Pakistan—Fleming Fund

Client: U.K. Department of Health and Social Care

Duration: 2019-2023

Region: Eastern Europe and Central Asia

Country: Pakistan

Solutions: Global Health

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 Pakistan was a collaboration with the Pakistani 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 One Health, the DAI team helps incorporate One Health across programme interventions. DAI is helping Pakistan become a leader in combating antimicrobial resistance, and a model for better management of antimicrobials in human and animal populations.

Fleming Fund Pakistan partners include the Aga Khan University, Health Security Partners, Indus Hospital Network, and Liverpool School of Tropical Medicine.

Sample Activities

  • Use an evidence-to-action approach that builds on existing assessments to enable a nuanced understanding of the antimicrobial resistance and use (AMR/AMU) challenges and opportunities, entry points, and policy constraints.
  • Foster a data for decision-making mindset, where decision-makers demand evidence for policy and stakeholders are empowered to hold those decision-makers accountable.
  • Build a national-level multisectoral coordination mechanism to effectively address the complexities of AMR/AMU, strengthening information-sharing and coordination across public and private sectors and catalysing political commitment and leadership to drive the AMR agenda.

Select Results

  • Assessed and refurbished 22 animal and human health laboratories.
  • Signed agreements with the Ministry of Health and Ministry of National Food Security & Research
  • Developed operational cost plan for Pakistan’s National AMR Action Plan.
  • Provided high-tech laboratory equipment to national reference laboratories.
  • Conducted surveys of 164 in-service field veterinarians and 443 dairy farmers to assess knowledge, attitudes, and practices regarding AMR/AMU, herd health management and laboratory use.
  • Published a peer-reviewed research article titled “Quantification and Trends of Antimicrobial Use in Commercial Broiler Chicken Production in Pakistan” in the journal Antibiotics.
  • Conducted point prevalence surveys identifying antimicrobial use patterns across human and animal health domains.
  • Delivered training in basic and advanced AMR, biosafety and biosecurity, data analysis for whole genome sequencing, and laboratory quality management systems.
  • Developed governance manual for One Health approach to AMR across Pakistan.
  • Supported the microbiology department in Pakistan’s National Institute of Health Laboratory to pursue accreditation (ISO 15189) used by medical laboratories to certify quality management systems.
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