Fleming Fund Implementation in Kenya: What Have We Learned About Strengthening One Health Antimicrobial Resistance Surveillance for Decision-making?
24 affiliations
- 1Family Health and Infectious Diseases, East Central and Southern Africa Health Community, Arusha, Tanzania.
- 2Itad, United Kingdom.
- 3Global Health-AMR, Nairobi, Kenya.
- 4Division of Quality Improvement, Infection Prevention and Control and Antimicrobial Resistance, Kenya National Public Health Institute, Nairobi, Kenya.
- 5State Department of Livestock Development, Directorate of Veterinary Services, Nairobi, Kenya.
- 6National Laboratory Science and Biosecurity, Kenya National Public Health Institute, Nairobi, Kenya.
- 7International Livestock Research Institute (ILRI), Nairobi Kenya.
- 8Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.
- 9Department of Laboratory Medicine, Kenyatta National Hospital, Nairobi, Kenya.
- 10Department of Veterinary Pathology, Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya.
- 11Department of Medicine, University of Nairobi, Nairobi, Kenya.
- 12Aga Khan University Hospital, Nairobi, Kenya.
- 13Commonwealth Pharmacists Association, London, United Kingdom.
- 14African Society for Laboratory Medicine, Addis Ababa, Ethiopia.
- 15University of Copenhagen, Copenhagen, Denmark.
- 16Mott MacDonald.
- 17Otago Global Health Institute, University of Otago, Aotearoa, New Zealand.
- 18The Aga Khan University Centre for Global Child Health.
- 19Fleming Fund Technical Advisory Group AG.
- 20University of Oxford.
- 21Oxford Health Evaluations, United Kingdom.
- 22Independent Consultant, Brighton, United Kingdom.
- 23City St George's, University of London.
- 24Fleming Initiative, Imperial College, London, United Kingdom.
Abstract
Background
Kenya has moved from fragmented, pilot-based antimicrobial resistance (AMR) surveillance toward a coordinated One Health system, and its experience, pathways of change, and remaining gaps are relevant for other low- and middle-income settings working to operationalize One Health AMR surveillance.Methods
Here, we report a narrative overview of programmatic learning using 2018 as the pre-Fleming Fund baseline, drawing on national and global surveillance reports, monitoring frameworks from the Quadripartite indicators, qualitative evidence on governance, implementation and policy evolution across the One Health sectors, and Fleming Fund documentation.Results
Since 2018, AMR surveillance expanded from 2 human health sites to 30 human, animal, and environmental sites by 2025. National reports evolved to integrate AMR, antimicrobial consumption, and antimicrobial use data; routine reporting to global platforms matured; and outputs such as dashboards, reports, and policy briefs informing stewardship, Infection Prevention and Control, regulatory action, and policy decisions. External benchmarks showed improvement in AMR-related capacity, with World Health Organization Joint External Evaluation scores moving from limited to demonstrated capacity for surveillance and multisectoral coordination.Conclusions
Kenya's experience suggests that sustainable progress depends on embedding AMR surveillance within government-led governance structures, technical systems, and coordinated partner support, but sustaining gains will require predictable financing and routine data use.
Related
- The Fleming Fund: Key Features of Design and Approach to Strengthening Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries.
- Antimicrobial Resistance (AMR) Surveillance: Ten Years On.
- Antimicrobial resistance of bacteria isolated from blood cultures at a tertiary hospital in Papua New Guinea: implications for antimicrobial stewardship and surveillance
- A practical guide to structured data processing for antimicrobial resistance surveillance.
- Surveillance Data Use Through the Fleming Fund: Informing Action on Antimicrobial Resistance in Low- and Middle-Income Countries.
BibTeX
@article{wesangula2026fleming,
title = {{Fleming Fund Implementation in Kenya: What Have We Learned About Strengthening One Health Antimicrobial Resistance Surveillance for Decision-making?}},
author = {Evelyn Wesangula and Nkatha Gitonga and Emmanuel Tanui and Romona Ndanyi and Susan Githii and Bridgit Syombua Muasa and Eunice Omondi and Eric M Fèvre and Dishon M Muloi and Ali Kassim and Josiah Mwenda and Christine Minoo Mbindyo and Irungu John Kamau and Loice Achieng Ombajo and Gunturu Revathi and Veronica Chuchu and Anafi Mataka and Moctar M M Mouiche and Arshnee Moodley and Stanley Fenwick and Deborah Nanjebe and Lillian Bibangamba and Patrick Mubangizi and Toby Leslie and John A Crump and Zulfiqar Ahmed Bhutta and Tim Walsh and Kate Macintyre and Rebecca Maudling and Solomon Mugabe and Raheelah Ahmad and Lamiaa Shehata and Tim Shorten},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {2026},
month = oct,
doi = {10.1093/cid/ciag500},
url = {https://europepmc.org/article/MED/42895841},
note = {CC BY},
}
RIS
TY - JOUR
TI - Fleming Fund Implementation in Kenya: What Have We Learned About Strengthening One Health Antimicrobial Resistance Surveillance for Decision-making?
AU - Evelyn Wesangula
AU - Nkatha Gitonga
AU - Emmanuel Tanui
AU - Romona Ndanyi
AU - Susan Githii
AU - Bridgit Syombua Muasa
AU - Eunice Omondi
AU - Eric M Fèvre
AU - Dishon M Muloi
AU - Ali Kassim
AU - Josiah Mwenda
AU - Christine Minoo Mbindyo
AU - Irungu John Kamau
AU - Loice Achieng Ombajo
AU - Gunturu Revathi
AU - Veronica Chuchu
AU - Anafi Mataka
AU - Moctar M M Mouiche
AU - Arshnee Moodley
AU - Stanley Fenwick
AU - Deborah Nanjebe
AU - Lillian Bibangamba
AU - Patrick Mubangizi
AU - Toby Leslie
AU - John A Crump
AU - Zulfiqar Ahmed Bhutta
AU - Tim Walsh
AU - Kate Macintyre
AU - Rebecca Maudling
AU - Solomon Mugabe
AU - Raheelah Ahmad
AU - Lamiaa Shehata
AU - Tim Shorten
PY - 2026
DA - 2026/10/01
JO - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
DO - 10.1093/cid/ciag500
UR - https://europepmc.org/article/MED/42895841
AB - Background Kenya has moved from fragmented, pilot-based antimicrobial resistance (AMR) surveillance toward a coordinated One Health system, and its experience, pathways of change, and remaining gaps are relevant for other low- and middle-income settings working to operationalize One Health AMR surveillance.Methods Here, we report a narrative overview of programmatic learning using 2018 as the pre-Fleming Fund baseline, drawing on national and global surveillance reports, monitoring frameworks from the Quadripartite indicators, qualitative evidence on governance, implementation and policy evolution across the One Health sectors, and Fleming Fund documentation.Results Since 2018, AMR surveillance expanded from 2 human health sites to 30 human, animal, and environmental sites by 2025. National reports evolved to integrate AMR, antimicrobial consumption, and antimicrobial use data; routine reporting to global platforms matured; and outputs such as dashboards, reports, and policy briefs informing stewardship, Infection Prevention and Control, regulatory action, and policy decisions. External benchmarks showed improvement in AMR-related capacity, with World Health Organization Joint External Evaluation scores moving from limited to demonstrated capacity for surveillance and multisectoral coordination.Conclusions Kenya's experience suggests that sustainable progress depends on embedding AMR surveillance within government-led governance structures, technical systems, and coordinated partner support, but sustaining gains will require predictable financing and routine data use.
SN - 1058-4838
SN - 1537-6591
ER -