The second presentation, delivered by Dr. Afreenish Amir, examined the operational and technical requirements for effective AMR surveillance in LMICs. Drawing on her experience in low-resource settings, she illustrated how rapid shifts in resistance patterns such as the emergence of NDM-5 carbapenem-resistant Salmonella Typhi demonstrate the urgency of building surveillance systems capable of early detection and timely reporting. Dr. Amir emphasized the need to strengthen sentinel laboratory networks supported by robust quality management systems, standardized antimicrobial susceptibility testing (CLSI/EUCAST), reliable specimen referral pathways, and expanded use of digital platforms such as WHONET, DHIS2, and other open-source tools to improve data capture, interoperability, and reporting into national systems and GLASS. She highlighted the importance of integrating human, animal, food, and environmental data within a One Health framework and ensuring that surveillance findings inform antimicrobial stewardship, clinical guidelines, and policy decisions. While acknowledging ongoing challenges such as limited infrastructure, supply chain constraints, and workforce shortages, she underscored that sustainable progress requires strong governance structures, clear national SOPs, dedicated financing mechanisms, and continued capacity development in laboratory, epidemiology, and data analytics competencies.

During the open discussion moderated by Dr. Sirdar, Dr. Tapfumanei Mashe (AMR Project Coordinator, WHO Zimbabwe) contributed an important perspective on African experiences. He highlighted how many African countries face unique barriers related to coordination, data sharing, and sustainable financing for AMR surveillance. Dr. Mashe emphasized that while technical tools exist, countries often struggle with harmonizing data across ministries, ensuring timely reporting into national and global systems, and securing consistent funding for laboratory reagents (although these are partially funded by government), workforce development, and digital infrastructure. His reflections underscored the need for regionally coordinated financing models, standardized data governance agreements, and cross-country learning platforms to support shared progress across the continent.

The broader discussion centred on identifying core priorities for advancing AMR surveillance in LMICs. The webinar reflected on the technical components requiring the most urgent strengthening such as isolate workflows, metadata quality, AST harmonization, and LIMS interoperability and examined strategies for enhancing detection, reporting, and data integration. The importance of linking formal laboratory networks with alternative data sources such as ProMED-AMR, environmental monitoring, and wastewater surveillance was repeatedly highlighted. Discussions also emphasized the long-term sustainability of surveillance systems, drawing attention to the need for strong national policies, stable financing, capable workforce pipelines, and governance structures that can support scalable, multi-sector surveillance ecosystems.

Across the session, it became clear that despite the significant challenges facing LMICs, there is considerable opportunity for innovation. Digital platforms strengthened laboratory networks, One Health integration, and community-driven early warning systems all offer powerful pathways to improve AMR surveillance in resource-limited settings.

The WAAW 2025 webinar reaffirmed ISID’s commitment to supporting global collaboration and capacity strengthening, and to advancing practical, equitable solutions that help countries detect threats earlier, respond more effectively, and ultimately protect populations from the rising tide of antimicrobial resistance.

ISID expresses its appreciation to Professor Ghassan M. Matar, Dr. Afreenish Amir, and all participants for their contributions to a rich, insightful, and action-oriented dialogue.