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Antibiotics
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Global Partnerships in Response to Antimicrobial Resistance: From Policy to...
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Global Partnerships in Response to Antimicrobial Resistance: From Policy to Practice

A Special Issue of Antibiotics (ISSN 2079-6382) belonging to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 3783

Editor

Dr. Helena Rosado

E-Mail Website
Guest Editor
Commonwealth Pharmacists Association, London E1W 1AW, UK
Interests: global and public health; multidisciplinary and collaborative work; education; equity in healthcare; pharmacy; antimicrobial resistance and stewardship

Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) poses a critical threat to global health, disproportionally affecting low- and middle-income countries (LMICs) where health systems face infrastructure and resource constraints. While robust policy frameworks are essential, addressing AMR also requires actionable implementation through effective, real-word interventions and innovation.

This Special Issue aims to highlight the unique intersection of global health partnerships in AMR, with a particular focus on initiatives in LMICs—from strategic frameworks to on-the-ground impact.

We welcome contributions from professionals across the health sector—from academics, researchers, and policy makers to healthcare providers, implementers, and community health workers—sharing their practical experiences, innovations, and evidence-based solutions. Submissions may include original research, case-studies, and policy analyses that explore the design and implementation of AMR interventions, the influence of health partnerships, multidisciplinary, and collaborative work on national, regional, and local practices, and lessons learnt from global health initiatives.

By showcasing real-world solutions and fostering dialogue in the global health arena, this Special Issue aims to deepen understanding of how global health partnerships and collaborations drive sustainable progress, from policy to practice, for the contention of AMR.

Dr. Helena Rosado
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antimicrobial resistance
  • antimicrobial stewardship
  • global health partnerships
  • collaboration
  • low- and middle-income countries
  • health systems strengthening
  • actionable implementation
  • AMR interventions

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Published Papers (5 papers)

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Research

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18 pages, 810 KB  
Article
UK–Africa Leadership Fellowship for Antimicrobial Stewardship (UK-ALF-A): A Bilateral Learning Approach to Advancing AMS Expertise Among Pharmacists
by Siân Price, Yen Truong, Paria Sanaty Zadeh, Gloria Tumukunde, Claire Brandish, Edwin Panford-Quainoo, Sarah Cavanagh, Esther Obiri-Yeboah, Maxencia Nabiryo, Elizabeth Ward, Gizem Gülpinar, Victoria Rutter, Helena Rosado and Chikondi Savieli
Antibiotics 2026, 15(9), 833; https://doi.org/10.3390/antibiotics15090833 - 27 Aug 2026
Viewed by 196
Abstract
Background: Antimicrobial resistance is a growing global health challenge, particularly in low- and middle-income countries where antimicrobial stewardship (AMS) implementation and leadership capacity remain limited. Pharmacists play a central role in AMS but often lack access to structured leadership development. To address [...] Read more.
Background: Antimicrobial resistance is a growing global health challenge, particularly in low- and middle-income countries where antimicrobial stewardship (AMS) implementation and leadership capacity remain limited. Pharmacists play a central role in AMS but often lack access to structured leadership development. To address this gap, the Commonwealth Pharmacists Association developed the UK–Africa Leadership Fellowship in Antimicrobial Stewardship (UK-ALF-A), a 12-month bidirectional leadership development programme combining online learning modules, live webinars, peer-learning sessions, dual mentorship from UK- and Africa-based mentors, and workplace-based AMS continuous quality improvement projects. UK-ALF-A was designed to strengthen leadership capability among pharmacists in the United Kingdom and sub-Saharan Africa. Methods: This study evaluated changes in leadership capability among pharmacists participating in the programme and explored how fellows applied these capabilities within AMS-related practice. A mixed-methods evaluation was conducted with 40 fellows (20 UK, 20 Africa), using pre- and post-programme self-assessments and 360-degree colleague feedback based on the International Pharmaceutical Federation Global Advanced Development Framework (FIP GADF), alongside post-fellowship surveys and semi-structured interviews. Results: The proportion of fellows self-assessing at the highest competency level increased from 10% pre-programme to 39% post-programme, with corresponding increases in colleague feedback ratings from 17% to 49%. Qualitative data from open-ended survey responses and semi-structured interviews suggested improvements in leadership confidence, communication, and ability to influence AMS practice. Fellows reported leading prescribing improvements and multidisciplinary engagement, often without formal authority, with greater relative gains observed among Africa-based participants. Conclusions: UK-ALF-A was associated with enhanced leadership capability and contributions to AMS practice, alongside reported changes in individual and organisational practices that support broader health system strengthening, highlighting its value as a workforce development model. Full article
(This article belongs to the Special Issue Global Partnerships in Response to Antimicrobial Resistance: From Policy to Practice)
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21 pages, 1428 KB  
Article
Landscape Analysis of Existing Policies, Laws and Regulations on Antimicrobial Stewardship in 10 Low- and Middle-Income Countries
by J.P. Waswa, Mohan P. Joshi, Reuben Kiggundu, Francis Kakooza, Dathan M. Byonanebye, Rodgers Rodriguez Ayebare, Kate Kikule, Hassan Kasujja, Niranjan Konduri and Emmanuel Nfor
Antibiotics 2026, 15(8), 770; https://doi.org/10.3390/antibiotics15080770 - 10 Aug 2026
Viewed by 279
Abstract
Background/Objectives: Effective antimicrobial stewardship (AMS) is vital for containing antimicrobial resistance (AMR), yet evidence regarding existing regulatory frameworks in low- and middle-income countries (LMICs) remains scarce. This study conducted a landscape analysis of policies, laws, and regulations governing AMS across human and animal [...] Read more.
Background/Objectives: Effective antimicrobial stewardship (AMS) is vital for containing antimicrobial resistance (AMR), yet evidence regarding existing regulatory frameworks in low- and middle-income countries (LMICs) remains scarce. This study conducted a landscape analysis of policies, laws, and regulations governing AMS across human and animal health sectors in ten LMICs to identify gaps and inform national action plans. Methods: Between October 2019 and September 2022, data were collected through desk reviews of national documents and a standardized, structured questionnaire administered to key national informants in ten countries: Bangladesh, Burkina Faso, Cameroon, Côte d’Ivoire, Mali, Mozambique, Nigeria, Senegal, Tanzania, and Uganda. Results: Findings were analyzed across five core regulatory domains. While all countries maintained national medicine policies and regulatory authorities, antimicrobial-specific measures were often insufficient, particularly in the animal health sector. Human health frameworks were generally more advanced; however, overarching regulations for marketing authorization, post-marketing surveillance, and pharmacovigilance frequently lacked the necessary specificity for antimicrobials. Conclusions: Addressing these gaps requires strengthening One Health legal frameworks, particularly through targeted animal health policies and multisectoral coordination. Enhanced investments in capacity-building and systematic enforcement are essential to optimize antimicrobial use and strengthen the AMR response. Full article
(This article belongs to the Special Issue Global Partnerships in Response to Antimicrobial Resistance: From Policy to Practice)
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16 pages, 320 KB  
Article
Comic-Based Educational Intervention Enhances Antimicrobial Resistance Knowledge and Perceptions Among Adolescents in Ghana
by Obed Kwabena Offe Amponsah, Marie Millicent Baffoe-Bonnie, Annabella Bensusan Osafo, Nana Akua Abruquah, Emmanuel Konadu, Douglas Aninng Opoku, Charlotte Boachie Danquah, Benedicta Bosu, Evans Owusu-Ansah, Nana Kwaku Bugyei Buabeng, Aaron Courtenay, Ahmed Abuelhana, Kwame Ohene Buabeng and Nana Kwame Ayisi-Boateng
Antibiotics 2026, 15(7), 646; https://doi.org/10.3390/antibiotics15070646 - 29 Jun 2026
Viewed by 538
Abstract
Background: Antimicrobial resistance (AMR) is a major global health threat, yet awareness among adolescents remains low, especially in low-resource settings. Novel educational approaches are needed to appropriately inform and sustain the interest of young people to encourage behavioral change in the use [...] Read more.
Background: Antimicrobial resistance (AMR) is a major global health threat, yet awareness among adolescents remains low, especially in low-resource settings. Novel educational approaches are needed to appropriately inform and sustain the interest of young people to encourage behavioral change in the use of antimicrobials. This study aimed to evaluate the impact of a comic-based intervention in improving AMR knowledge and perceptions regarding the responsible use of antimicrobials among junior high school students in Ghana. Methods: We conducted a before-and-after educational intervention at the Kwame Nkrumah University of Science and Technology (KNUST) Basic Schools in Kumasi, Ghana, during the 2023 World AMR Awareness Week. All junior high students (JHS 1–3) present were exposed to a comic storyline illustrating appropriate antibiotic use and the risks of AMR, delivered via PowerPoint presentation and print, as an intervention. Questionnaires were administered pre- and post-intervention to assess changes in AMR knowledge and perceptions. Results: The median age of the student participants was 13 years. Out of the 1068 students involved, 611 matched responses were analyzed. Knowledge of AMR increased significantly after the comic intervention (p < 0.001). Correct responses increased across all items, and the proportion of students with a knowledge score increased substantially (33% to 70%). Attitudinal perceptions also shifted positively: 85.1% acknowledged their personal role in tackling AMR after the intervention, up from 67.4% before the intervention (p < 0.001). Conclusions: The educational intervention resulted in increased AMR knowledge and positive perceptions among the adolescents. The study findings suggest that comics and their deployment are viable tools for enhancing AMR awareness in school settings. Therefore, integrating and engaging visual storytelling in health education programs can increase awareness and promote responsible behavior towards the use of antimicrobials and support the global and national efforts for the containment of AMR. Full article
(This article belongs to the Special Issue Global Partnerships in Response to Antimicrobial Resistance: From Policy to Practice)
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20 pages, 338 KB  
Article
The Applicability of AWaRe-Based Antibiotic Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa: A Multicentre Point Prevalence Study and Implications for the Future
by Audrey K. Chigome, Aislinn Cook, Yasmina Johnson, Sabiha Essack, Adrian Brink, Marc Mendelson, Stephen M. Campbell, Brian Godman and Johanna C. Meyer
Antibiotics 2026, 15(6), 562; https://doi.org/10.3390/antibiotics15060562 - 1 Jun 2026
Cited by 1 | Viewed by 915
Abstract
Background/Objectives: Inappropriate antibiotic prescribing in primary healthcare (PHC) contributes to bacterial antimicrobial resistance (AMR). Antibiotic stewardship, including measuring the appropriateness of antibiotic prescribing using quality indicators, is a priority in PHC where most antibiotics are used. Using previously developed WHO AWaRe classification-based [...] Read more.
Background/Objectives: Inappropriate antibiotic prescribing in primary healthcare (PHC) contributes to bacterial antimicrobial resistance (AMR). Antibiotic stewardship, including measuring the appropriateness of antibiotic prescribing using quality indicators, is a priority in PHC where most antibiotics are used. Using previously developed WHO AWaRe classification-based quality indicators, we aim to test the clinimetric properties of 13 acute respiratory tract infection (RTI) quality indicators and qualitatively explore factors influencing PHC antibiotic prescribing in South Africa. Methods: We conducted a mixed-methods exploratory feasibility study using point prevalence surveys (PPSs) with clinimetric assessment and prescriber interviews. PPSs were conducted at four PHC facilities in Gauteng province that had taken part in previous PPS studies, alongside face-to-face interviews with PHC personnel. Results: In total, 52/52 (100%) RTI patients received antibiotics. Four (30.8%) indicators achieved scores above 85%, while six (46.2%) scored below 50%. All indicators had applicability scores ≥10%. Twelve (92.3%) indicators had a measurability score of 100%, while one (7.7%) had a measurability score <75%. Twelve (92.3%) indicators met all predefined acceptable scores for applicability and measurability. No participant knew of the WHO’s AWaRe classification and none had specific training on antibiotic prescribing and AMR. They also had no antibiotic stewardship programmes (ASPs) or specific antibiotic-prescribing guidelines at their facilities. Key factors affecting antibiotic prescribing included shortages, patient expectations and fear of complications. Conclusions: The indicators demonstrated acceptable clinimetric properties in South Africa. Robust locally validated indicators, combined with ASPs promoting the AWaRe classification, are imperative for accurate assessment and improvement of antibiotic prescribing. Full article
(This article belongs to the Special Issue Global Partnerships in Response to Antimicrobial Resistance: From Policy to Practice)

Other

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18 pages, 711 KB  
Protocol
A Hybrid Type II Hub-and-Spoke Model Evaluation Framework in the Commonwealth Partnerships for Antimicrobial Stewardship Programme—A Study Protocol
by Ayesha Iqbal, Gizem Gülpinar, Claire Brandish, Maxencia Nabiryo, Frances Garraghan and Victoria Rutter
Antibiotics 2025, 14(12), 1218; https://doi.org/10.3390/antibiotics14121218 - 3 Dec 2025
Viewed by 975
Abstract
Introduction: The hub-and-spoke model (HSM) offers a methodological and hierarchical project management framework for efficient healthcare service delivery. The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme supports the development and implementation of antimicrobial stewardship (AMS) interventions to optimise the use of antimicrobials across [...] Read more.
Introduction: The hub-and-spoke model (HSM) offers a methodological and hierarchical project management framework for efficient healthcare service delivery. The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme supports the development and implementation of antimicrobial stewardship (AMS) interventions to optimise the use of antimicrobials across eight African countries: Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia. Currently the second phase of the programme (CwPAMS 2.0) is being implemented, between March 2023 and March 2025, in which six countries are adopting the HSM to deliver AMS interventions. The aim of this study was to design a hybrid II monitoring, evaluation and learning (MEL) framework to assess the implementation and effectiveness of the HSM in delivering and adapting AMS interventions. Methods: A mixed-methods Hybrid II Implementation trial design was used to develop the MEL framework, guided by the Theory of Change, Socio-Ecological Theory, and Normalisation Process Theory and in alignment with the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will be continuous and longitudinal (pre-, mid- and post-implementation). The evaluation framework has been designed to study implementation evaluation at three ecological levels: programme, partnership, and individual site level. Data collection will encompass mixed methodologies and include non-participant observations, formal and informal feedback (from individual key stakeholders and groups), knowledge tools and surveys, scored evaluations, pre-and post-assessments, semi-structured interviews, focus groups, and data collected during formal and informal meetings. This approach will facilitate continuous data collection for evaluation and help study the utilisation and adaptation of AMS interventions. Discussion: This study provides a protocol for developing and utilising an MEL framework to study the application of the HSM in delivering AMS interventions. Developing an evaluation framework requires meticulous planning and a robust implementation and evaluation protocol to ensure methodological rigour, transparency, and effective resource management throughout the project lifecycle. Despite comprehensive consideration of developing progress and programmatic indicators and measures across all domains, the study acknowledges limitations in definitively attributing causality to individual AMS interventions due to their complexity and varied implementation contexts. Full article
(This article belongs to the Special Issue Global Partnerships in Response to Antimicrobial Resistance: From Policy to Practice)
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