Low- and Middle-income Countries (LMICs)
Community Based Surveillance for AMR Monitoring: Significance, Requirements and Feasibility in LMICS
By Afreenish Amir
Community based surveillance, in addition to clinical antimicrobial resistance (AMR) surveillance, plays an essential role in AMR and antimicrobial use trend monitoring. Various community-based AMR surveillance studies to monitor trends in AMR and use of antimicrobials have been conducted and shown its potential to facilitate evidence-based interventions and policy making for control of AMR. Many low and middle income countries (LMICs) lack the necessary systems and resources to establish effective surveillance systems. Specifically, the surveillance capacity at hospitals and other health facilities is limited, and the overall human resource capacity for community-level data collection, analysis, and multi-sectoral coordination is severely constrained. Prior to planning for community based AMR surveillance, a country should have established mechanisms to run the system efficiently, including strong governance and regulations, surveillance infrastructure, laboratory capacities, skilled human resources, data collection and management, funding and sustainability.
The World Health Organization and quadripartite partners have recommended advancing community based AMR surveillance in LMICs, and integrated AMR surveillance combining information from humans, animals and ecosystems, which seems a challenge in the current situation. Considering the significant gaps in systems, resources, and capacities, it is important to prioritize strengthening the country’s core capacities and addressing the underlying gaps in healthcare systems. Efforts should focus on enhancing the country’s core capacities, systems, and technical requirements while exploring the potential of advancing selective community based AMR surveillance interventions and systems in the future.
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Designing an Independent Panel on Evidence for Action on Antimicrobial Resistance: Lessons from Selected Bodies in Global Health, Climate Change and Biodiversity
By Viviana Munoz Tellez and Francesca Chiara
This paper proposes a framework for designing an Independent Panel on Evidence for Action on Antimicrobial Resistance (IPEA), responding to the 2025 United Nations General Assembly mandate. Through a comparative analysis of selected international scientific advisory bodies, we identify the panel’s mandate as the foundational element that will critically shape its composition, scope, deliverables, and governance structure. Our framework addresses key domains of credibility, scientific integrity, authority, policy relevance, and sustainability while establishing equity as a fundamental design principle—not merely ensuring low and middle-income country (LMIC) participation but designing the IPEA to address existing imbalances in antimicrobial resistance (AMR) evidence production and dissemination. We analyse potential mandate options, from evidence synthesis to policy recommendations, highlighting the importance of defining a unique and complementary role for IPEA within the existing AMR governance landscape to avoid duplication and maximize impact on global AMR response.
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Policy in Practice: Implementing Antimicrobial Stewardship Post-COVID-19
Q&A and Commentary
By Dr Rasha Abdelsalam Elshenawy
This report summarises the key questions and expert commentary for the South Centre, as well as the South Centre Policy Brief on lessons from the COVID-19 pandemic, to strengthen antimicrobial stewardship and provide practical recommendations discussed during the South Centre webinar on “Strengthening Antimicrobial Stewardship: Policy Insights from COVID-19 and Future Pandemic Preparedness.”
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ReAct Africa-South Centre Annual Conference 2025:
From global to local action: Operationalising AMR commitments in Africa and beyond
11-12 June 2025
Lusaka, Zambia
The ReAct Africa-South Centre Annual Conference 2025 aims to translate these global and regional commitments into actionable strategies for local and national contexts in low- and middle-income countries; with a specific focus on Africa’s needs and priorities. It will serve as a platform for key stakeholders from, but not limited to governments at the regional, national and sub-national levels
A great variety of stakeholders will join the conference in Lusaka: International & regional organizations (Quadripartite organs – FAO, WHO, WOAH & UNEP; Africa CDC, ECSA-HC, etc.), public health professionals and health practitioners, civil society and community organizations, academia and research institutions, youth in AMR, faith sector, private sector leaders and innovators, media and communication experts.
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Webinar Report:
Advancing Antimicrobial Stewardship Policies: Lessons from the COVID-19 Pandemic and Priorities for Future Health Emergencies
By Dr Rasha Abdelsalam Elshenawy
Our recent South Centre webinar examined how the pandemic created a dual challenge for global health:
– MISUSE: 35-75% of hospitalized COVID-19 patients received antibiotics despite low bacterial co-infection rates.
– ACCESS BARRIERS: The pandemic disrupted supply chains and healthcare access, limiting antimicrobial availability in many regions.
This paradox—overuse alongside access challenges—must inform future pandemic preparedness.
Our experts call for:
– Integrating antimicrobial stewardship into emergency response
– AMS frameworks must be established BEFORE health emergencies
– Strengthening surveillance systems and diagnostic capacity
– Ensuring sustainable and equitable access to antimicrobials
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Lessons from COVID-19: Strengthening Antimicrobial Stewardship Prior and During Pandemics
By Dr Rasha Abdelsalam Elshenawy
The COVID-19 pandemic has had a complex impact on the silent pandemic of antimicrobial resistance (AMR). While increased antibiotic misuse and disrupted antimicrobial stewardship (AMS) programs exacerbated AMR in some settings, heightened awareness and improved infection prevention measures implemented to control COVID-19 provided valuable lessons on sustaining these practices in the fight against AMR. This brief highlights lessons learned from the pandemic, such as the importance of access to antimicrobials and the urgent need for resilient and sustainable AMS integrated into pandemic preparedness, strengthening infection prevention and surveillance systems, enhancing access and use of diagnostics, and promoting a One Health approach. By leveraging these lessons, policymakers can build more resilient health systems, maintain the effectiveness of antimicrobials and be better prepared for future pandemics, particularly in developing countries. Immediate action is essential to protect public health and combat AMR effectively.
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Taxation of the Digital Economy
by Adnan Sose, Nicolás Tascon and Anders Viemose
As globalisation has pushed through complex inter-State trade in goods and services, in parallel there is a growing complexity in determining the taxation of Multinational Enterprises (MNEs) in an increasingly digitalized economy. This report reviews existing bilateral tax treaties between South Centre’s Member States and States where most digitalised MNEs are headquartered, using a threshold of EUR 750 million in annual turnover to limit the number of in-scope MNEs in the study. This analysis produced primary data on South Centre Member States’ source taxing rights scores and the implications of this on tax treaty negotiations to enable effective taxation in the digital economy through the inclusion of the United Nations (UN) solution for digital taxation, Article 12B of the UN Model Tax Convention. Further, the study sought to identify ‘weak’ tax treaties with low source taxing rights which merited a comprehensive renegotiation beyond the inclusion of Article 12B. Furthermore, the reports examined the treatment of “Computer Software” in the tax treaties under study, and concluded with recommendations going forward.
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Expanding the production of COVID-19 vaccines to reach developing countries
Lift the barriers to fight the pandemic in the Global South
By Carlos M. Correa
The unfolding of COVID-19 has shown that the international system has been unable to ensure equal access to the vaccines and other products necessary to fight the pandemic. While the need for a strong response remains obvious, proposals for scaling up the production of COVID-19 vaccines across the globe are still blocked in the World Trade Organization.
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