Indonesia—Fleming Fund

The Fleming Fund is a U.K Department of Health and Social Care programme to help low- and middle-income countries fight antimicrobial resistance (AMR). DAI’s Fleming Fund programme in Indonesia is a collaboration with the Indonesian 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 global leaders in the approach, the DAI team is helping incorporate One Health across programme interventions. DAI helps Indonesia become a leader in combating AMR, and a model for better management of antimicrobials in human and animal populations.

Fleming Fund Bangladesh partners include Liverpool School of Tropical Medicine, The Aga Khan University, and Health Security Partners.

Sample Activities

• Conduct a political economy analysis to create a formal stakeholder map, review current AMR activities, and consider various AMR governance models. This analysis will be used to conduct an advocacy strategy for sustained high-level ownership by the government to strengthen the capacity of multisectoral coordination.
• In collaboration with the human health technical working group, conduct antimicrobial use and resistance studies and identify a hospital cluster to study prescription patterns.
• Link existing systems in the animal health sector and create means of capturing disaggregated antimicrobial use data, including in-feed use, treatments, pharmacy dispensing for animal use, and public and private clinical usage.

Select Results

• Developed national coordinating mechanisms for AMR plans and strategies across multiple ministries.
• Developed an integrated national information management system to share and analyze AMR data across sectors.
• Piloted AMU study across hospitals.
• Assessing and renovating 32 laboratories in animal health, human health, and aquaculture and procuring blood culture, antimicrobial susceptibility testing, and mass spectrometer instruments for key sites.
• Trained technical laboratory staff in biosafety and biosecurity, bioinformatics and sequencing, epidemiology, antimicrobial susceptibility training, and external quality assurance.
• Implemented a laboratory information management system in animal health laboratories.
• Developed surveillance plans and protocols for AMR and antimicrobial use for cattle and poultry, which have been endorsed by the Government of Indonesia.
• Developing a genomics study, co-funded by the Government of Indonesia, sequencing 200 strains.