^{By Tatenda Chimbwanda}  

Masvingo, Zimbabwe – Antimicrobial resistance (AMR) is a threat to global public health, which involves the human, animal, food, plants, and environment sectors. AMR occurs when bacteria and fungi can resist the effects of medications intended to destroy them. As a result, the medications stop working, and diseases may continue to exist in the body or spread to other people.  This increases illness and even death in humans, animals, and plants. It also has implications for food safety, food security and the economic well-being of millions of people. AMR monitoring, which attempts to optimize antibiotic treatment to enhance patient outcomes, decrease possible harm, avoid the evolution of resistance, and save healthcare costs, depends on fully operational microbiology facilities.

“Our microbiology laboratory was almost nonexistent. We used to send samples of our patients to Harare for testing, which delayed diagnosis and occasionally caused patients to pass away before the findings were available,” says Susan Taruwona, Masvingo Provincial Hospital Microbiology Laboratory Technician.

Thanks to the United Kingdom’s (UK) Fleming Fund, the Masvingo Provincial Hospital storeroom was transformed into a new standalone Microbiology Laboratory. In addition, the laboratory was provided with new equipment such as an automated blood culture machine. Blood cultures have always been a critical tool in the management of life-threatening conditions like septicemia, enteric fever, infective endocarditis, and brucellosis. Today Masvingo is now able to conduct blood cultures, which will drastically improve patient management in the province.

The UK’s Development Director and Deputy Head of Mission in Zimbabwe, Mrs Geraldine O'Callaghan expressed how the UK was glad to have funded the upgrade to these laboratories because of the positive impact this will have for Zimbabweans and the health sector. “Reducing the time for laboratory samples to be analyzed allows patients to get an accurate diagnosis and effective treatment faster. This will ultimately save lives,” she said.

Masvingo Provincial Hospital Microbiology Laboratory is one of the 14 newly renovated laboratories furnished with modern equipment and reagent purchases as part of the £4 million Fleming Fund project, "Addressing Gaps in Surveillance of Antimicrobial Resistance in Zimbabwe.” The project's main goal is to support the implementation of activities outlined in Zimbabwe’s National AMR Action Plan (2017-2025).

Zimbabwe’s AMR Fleming Fund grant consortium of the Food and Agriculture Organization of the United Nations (FAO) Biomedical Research and Training Institute (BRTI), and the World Health Organization (WHO) partnered to rehabilitate 14 human and animal health laboratories in three provinces (Bulawayo, Mutare and Masvingo) which were commissioned in May 2022.  The rehabilitation process was part of the first phase of the project which focused on upgrading laboratory infrastructures.  As well as improved capacity at all Fleming Fund-supported sites for bacterial culture, identification, and antimicrobial susceptibility testing (AST) for relevant bacterial pathogens.

The Ministry of Lands, Agriculture, Fisheries, Water and Rural Development (MoLAFWRD) through the Department of Veterinary Services (DVS), the Ministry of Health and Child Care (MoHCC) and the Ministry of Environment, Climate, Tourism and Hospitality Industry (MECTHI) with support from BRTI, FAO and WHO formulated a One Health approach to strengthen the countries AMR surveillance.

“FAO in collaboration with the WHO and BRTI are strengthening AMR surveillance in the Agriculture, Environment and Human Health sectors. This includes laboratory capacity building of the three sectors; strengthening biosecurity and biosafety and improving governance and diagnostic stewardship on AMR including strengthening One Health governance structure for AMR,” said Dr Patrice Talla, FAO Subregional Coordinator for Southern Africa and FAO Representative to Zimbabwe.

Progress review visit of the rehabilitated laboratories in Manicaland, Masvingo and Bulawayo provinces

DVS, MoHCC together with FAO BRTI, and WHO recently conducted a progress review mission in Bulawayo, Masvingo and Mutare. The one-week visit took place between 30 January – 3 February 2023. The joint progress review mission's main objective was to evaluate the 14 laboratories' performance in AMR surveillance to address any challenges to ensure the effective performance of the laboratories. Moreover, the joint visit also focused on supporting the laboratories' sustainable One Health roadmap.

“This joint progress review visit has made us fully appreciate the importance of the One Health Approach in strengthening our AMR surveillance. The 14 rehabilitated laboratories have been incorporated in the MoHCC (2023- 2027) strategic planning for sustainability and the positive results from this visit will go a long way in helping us lobby for more resources to support the laboratories,” says MoHCC, National TB Coordinator, Mr Tanaka Sakubani.

Evidence from the progress review mission showed that there had been a rise in AMR awareness and improved animal-health cooperation. The laboratory staff's capability for AMR surveillance has been bolstered by the new technology, which has also improved results turnaround time. Water and power supply, however, continue to be significant issues that must be resolved to ensure the best performance of the renovated facilities.

Speaking on the sidelines of the progress review mission, WHO Health Strengthening System Technical Officer Dr Stanely Midzi reaffirmed WHO's commitment to continuing to support implementation of the project on AMR surveillance in the human health sector, development of laboratory capacity, and improvement of biosafety.