Locale : Global (English)
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The Fleming Fund
We are the managing agent for the programme, responsible for awarding grants to strengthen AMR data collection and analysis.
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Tracking the superbugs

Microbes dangerous to human and animal health are becoming increasingly resistant to the drugs used to fight them. We’re helping low- and middle-income countries to understand, detect and tackle this growing global threat.

Client
UK Department of Health and Social Care
Expertise
Project management

Opportunity

Overuse of antimicrobial drugs is making them increasingly ineffective against the bacteria, fungi, viruses and parasites responsible for a host of diseases. Antimicrobial resistance (AMR) poses a global health risk, particularly in low- and middle-income countries. Worldwide, 700,000 people die each year from drug-resistant infections. This is set to rise to 10M annual deaths globally by 2050, with lost production causing a cumulative economic cost of US$100trn.

Reliable global data on the scale of the problem and trends in resistance is needed to tackle and mitigate the growing threat of AMR. In 2015, the UK government launched the £265M Fleming Fund to improve surveillance of AMR in up to 24 low- and middle-income countries. By improving the quality of AMR data collected and reported and national laboratory capacity, the programme’s long-term aim is to leave a legacy of sustainable surveillance that will contribute to the fight against the spread of AMR. We are the managing agent for the programme, responsible for awarding grants to strengthen AMR data collection and analysis.

Solution

About 75% of the funding has been in the form of country grants. These support governments to develop the surveillance capacity needed to achieve their AMR national action plans, developed with the World Health Organization. We review these action plans with governments, then craft the terms of reference for an intervention that will improve the surveillance system. We then oversee procurement of the right delivery partner, check that value for money is being achieved, watch for risks and monitor for technical excellence.

The rest of the funding is split between fellowships and regional grants. Fellowships are awarded to 12-15 people in each country who receive up to 18 months’ training, including mentoring and career development, to build in-country expertise. Regional grants are awarded for multi-country projects, where economies of scale can be achieved. These are focused in areas such as advanced training, which is more cost-effective when done at regional level and boosts knowledge sharing; and standardisation, which improves compatibility between datasets to increase collaboration and a holistic understanding of AMR.

Outcome

So far, we have allocated grants of about £170M in 22 countries in Africa and Asia. This has bolstered AMR surveillance capacity at more than 250 labs and provided more than 20,000 places on training programmes. Our Fleming Fund fellows have already published papers on their findings and recommendations in scientific journals, spreading knowledge and providing a valuable, lasting resource.

Insights into the origin and spread of AMR are already being used to adjust healthcare provision at hospitals and change farmers’ approaches to animal husbandry, with both reducing inappropriate use of antimicrobials.
However, the Fleming Fund will continue to provide benefits long after the programme is wrapped up. As better surveillance, robust monitoring infrastructure and effective international networks provide better data and insights over the coming years, governments will be better equipped to tackle the growing threat of AMR.

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