ASM Responds to PACCARB on Addressing AMR
Paul Plummer, DVM, Ph.D., DACVIM, DECSRHM
Chair, Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Dear Dr. Plummer,
On behalf of the American Society for °®¶¹´«Ã½, thank you for the opportunity to comment on gaps, challenges and opportunities to combat antimicrobial resistance (AMR) globally—specifically in low- and middle-income countries (LMICs). With more than 36,000 members in the °®¶¹´«Ã½ States and around the globe, ASM’s mission is to promote and advance the microbial sciences.
AMR disproportionately affects low- and middle-income countries. Yet, many of these countries lack the infrastructure and resources to perform surveillance required to assess AMR. According to the Mapping AMR and AMU Partnership, a multiorganization and multinational consortium led by the African Society for Laboratory Medicine, only 1.3% of the 50,000 medical laboratories across 14 participating countries conduct bacteriology testing; also noted a shortage of approximately 850,000 laboratory workforce across Africa. A 2018 Lancet paper by Ambassador Nkengasong highlighted the lack of accredited laboratories in Africa. Furthermore, lack resources to establish antimicrobial stewardship programs.
ASM’s Global Public Health Programs work with local, state and national governments to strengthen laboratory capacity in resource-limited settings and to empower microbiology laboratories to integrate clinical care and population surveillance in underserved areas. Over the past few years, we have supported more than 20 countries in strengthening their ability to surveil for, and respond to, over 30 emerging infectious diseases, with over 12,000 laboratorians trained across 400 facilities. This has resulted in accreditation of central laboratories and reporting of data into the World Health Organization’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) and OIE-WAHIS, the Organisation for Animal Health’s World Animal Health Information System. Our goal is to enable sustained, equitable access to quality-assured microbiology services and resources across the One Health spectrum.
Antimicrobial stewardship and other measures to combat AMR are most successful within the context of a strong public health system. Laboratories are the backbone of public health systems and instrumental in controlling the spread of infectious disease and the development of AMR. Addressing AMR will require multilateral commitments to public health and laboratory systems strengthening. While federal funding for lab strengthening continues to be instrumental for low-resource countries to build up their detection and surveillance capabilities, funding commensurate with global risk and impact is needed.
The U.S. must continue investing in programs that strengthen health systems and build laboratory capacity. For example, with funding from the Centers for Disease Control and Prevention's Global AR Lab & Response Network, ASM currently supports programs in Mexico and Brazil. These projects are improving the detection of antimicrobial resistance threats and identifying risk factors that drive the emergence and spread of resistance across health care, the community and the environment. This global network also responds to these threats and informs global prevention strategies for antimicrobial resistance.
Financing research and development of medical products and diagnostics for diseases endemic in LMICs is another challenge that warrants more attention. AMR does not respect geopolitical borders, so efforts to combat AMR domestically should also consider diseases with a significant global burden. In addition to updated breakpoint uptake for diagnostics available and accessible globally, new diagnostics that work within the framework of addressing global delivery challenges are an important part of the solution. This includes both affordability and contextualization to align with target populations. We need end-to-end policies that catalyze both the R&D of novel medical products and equitable access and uptake to global populations.
In closing, ASM recognizes that we cannot meet 21st century challenges without robust and sustained support for global lab capacity. We appreciate this committee’s commitment to amplifying these concerns. ASM appreciates the opportunity to support the committee’s work, and we stand ready to engage our global membership in the fight against AMR. If you have any questions, please contact Wes Kim, Director of Global Public Health, at wkim@asmusa.org or Amalia Corby, ASM Interim Director of Federal Affairs, at acorby@asmusa.org.
Sincerely,
Amalia Corby
Interim Director of Federal Affairs
American Society for °®¶¹´«Ã½
Chair, Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Dear Dr. Plummer,
On behalf of the American Society for °®¶¹´«Ã½, thank you for the opportunity to comment on gaps, challenges and opportunities to combat antimicrobial resistance (AMR) globally—specifically in low- and middle-income countries (LMICs). With more than 36,000 members in the °®¶¹´«Ã½ States and around the globe, ASM’s mission is to promote and advance the microbial sciences.
AMR disproportionately affects low- and middle-income countries. Yet, many of these countries lack the infrastructure and resources to perform surveillance required to assess AMR. According to the Mapping AMR and AMU Partnership, a multiorganization and multinational consortium led by the African Society for Laboratory Medicine, only 1.3% of the 50,000 medical laboratories across 14 participating countries conduct bacteriology testing; also noted a shortage of approximately 850,000 laboratory workforce across Africa. A 2018 Lancet paper by Ambassador Nkengasong highlighted the lack of accredited laboratories in Africa. Furthermore, lack resources to establish antimicrobial stewardship programs.
ASM’s Global Public Health Programs work with local, state and national governments to strengthen laboratory capacity in resource-limited settings and to empower microbiology laboratories to integrate clinical care and population surveillance in underserved areas. Over the past few years, we have supported more than 20 countries in strengthening their ability to surveil for, and respond to, over 30 emerging infectious diseases, with over 12,000 laboratorians trained across 400 facilities. This has resulted in accreditation of central laboratories and reporting of data into the World Health Organization’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) and OIE-WAHIS, the Organisation for Animal Health’s World Animal Health Information System. Our goal is to enable sustained, equitable access to quality-assured microbiology services and resources across the One Health spectrum.
Antimicrobial stewardship and other measures to combat AMR are most successful within the context of a strong public health system. Laboratories are the backbone of public health systems and instrumental in controlling the spread of infectious disease and the development of AMR. Addressing AMR will require multilateral commitments to public health and laboratory systems strengthening. While federal funding for lab strengthening continues to be instrumental for low-resource countries to build up their detection and surveillance capabilities, funding commensurate with global risk and impact is needed.
The U.S. must continue investing in programs that strengthen health systems and build laboratory capacity. For example, with funding from the Centers for Disease Control and Prevention's Global AR Lab & Response Network, ASM currently supports programs in Mexico and Brazil. These projects are improving the detection of antimicrobial resistance threats and identifying risk factors that drive the emergence and spread of resistance across health care, the community and the environment. This global network also responds to these threats and informs global prevention strategies for antimicrobial resistance.
Financing research and development of medical products and diagnostics for diseases endemic in LMICs is another challenge that warrants more attention. AMR does not respect geopolitical borders, so efforts to combat AMR domestically should also consider diseases with a significant global burden. In addition to updated breakpoint uptake for diagnostics available and accessible globally, new diagnostics that work within the framework of addressing global delivery challenges are an important part of the solution. This includes both affordability and contextualization to align with target populations. We need end-to-end policies that catalyze both the R&D of novel medical products and equitable access and uptake to global populations.
In closing, ASM recognizes that we cannot meet 21st century challenges without robust and sustained support for global lab capacity. We appreciate this committee’s commitment to amplifying these concerns. ASM appreciates the opportunity to support the committee’s work, and we stand ready to engage our global membership in the fight against AMR. If you have any questions, please contact Wes Kim, Director of Global Public Health, at wkim@asmusa.org or Amalia Corby, ASM Interim Director of Federal Affairs, at acorby@asmusa.org.
Sincerely,
Amalia Corby
Interim Director of Federal Affairs
American Society for °®¶¹´«Ã½
