Antimicrobial resistance surveillance with whole genome sequencing in Africa: It’s (about) time

The current move to establish a global system for antimicrobial resistance (AMR) surveillance was born of the need for reliable data that would allow estimating the impact of AMR on public health and the economy, strengthen the evidence for acting, and point toward appropriate interventions. Surveillance represents an important component of the global action plan on AMR adopted by the 68th World Health Assembly and embodied in the World Health Organization’s developing Global Antimicrobial Resistance Surveillance System (GLASS).1 GLASS is partly predicated on reproducing programmes that have been successful in Europe and elsewhere, following a longstanding and often successful tradition of transferring public health strategies from richer to poorer countries. The main aim is to generate datasets for trend analysis and benchmarking across nations. This is an important and useful purpose, mainly to guide policy decisions and allocate resources where and when predictable threats to public health need to be addressed. At the same time, it should not be seen as a reason to delay the introduction of another layer that is already being added in Europe2,3 - whole genome sequencing (WGS) enrich our understanding of AMR evolution and spread and contribute practical information for local and national infection control and clinical guidance. Our view is that WGS-based surveillance could and should be developed now in Africa in parallel, and may actually produce informative results more quickly until the conventional approach renders authoritative and comparable data. Our rationale is explained in this article.