In the ongoing battle against the growing threat of antimicrobial resistant (AMR) pathogens, Sierra Leone's Ministry of Health, with support from the World Health Organization (WHO), has embarked on a series of crucial training initiatives. These efforts aimed to equip healthcare professionals especially laboratory officers with the necessary skills to identify bacterial agents and perform antibiotic susceptibility tests as part of activities to combat the threat of AMR effectively.

At the forefront of these initiatives are two comprehensive training programs that were held at the Wusum Hotel in Makeni. The first program, spanning two days from the 15^th -16^th February 2024, provided a refresher training and orientation sessions for twenty-nine (29) phlebotomists. The training focused on enhancing their expertise in aseptic collection of blood sample, packaging, and efficient shipping to microbiology laboratories for further analytical processes.

In the second initiative, a four-day training session from the 18^th -22^nd February 2024, brought together twenty-seven (27) laboratory technologists from hospitals across various districts, including Kailahun, Kenema, Kambia, Western Area Urban, Western Area Rural, and Tonkolili. The primary objective was to empower these professionals with crucial skills in Laboratory Quality Management Systems (LQMS), essential for ensuring the accuracy and reliability of laboratory tests, particularly in identifying bacterial pathogens and conducting antibiotic susceptibility testing.

AMR has been identified as a significant public health challenge by the WHO, with bacterial agents rapidly developing resistance to antibiotics. To address this issue, the WHO has established the Global Antimicrobial Resistance and Use Surveillance System (GLASS) to collect data on AMR from member countries.

In 2019, it was estimated that there were 9,700 AMR-related deaths in Sierra Leone. Out of 19 countries in the African region, Sierra Leone had the 5th highest age-standardized AMR-related mortality.  The absence of bacteriology capacities, antimicrobial stewardship programs, and the high usage of antibiotics in public hospitals will increase the burden of AMR in the country.

In line with WHO recommendations, Sierra Leone is actively working to establish national coordinating centers for AMR surveillance and enhance laboratory capacities for testing and surveillance. While AMR surveillance strategies have been developed, there is a pressing need to strengthen national laboratory capabilities for bacterial identification and antibiotic susceptibility testing.

Thanks to financial support from the Fleming Fund, WHO Sierra Leone has facilitated the procurement laboratory equipment and reagents, renovation of three laboratory sites, and provided capacity building for laboratory staff. The training on LQMS, jointly facilitated by MOH officials and WHO technical officers covered 12 essential quality elements outlined in the WHO Laboratory Quality Management System curriculum.

Upon completion of these activities, Sierra Leone will boast three bacteriology laboratories capable of testing and confirming diseases such as acute watery diarrhea, bacterial meningitis, and other bacterial infections. These laboratories will also conduct antibiotic susceptibility testing that will provide clinicians with evidence-based data for antibiotic prescription and generate AMR data that will be submitted to GLASS. Moreover, Sierra Leone's contributions to global surveillance programs like GLASS will enable policymakers to make informed decisions and update guidelines for improving antibiotic treatments regularly. By strengthening laboratory capacities and enhancing AMR surveillance, Sierra Leone is taking proactive steps towards safeguarding public health and combating the global threat of antimicrobial resistance.Top of Form