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HSP in Pakistan: Building Capacity for Antimicrobial Resistance Surveillance

The growing prevalence of antimicrobial resistance (AMR) is a health security issue of global concern. Resistant strains of infectious pathogens spread across national borders quickly and easily, and antibiotic resistance is outpacing the discovery of new drugs. In 2014, the World Health Organization warned that a post-antibiotic era, in which people will die from common infections, is a real and imminent threat.

Though tuberculosis (TB) is traditionally a curable disease, in 2013, there were 480,000 new cases of multi-drug-resistant TB worldwide, the treatment of which requires scarce, costly, and toxic drugs.  Moreover, the U.S. Centers for Disease Control and Prevention (U.S. CDC) estimates that antibiotic resistance causes more than 2 million illnesses and 23,000 deaths each year in the United States alone. While it is difficult to calculate the full social and economic costs of AMR, the combined impact of disability and death, loss of labor productivity, cost to health systems, and the burden of care on communities has extensive repercussions. This challenge has become so pressing that the United Nations is convening a high-level meeting on AMR this month, only the fourth time (after HIV, NCDs, and Ebola) that the General Assembly will be discussing a health-related topic.

To combat the rising AMR crisis in a sustainable manner, HSP is supporting efforts in Pakistan to improve local laboratory capacity for antimicrobial susceptibility testing (AST). Most recently, HSP collaborated with the Department of Pathology and Laboratory Medicine at the Aga Khan University (AKU) Hospital in Karachi and the Medical Microbiology and Infectious Diseases Society of Pakistan (MMIDSP) to host a AMR workshop on August 11th in Peshawar (pictured above) and on September 5th in Lahore.

The events engaged 51 laboratory personnel from Peshawar, Kohat, Rawalpindi, and Lahore to provide training on quality control and the identification and selection of antibiotics for different types of bacteria based on AST guidelines. Expert speakers facilitated group discussions on case studies on identifying and selecting appropriate antibiotic regimes for treating bacterial pathogens. Overall, the exercises aimed to equip the participants with the necessary skills to standardize AST protocols in their own laboratories.

This workshop was a part of a larger effort by HSP and AKU to assist clinical labs to standardize AST procedures and improve quality control. The project, supervised by Prof. Dr. Rumina Hasan at AKU, aims to improve the process of AST standardization and quality assurance as well as provide guidance on equipment monitoring and maintenance involved in AST. As follow-on to this event, participant labs will be invited to an intensive training program to further improve and standardize their AST protocols, build local and sustainable laboratory capacity, and contribute to Pakistan Antimicrobial Resistance Network’s national AMR surveillance program database.

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