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Rapid consensus building to strengthen AMR surveillance in LMICs using One Health approach: a modified table-top
Prakash Ghosh1,2,3, Nicola Reck4, Gisela Schneider5
1Institute for Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany prakash.ghosh@uni-leipzig.de.
BMJ Open
|August 4, 2026
Summary
This study aims to establish an operational standard for One Health antimicrobial resistance (OH-AMR) surveillance in low- and middle-income countries (LMICs). A modified Delphi method will be used to achieve expert consensus on OH-AMR surveillance strategies for improved global data quality.
Area of Science:
- Global Health Security
- Infectious Disease Epidemiology
- One Health Surveillance
Background:
- Implementing integrated One Health antimicrobial resistance (OH-AMR) surveillance is challenging in developing countries due to resource limitations and inadequate capacity.
- Disparities in OH-AMR surveillance systems hinder global data harmonization and comparative analyses.
- A multidisciplinary research agenda is crucial for effective OH-AMR surveillance in low- and middle-income countries (LMICs).
Purpose of the Study:
- To set an operational standard for OH-AMR surveillance in LMICs.
- To prioritize a consensus-based multidisciplinary research agenda for OH-AMR.
- To engage experts from relevant domains using a Delphi study.
Main Methods:
- A modified Delphi technique, including a real-time Table-Top Delphi exercise and a second online round.
- Conducting the study during an international conference on AMR to engage diverse experts.
- Utilizing an electronic platform for anonymous data collection and controlled feedback, with consensus defined as >=70% agreement.
Main Results:
- The study aims to achieve consensus among 50 experts from multiple domains.
- Expected participation of at least 40 experts in both Delphi rounds.
- The outcome will inform an optimized OH-AMR surveillance strategy, particularly for the global south.
Conclusions:
- The Delphi study will provide actionable outcomes for implementing optimized OH-AMR surveillance.
- Establishing standardized OH-AMR surveillance is critical for resource-constrained settings.
- This research contributes to improving global antimicrobial resistance data quality and comparability.
