Editorial Antimicrobial resistance surveillance in Africa: Successes, gaps and a roadmap for the future

Since the World Health Organization (WHO) launched the Global Antimicrobial Resistance Surveillance System (GLASS) in 2015,1 there has been rapidly growing awareness among many African countries that they need to be doing more to combat antimicrobial resistance (AMR). The Africa Centres for Disease Control and Prevention (CDC) was officially inaugurated in January 20172 and will support countries commencing surveillance for serious infectious disease threats in Africa, including resistance. Review of the recent WHO GLASS report suggests that, while certain nations do have some surveillance systems in place, very few countries in Africa currently conduct effective routine surveillance.1 As editors of this special edition, our experience confirms this observation. Nonetheless, we were encouraged by the range and scope of articles we received when the call for this special edition went out. The subjects covered include multi-drug resistant tuberculosis,3,4,5 which remains a critical public health threat on the African continent, nosocomial infections,6,7 including those due to Clostridium difficile8, laboratory methods and technical issues,9,10 including external quality assessment11 and molecular methods,3,12,13 and malaria.14 Community-acquired resistance was underrepresented, although there was a major review on AMR in Vibrio cholerae O1.15 The articles included opinion pieces, general and systematic reviews and original research. What we missed was more original research with a wider range of country submissions and better regional representation, more articles looking at One Health, veterinary medicine and AMR, more studies with data on AMR in community-acquired pathogens and AMR trend data by country, including bacteria, fungi and parasitic infections, and better detail on antiretroviral resistance in HIV infection. We are pleased to find that the special issue’s Call for Papers increased the overall frequency of submissions in this area and so subsequent regular issues of the journal are likely to continue the exposition of AMR surveillance in Africa that this issue has initiated.