An integrated approach to surveillance spanning different sectors has been promoted by international organisations for more than a decade and constitutes a central recommendation of the WHO action plan on AMR. The objective of the network is to develop guidance for a harmonised evaluation framework that will address the specific needs of integrated surveillance systems for AMR.
Two main scientific workshops will be used to build on researchers’ experience and expertise and harmonise existing evaluation frameworks and approaches. Protocols and written guidance will be developed and made publicly available through an existing online website used for surveillance evaluation (SurvTools). Results will allow understanding of the potential value of integrated surveillance for AMR, and comparing integrated surveillance strategies across countries in order to identify the most cost-effective approaches.
- Barbara Haesler, Royal Veterinary College, United Kingdom (Coordinator)
This network includes 19 partners, please click on the following link to see complete network composition: Network composition Convergence in evaluation frameworks for integrated surveillance of AMR (CoEval-AMR)
Antimicrobial resistance refers to the ability of a microorganism (such as bacteria, viruses and fungi) to resist the effects of a drug. Consequently, common medicines used to treat infections may no longer be effective. Antimicrobial-resistant microorganisms can be found in people, animals, food and the environment and may spread from one to the other. These linkages need to be considered when designing surveillance strategies to monitor existing resistance, identify new resistance, understand how resistance evolves, and plan and evaluate policies for resistance reduction. International organisations have called for collaboration across public, animal and environmental health sectors. Several surveillance strategies exist that span multiple sectors, but their effectiveness and economic efficiency remain ambiguous.
Therefore, we created the network CoEvalAMR, which stands for “Convergence in evaluation frameworks for integrated surveillance of antimicrobial usage and antimicrobial resistance”. The network brought together more than 30 international experts (researchers and other stakeholders) in surveillance, evaluation and antimicrobial resistance to develop guidance for the evaluation of integrated surveillance for antimicrobial use and antimicrobial resistance. We were particularly interested in researching the cross-sectoral dimensions of such integrated surveillance.
We formed 5 working groups (WGs) and compiled a list of existing evaluation tools for surveillance (some were general tools and some targeted specifically antimicrobial usage and antimicrobial resistance). WG1 characterised these existing evaluation tools and categorised them based on defined attributes. WG2 conducted interviews among surveillance stakeholders to determine their most pressing needs for conducting surveillance evaluations in the future. WG3 conducted case studies of a range of existing evaluation tools and documented the experiences of users. Finally, WG4 assembled all aspects to create a publicly available online guidance that also includes an interactive decision-support tool. WG5 was responsible for dissemination, communication and engagement.
The guidance is publicly accessible. It helps users (e.g. personnel working to protect the health of humans, animals, plants and the environment) to gain a better understanding of what needs to be considered when planning an evaluation of integrated surveillance of antimicrobial usage and antimicrobial resistance and what the benefits of such surveillance may be. Moreover, it supports the user in choosing the most appropriate evaluation tool to fulfil their specific evaluation goals and gives them access to the experiences of other users. Ultimately, the guidance helps people to conduct evaluations of their surveillance systems for antimicrobial usage and antimicrobial resistance. The results of such evaluations will allow stakeholders to identify how surveillance effectiveness and efficiency could be improved.
- Clinical Microbiology and Infection, 2020. Evaluating integrated surveillance of antimicrobial resistance: experiences from use of three evaluation tools