In LMICs, several factors have led to a lack of AMR surveillance, from inadequate laboratory capacity to a simple lack of funding for such programs. In public health laboratories, many lab workers aren’t trained and can’t carry out tests for antimicrobial resistance. Facilities frequently lack functioning equipment, or have unreliable access to electricity, water, or necessary chemicals to carry out tests. In places where public labs have some testing capacity, there’s little to no standardization between locations.

 

In these countries, though, private healthcare and private labs are a quickly growing enterprise—and can solve some of the quality problems of public facilities. Majority of the labs accredited by national and international organizations in these countries belong to private sector. For example in India and South Africa >90% and >80% of the accredited labs belong to private sector, respectively. These accredited labs have better trained staff, greater capacity for quality testing and information systems to store and manage data.

 

CDDEP’s ResistanceMap is one of the first projects to collect AMR data from LMICs, gathering information on antibiotic resistance rates from private lab networks. For instance, in India, ResistanceMap utilizes data from a large private laboratory network with, approximately 5700 collection points including private hospitals and community diagnostic labs in 26 states, aggregating more than 18,000 blood isolates between 2008 and 2014. In South Africa, CDDEP has combined private lab data with public sector data to estimate the extent of antibiotic resistance using several sources, and compare resistance rates between public and private sectors.