Evaluation of Integrated Antimicrobial Resistance Surveillance Capacity: A Multi-Sectoral Survey of Veterinary, Public Health, and Environmental Laboratories

Abstract

The current paper is an analysis of the global trends and barriers to the combined antimicrobial resistance surveillance capacity in human, veterinary, and environmental laboratories during 2021 to 2024. The study was a hybrid cross-sectional and longitudinal study that entailed the use of standardized tests and key informant interviews of 150 laboratories within the One Health sectors. The results suggest that long-standing unequal distribution of surveillance capacity of antimicrobial resistance has existed, with the public health labs possessing more infrastructure, quality management, and antimicrobial susceptibility testing (AST) capacity as compared to their counterparts in the veterinary and environmental sectors. Despite the gradual technical improvements mentioned, certain internal flaws, such as unreliable utilities, inadequate training, and inefficient quality management systems, remain. There was no significant difference in measures of integration (inter-sectoral coordination and data interoperability), with only the data harmonization being statistically significant (p=0.045). In the research article, the governance failure in the systems, particularly the absence of legally enforceable frameworks, and the poor representation of the environmental sector, are cited as the main impediments to operational integration of One Health. The strategic suggestions demand the harmony of data management protocols, the necessity to invest in the laboratory infrastructure, the need to apply the concept of total quality management, and the need to have the legal provisions of inter-sectoral coordination. These areas need to be intensified to convert the current soiled surveillance systems into a practical network, which is integrated to an extent of informing the evidence-based antimicrobial resistance policy and response.