Implementation of GLASS-AMR: An assessment in WHO's Eastern Mediterranean Region

Area of Science:

• Public Health
• Epidemiology
• Global Health Security

Background:

• The Global Antimicrobial Resistance and Use Surveillance System (GLASS) was established to monitor antimicrobial resistance (AMR) globally.
• Antimicrobial resistance poses a significant threat to public health worldwide, necessitating robust surveillance systems.

Purpose of the Study:

• To evaluate the implementation of the GLASS AMR surveillance system in the World Health Organization's Eastern Mediterranean Region.
• To assess the key attributes of the GLASS AMR system using a mixed-methods approach.

Main Methods:

• Adapted the US Centers for Disease Control framework for evaluation.
• Utilized mixed methods, including document review, analysis of surveillance data, and triangulation with national focal points.
• Reviewed GLASS documents, reports, Regional External Quality Assessment Scheme (REQAS) data, and WHO consultant reports.

Main Results:

• All countries in the region submitted data to GLASS by 2022, but representativeness varied.
• Complex data management and reporting requirements, alongside potential issues in patient selection and laboratory quality assurance, impacted data sensitivity and quality.
• While data quality showed some strengths compared to other WHO regions, significant inter-country variations in quality and completeness were observed.
• The system's yearly reporting structure limited timely local feedback loops for decision-making.

Conclusions:

• Variable data quality, sensitivity, representativeness, and timeliness may have hindered the system's utility for guiding decision-making.
• Future implementation of national AMR surveillance systems must prioritize sustainability and the generation and utilization of high-quality data for prompt interventions.