AMR Genomic Surveillance

Establishing regular sampling and genomic surveillance for antimicrobial resistance at the National Institute of Health. This surveillance will inclusde all outbreak casuing pathogens as indicated by GLASS. This initiative will assess Pakistan's AMR status. A second phase, contingent on budget, involves nationwide drug store surveillance with the the Health Care Commission and Drug Regulatory Authority to evaluate antibiotic distribution.

Dr. Muhammad Salman, ED, National Institute of Health, Focal person, AMR Pakistan

Antimicrobial resistance (AMR) poses a significant and growing threat to public health in Pakistan. With widespread misuse and overuse of antibiotics, coupled with inadequate infection prevention and control measures, the country is facing a concerning rise in resistance to antimicrobial agents. Factors such as easy access to antibiotics without prescription, limited awareness among healthcare professionals and the general public about the appropriate use of antibiotics, and substandard sanitation and hygiene practices contribute to the proliferation of AMR. This situation is exacerbated by the presence of counterfeit and substandard antibiotics in the market, further complicating efforts to combat AMR. The consequences of AMR are far-reaching, impacting the effectiveness of treatments for common infections and increasing healthcare costs due to prolonged illness and the need for more expensive or alternative medications. Addressing the AMR problem in Pakistan requires a multifaceted approach, including strengthening antibiotic stewardship programs, enhancing surveillance and regulatory measures, promoting rational prescribing practices, and improving sanitation and infection control measures in healthcare settings and communities.

Firstly, this solution will bolster the efforts of the NIH. Despite the OneHealth program being situated within the NIH, there are shortcomings in sample collection. This solution aims to fortify the sample collection system.

Lastly, the genomic analysis will not only help in maintaining the data but also help in highlighting the antibiotics for which microbes have built resistance.

Enhancing the AMR sample collection system ensures the availability of reliable data for surveillance. By implementing meticulous strategies such as assigning individuals to territories for weekly sample collection, we guarantee a continuous stream of accurate data that is essential for monitoring AMR trends. This improved surveillance system not only provides valuable insights into the prevalence and spread of AMR but also facilitates early detection of emerging resistance patterns, enabling prompt interventions to safeguard public health.

Genomic analysis in AMR surveillance represents a significant advancement in understanding AMR mechanisms and tracking resistance evolution over time. By leveraging genomic data from collected samples, we gain valuable insights into the genetic basis of antimicrobial resistance, allowing for the development of precise interventions and tailored treatment guidelines. This empowers health authorities and researchers to effectively combat AMR and minimize its impact on public health.

Antibiotic market analysis contributes to the public good by providing insights into antibiotic consumption patterns nationwide. By collaborating closely with regulatory bodies and compiling detailed information on antibiotic usage, we can identify areas of misuse and develop targeted interventions to mitigate AMR. This proactive approach not only helps combat AMR but also promotes responsible antibiotic use, ultimately benefiting public health.

Our solution for AMR genomic surveillance will create tangible impact by strengthening surveillance efforts and informing targeted interventions to combat antimicrobial resistance (AMR). By enhancing the sample collection system, we ensure a continuous stream of accurate data crucial for monitoring AMR trends. This will benefit health authorities, researchers, and policymakers by providing them with reliable information to develop precise interventions and tailor treatment guidelines. Additionally, our genomic analysis will deepen understanding of AMR mechanisms, enabling the identification of emerging resistance patterns and tracking resistance evolution over time. This empowers stakeholders to assess the impact of public health initiatives and implement effective strategies to mitigate AMR. Our comprehensive antibiotic market analysis will further inform interventions to combat misuse and promote responsible antibiotic use, benefiting public health in Pakistan and contributing to the global fight against AMR.

Over the next year, we aim to scale our impact by expanding the reach of our enhanced sample collection system. Through strategic partnerships with OneHealth and other relevant stakeholders, we will establish additional collection points and increase the frequency of sample collection. This will ensure a more comprehensive and timely data collection process, enabling us to monitor AMR trends more effectively. Furthermore, we will focus on optimizing our genomic analysis capabilities, investing in advanced technologies, and training to enhance our ability to identify emerging resistance patterns and track resistance evolution.Looking ahead to the next three years, we plan to further scale our impact by leveraging our established infrastructure and expertise. We will explore opportunities to integrate our solution into existing healthcare systems, collaborating with government agencies and healthcare providers to institutionalize AMR surveillance practices. Additionally, we will seek to expand our antibiotic market analysis efforts to other regions beyond Pakistan, applying our insights and methodologies to address AMR on a broader scale. By continuously refining our approach and expanding our reach, we aim to make a significant and sustained contribution to the global fight against antimicrobial resistance.

We measure success against our impact goals through a multi-faceted approach that encompasses several key indicators. Firstly, we track the effectiveness of our enhanced sample collection system by monitoring the frequency and coverage of sample collection activities, ensuring that samples are collected consistently and from diverse geographical areas. Additionally, we assess the quality and accuracy of the collected data by evaluating the reliability of the information provided and comparing it with established benchmarks. Gauge the impact of our genomic analysis efforts by monitoring our ability to identify and track emerging resistance patterns over time. By analyzing trends in resistance data and correlating them with our interventions, we can evaluate the effectiveness of our strategies in combating AMR. Finally, we measure the success of our comprehensive antibiotic market analysis by assessing the extent to which our insights inform targeted interventions to mitigate misuse and combat AMR. By tracking changes in antibiotic consumption patterns and assessing the impact of our interventions on prescribing practices, we can determine the effectiveness of our efforts in promoting responsible antibiotic use and reducing AMR prevalence.

Barriers to accomplishing our goals in Pakistan over the next year and three years include logistical challenges in implementing our enhanced sample collection system, limited resources for conducting comprehensive antibiotic market analysis, and potential regulatory hurdles in genomic analysis.

To overcome these barriers, we plan to establish strong partnerships with local stakeholders, including government agencies and healthcare providers, to streamline sample collection processes and ensure consistent data flow to the NIH. Additionally, we will seek funding opportunities and collaborations to expand our antibiotic market analysis efforts and overcome resource constraints. We will also engage proactively with regulatory authorities to address any regulatory challenges related to genomic analysis, advocating for streamlined processes and compliance standards.

Furthermore, investing in capacity-building and training programs for local staff will enhance our operational efficiency and ensure the sustainability of our initiatives. By fostering collaboration, leveraging resources effectively, and advocating for regulatory support, we are confident in our ability to overcome these barriers and achieve our goals in combating antimicrobial resistance in Pakistan.