Bangladesh—Fleming Fund Phases I and II

The Fleming Fund is a U.K. Department of Health and Social Care program administered through Mott Macdonald to help low- and middle-income countries fight antimicrobial resistance (AMR).

AMR is a leading cause of death globally, research shows that 1.27 million deaths annually are attributable to drug resistance, higher than HIV/AIDS or malaria. DAI’s Fleming Fund program in Bangladesh is a collaboration with the Bangladesh government to strengthen systems using a “One Health” approach—a multisectoral approach to complex health problems that reaches across human health, animal health, and environment sectors. As a global leader in the approach, DAI helps incorporate One Health across program interventions, supporting Bangladesh to become a leader in combating AMR and a model for better management of antimicrobials in human and animal populations.

In Bangladesh, Phase I focused on enhancing laboratory infrastructure, strengthening human resources, improving the AMR and antimicrobial use (AMU) surveillance system, building foundations for using AMR data and promoting the rational use of antimicrobial medicines. Phase II is building on this work to achieve four outcomes: producing high-quality AMR, AMU, antimicrobial consumption, and burden data; developing high-quality analyses of data; sharing the analyses and data with relevant decision-makers; and promoting sustainable investment to counter AMR.

Sample Activities

• Finalize a national surveillance strategy to create sector-specific surveillance protocols and sampling strategies.
• Develop an advocacy strategy to gain key decision-makers’ support for AMR surveillance and its multisectoral governance structure and a national budget contribution.
• Implement a capacity strengthening plan, including joint training on data management and digital health technical support to the data coordinating center for health.
• Support the National Reference Laboratory to conduct monthly supervision visits to surveillance sites to ensure that laboratories have appropriate quality management systems in place.

Select Results

• Finalized the National AMR Surveillance Strategy endorsed by the Bangladeshi Government.
• Finalized sector-specific surveillance plans for human, animal, and aquatic sectors, using a One Health approach.
• Revised government-sponsored AMR sectoral working groups and reorganized or created the relevant committees.
• Completed assessment of targeted laboratories and finalized plans for refurbishment.
• Completed data management assessments in all laboratories and data coordination centers.
• Completed training of trainers program on basic microbiology, biosafety and biosecurity, laboratory data management, and advanced microbiology.
• Completed a survey to assess antimicrobial use in human health, poultry, and fishery sectors.