Kenya, Rwanda strengthen their defences against antimicrobial resistance

Kenya and Rwanda have reached an important milestone in the fight against antimicrobial resistance (AMR), strengthening their ability to track where drug-resistant infections are emerging, and how they are spreading.

Through improvements to their surveillance systems, both countries are now generating more detailed information to guide treatment decisions, strengthen public health action and help protect the effectiveness of life-saving medicines.

AMR is making infections harder to treat, increasing the risk of disease spread, severe illness and death, while placing growing pressure on health systems worldwide. Effective surveillance is essential for understanding where resistance is occurring, how it is evolving and what actions are needed to respond.

A key part of this progress has been the transition to individual-level reporting through the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS). This allows countries to collect and analyse more detailed information on resistance trends, helping health authorities make better-informed decisions on treatment, prevention and antimicrobial stewardship.

"Antimicrobial resistance is a growing threat to health systems across Africa and around the world. The progress demonstrated by Kenya and Rwanda shows that countries can successfully strengthen their data systems and generate evidence that informs policy, improves patient care and supports antimicrobial stewardship," said Dr Ali Ahmed Yahaya, Antimicrobial Resistance Team Lead at the WHO Regional Office for Africa.

Building a national surveillance network in Kenya

Kenya's journey shows how sustained investment and careful planning can build stronger public health intelligence over time.

What began in 2017 with two model surveillance sites has expanded into a nationwide network of 32 surveillance sites across 27 counties and multiple One Health sectors. Along the way, the country has strengthened laboratory systems, data management processes and workforce capacity, creating a robust platform for monitoring AMR.

Kenya first submitted AMR data to GLASS in 2021 and transitioned to individual-level reporting in 2025. Through its Central Data Warehouse, the country now integrates AMR surveillance, antimicrobial use and antimicrobial consumption data, providing a more comprehensive picture of national AMR patterns.

The country's progress has been supported by strong governance structures, standardized data collection tools, laboratory information systems, regular data quality reviews and multidisciplinary collaboration involving laboratory, data and informatics teams. A phased approach allowed Kenya to strengthen systems and improve data quality before expanding surveillance.

Between 2021 and 2025, more than 100 000 AMR surveillance records were collected, with 9039 records submitted to GLASS in 2025.

"Our transition to individual-level reporting has significantly improved the quality and usefulness of AMR data. The data generated are helping us better understand resistance trends and support evidence-based decision-making," said Susan Githii, Country GLASS Focal Person and AMR Surveillance Focal Point, Kenya.

Rwanda strengthens surveillance through partnership

Rwanda's experience highlights the importance of collaboration in building stronger surveillance systems.

Since enrolling in GLASS in 2022 and submitting its first AMR data in 2023, the country has worked closely with hospitals, national institutions and technical partners to strengthen data collection and reporting.

During the 2025 GLASS reporting cycle, Rwanda began reporting both aggregate and individual-level data, ensuring continuity while transitioning to more detailed surveillance reporting. Data from four major referral hospitals - the University Teaching Hospital of Kigali, the University Teaching Hospital of Butare, King Faisal Hospital and Rwanda Military Hospital - are helping health authorities better understand how resistance is evolving.

The transition was supported by strong leadership from the Ministry of Health and the Rwanda Biomedical Centre, close collaboration among participating hospitals, the use of standardized tools such as BacLink and WHONET, and technical support from WHO Headquarters and the WHO Regional Office for Africa.

"Reporting individual-level data has strengthened our ability to better understand resistance patterns and use evidence for decision-making. The experience has also highlighted the importance of collaboration in building a stronger surveillance system," said Misbah Gashegu, National AMR Focal Person and Rwanda GLASS-AMR Focal Person.

Turning challenges into progress

The transition to individual-level data reporting was not without challenges. Kenya identified gaps related to laboratory information system interoperability, missing patient variables, workforce capacity for data validation and initial concerns around data privacy. Rwanda faced challenges related to manual data collection in some facilities, limited human resources for data management and a lack of interoperability among hospital information systems.

Despite these obstacles, both countries demonstrated that progress is possible through structured planning, strong coordination, standardized tools, data quality assurance and sustained partner support.

To support countries in strengthening AMR surveillance and preparing data submissions to GLASS, the WHO Regional Office for Africa, in collaboration with the WHO Headquarters GLASS team, continues to provide technical guidance, capacity-building and opportunities for peer learning.

The experiences of Kenya and Rwanda demonstrate how better data can help countries stay ahead of one of the most significant public health threats of our time.