AMR in low-resource settings: Médecins Sans Frontières bridges surveillance gaps by developing a turnkey solution, the Mini-Lab

Abstract Background In low-and–middle-income countries (LMIC), data related to antimicrobial resistance (AMR) are often inconsistently collected. Humanitarian, private, and non-governmental medical organizations (NGO), working with or in parallel to public medical systems, are sometimes present in these contexts. Yet, what is the role of NGOs in the fight against AMR, and how can they contribute to AMR data collection in contexts where reporting is scarce? How can context-adapted, high-quality clinical bacteriology be implemented in remote, challenging, and underserved areas of the world? Aim To provide an overview of AMR data collection challenges in LMIC and describe one initiative, the Mini-Lab project developed by Medecins Sans Frontieres (MSF), that attempts to partially address them. Sources We conducted a literature review using PubMed and Google scholar databases to identify peer-reviewed research and grey literature from publicly available reports and websites. Content We address the necessity of and difficulties related to obtaining AMR data in LMIC, as well as the role that actors outside of public medical systems can play in the collection of this information. We then describe how the Mini-Lab can provide simplified bacteriological diagnosis and AMR surveillance in challenging settings. Implication NGOs are responsible for a large amount of healthcare provision in some very low-resourced contexts. As a result, they also have a role in AMR control, including bacteriological diagnosis and the collection of AMR-related data. Actors outside of the public medical system can actively contribute to implementing and adapting clinical bacteriology in LMIC and can help improve AMR surveillance and data collection.