Preventing and Controlling Global Antimicrobial Resistance — Implementing a Whole-System Approach

   This Perspective advocates for a whole-system approach to combating antimicrobial resistance (AMR), emphasizing the need to move beyond fragmented interventions toward integrated, sustainable solutions. Drawing on lessons from the SPIDAAR initiative in Ghana, Kenya, Malawi, and Uganda, the authors highlight systemic failures in surveillance, diagnostics, treatment, and data management. They propose five key strategies: (1) applying failure-mode analysis to identify weak points in AMR systems; (2) aligning national action plans with implementation and scale-up realities; (3) fostering peer-learning networks for AMR teams; (4) accelerating adoption of leapfrog innovations suited to low-resource settings; and (5) embedding AMR efforts within broader health system strengthening and One Health platforms. The Ugandan Ministry of Health’s surveillance diagram illustrates the complexity of AMR data flows across facility, national, and global levels. The authors call for coordinated, context-driven planning led by country stakeholders and supported by global partners.

   This Perspective advocates for a whole-system approach to combating antimicrobial resistance (AMR), emphasizing the need to move beyond fragmented interventions toward integrated, sustainable solutions. Drawing on lessons from the SPIDAAR initiative in Ghana, Kenya, Malawi, and Uganda, the authors highlight systemic failures in surveillance, diagnostics, treatment, and data management. They propose five key strategies: (1) applying failure-mode analysis to identify weak points in AMR systems; (2) aligning national action plans with implementation and scale-up realities; (3) fostering peer-learning networks for AMR teams; (4) accelerating adoption of leapfrog innovations suited to low-resource settings; and (5) embedding AMR efforts within broader health system strengthening and One Health platforms. The Ugandan Ministry of Health’s surveillance diagram illustrates the complexity of AMR data flows across facility, national, and global levels. The authors call for coordinated, context-driven planning led by country stakeholders and supported by global partners.