Health Surveillance and Disease Management / Communicable Diseases / Antimicrobial Resistance
South American Infectious Disease Initiative (SAIDI):Partnerships to Contain Antimicrobial Resistance in South America—An Integrated Approach | ||
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- Goal This fact sheet in PDF For detailed information about SAIDI activities in each country, please visit the special sites at MSH & USAID.
RAVREDA-AMI: Amazon Network for the Surveillance of Antimalarial Drug Resistance (RAVREDA) / Amazon Malaria Initiative (AMI) PAHO Site WHO Sites |
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Antimicrobial resistance (AMR) threatens to reverse advances made in controlling common infectious diseases by making currently available treatments useless. AMR occurs when the microorganisms that cause disease are exposed to inappropriate or low-quality antimicrobials and change in a way that reduces the effectiveness of these medicines. AMR can lead to increased mortality and morbidity (illness), and increase the cost and complexity of health care worldwide. From a public health perspective, the main causes of AMR are using antimicrobials unnecessarily for common illnesses and infections, not taking the prescribed amount in cases when antimicrobials are required, as well as the wide availability of poor quality or substandard medicines. A particularly alarming example of AMR is multidrug-resistant tuberculosis (MDR-TB). The current AMR worldwide epidemic requires local understanding and local solutions to ensure that effective medicines are available, to make well-informed policy decisions, and to set up effective ways to change the way people use antimicrobials. In response to this growing challenge, the USAID Bureau for the Latin America and Caribbean Region has supported the South American Infectious Disease Initiative (SAIDI). Goal: Prevent AMR from occurring, and keep AMR diseases—particularly MDR-TB—from spreading by improving the availability and use of good-quality antimicrobials in Peru, Paraguay, and Bolivia.
USAID has brought together partner organizations already working on rational medicine use and AMR-related activities. The hope is that the organizations' combined technical expertise in identifying what actions lead to inappropriate antimicrobial use, exploring underlying causes of why these actions occur, and documenting what is already known in each country will help national stakeholders find specific local approaches to contain AMR. The international partners contributing to SAIDI activities are:
Through this initiative, these international organizations partner with in-county local stakeholders to form national working groups responsible for coordinating national SAIDI activities. The working groups then communicate and partner with other countries' working groups to form regional collaborations. These multilevel partnerships allow SAIDI collaborators to pool resources, share experiences, create a common knowledge base, and forge long-lasting partnerships. SAIDI works within existing structures to build on in-country efforts to prevent and contain AMR. While supporting existing efforts in AMR surveillance and control, SAIDI creates new sets of community-focused activities that work with all involved groups (patients, health care providers, and organizations working on AMR) at all levels of society in a variety of ways. The long-term goal is a sustainable solution that builds on stakeholder interaction and existing resources. Activities to change how antimicrobials are used are designed using a systemic, interdisciplinary, and holistic approach that considers many aspects of the problem together instead of focusing on isolated components. The national working groups and partners, in conjunction with SAIDI international partners, have carried out a wide variety of assessment activities that provide a complete view of the factors contributing to AMR at the local level. With these results, new gaps in information were identified and, in Peru and Paraguay, intervention work plans were developed to systematically address the most important problem areas. Currently, international and national partners are working together in their implementation. This evidence-based and participatory approach differs from more conventional donor projects that generally support projects promoting preplanned activities addressing AMR solely within the health system. Lessons Learned As described above, approaching partners without a predefined focus or agenda is a key component of the SAIDI approach; it allows for all partners to contribute and own the interventions developed. However, it was found that success in each country is directly related to jointly establishing clearly defined goals, roles, and responsibilities (particularly related to project leadership) at the start of the initiative. Maintaining a flexible and participatory approach was critical to developing local strategies to prevent and contain AMR. As a result, SAIDI partners created individualized interventions in each of the participating countries corresponding to the specifics of local contexts. This flexibility was important when working with local partners to develop the framework of what should be achieved and activity work plans. In each country, SAIDI maximized buy-in by including the widest range of stakeholders possible in work plan development including international technical partners, Ministries of Health, academics, professional associations, and consumers. Whenever possible, lessons learned and best practices were shared between counterparts in each of the participating countries through regional conferences and online forums.
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