532.15","unstructured":"The Fleming Fund . Strengthening antimicrobial resistance surveillance to safeguard public health. Stories of national progress in Africa and Asia, supported by fleming fund investments. 2024."},{"key":"2026061605201030000_4.Suppl_1.e004532.16","unstructured":"World Health Organization . GLASS guide for national surveillance systems for monitoring antimicrobial consumption in hospitals. 2020."},{"key":"2026061605201030000_4.Suppl_1.e004532.17","unstructured":"World Health Organization, Regional Office for Africa . Regional strategy for integrated disease surveillance and response: 2020\u20132030. Sixty-ninth session Brazzaville, Republic of Congo, 19\u201323 August 2019. 2019."},{"key":"2026061605201030000_4.Suppl_1.e004532.18","doi-asserted-by":"crossref","DOI":"10.12688\/wellcomeopenres.23133.1","article-title":"Progress on implementing the WHO-GLASS recommendations on priority pathogen-antibiotic sensitivity testing in Africa: A scoping review","volume":"9","author":"Hope","year":"2024","journal-title":"Wellcome Open Res"},{"key":"2026061605201030000_4.Suppl_1.e004532.19","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3390\/antibiotics11040427","article-title":"Antimicrobial Susceptibility Testing: A Comprehensive Review of Currently Used Methods","volume":"11","author":"Gajic","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"2026061605201030000_4.Suppl_1.e004532.20","unstructured":"World Health Organization . WHO fungal priority pathogens list to guide research, development and public health action. Geneva World Health Organization; 2022."},{"key":"2026061605201030000_4.Suppl_1.e004532.21","doi-asserted-by":"crossref","first-page":"101438","DOI":"10.1016\/j.mycmed.2023.101438","article-title":"Fungal diseases in Africa: Closing the gaps in diagnosis and treatment through implementation research and advocacy","volume":"33","author":"Bongomin","year":"2023","journal-title":"J Med Mycol"},{"key":"2026061605201030000_4.Suppl_1.e004532.22","unstructured":"World Health Organization, Regional Office for Africa . AFR\/RC73\/7. Regional strategy on diagnostic and laboratory services and systems, 2023\u20132032 for the WHO African Region. Regional Committee for Africa; 2023."},{"key":"2026061605201030000_4.Suppl_1.e004532.23","unstructured":"World Health Organization . The fourth WHO model list of essential in vitro diagnostics: report of the fourth meeting of the WHO Strategic Advisory Group of Experts on In Vitro Diagnostics, 2022 (including the fourth WHO model list of essential in vitro diagnostics). Geneva World Health Organization; 2023."}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-004532","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:20:39Z","timestamp":1781612439000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-004532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":23,"journal-issue":{"issue":"Suppl 1","published-online":{"date-parts":[[2026,6,16]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bmjph-2025-004532"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-004532","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}