SDG and me: Advancing Diagnostics and Combatting Threat of Antimicrobial Resistance in Low and Middle-Income Countries

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I am Dr Nada Malou, holding a PhD in Infectious and Tropical Diseases. After completing my PhD, I dedicated my research background to improving access to care and diagnostics in low and middle-income countries (LMICs). As a microbiologist with Médecins Sans Frontières (MSF), I have implemented bacteriology laboratories in West African countries to diagnose bacterial infections among paediatric populations and in the Middle East for the treatment of war-wounded patients. After several years supporting access to diagnostics, in collaboration with MSF and The MSF Foundation, I developed a diagnostic tool – Antibiogo, the first digital health tool medical device developed for LMICs that aims to support improving access to bacteriology diagnostics and thereby antibiotic treatments for patients.

Today, antimicrobial resistance (AMR) stands as one of the greatest public health threats, causing over one million deaths annually. If no decisive actions are taken, it is estimated that by 2050, AMR will result in 10 million deaths per year, predominantly affecting the African and Asian continents.

For a long time, LMICs were considered blind spots for AMR. There was a prevailing belief that resistance was primarily a problem in high-income countries due to excessive antibiotic use, while LMICs struggled with access to antibiotics. In reality, the lack of access to bacteriology diagnostics meant that AMR remained invisible in LMICs for decades. Today, ensuring access to quality diagnostics is crucial to understanding the burden of AMR in these regions and to informing effective actions and policies.

From MSF's experience, we believe that sustainable solutions lie not in automated diagnostic equipment but in building the capacity of human resources. As a microbiologist for MSF, I have implemented bacteriology laboratories in 14 countries. Over the years, I have trained laboratory technicians who had never performed culture tests to identify the causative agents of bacterial infections. However, we have noticed that the interpretation of results remains a significant challenge, as this step is usually performed by trained microbiologists, whether clinical doctors, pharmacists, or PhDs.

Our work with Antibiogo is most closely aligned with SDG 3 targets, namely SDG 3.3 – Combat communicable diseases; SDG 3.8 – Achieve universal health coverage; and SDG 3.d – Strengthen the capacity of all countries, particularly developing countries, for early warning, risk reduction, and management of national and global health risks.

These goals are critical for MSF because they address some of the most pressing health challenges faced by vulnerable populations worldwide. Antimicrobial resistance threatens to undermine decades of medical progress by making common infections harder to treat. The impact of AMR extends beyond health, affecting livelihoods, food security, and economic growth, particularly in low- and middle-income countries.

One area that could be emphasized more within SDG 3 is the importance of developing and implementing affordable and accessible digital health tools in LMICs. While there is a focus on universal health coverage and combating diseases, the critical role of affordable digital health tools in achieving these targets could be more explicitly stated.

 

Médecins Sans Frontières (MSF)

MSF is an international, independent medical humanitarian organisation. We provide medical assistance to people affected by conflict, epidemics, disasters, or exclusion from healthcare. Our teams are made up of tens of thousands of health professionals, logistic and administrative staff - most of them hired locally. Our actions are guided by medical ethics and the principles of impartiality, independence and neutrality.

The MSF Foundation

The MSF Foundation is an extension of Médecins Sans Frontières (MSF), dedicated to pioneering innovative solutions and conducting research to enhance medical and humanitarian aid. Established to complement the operational work of MSF, the foundation focuses on developing new tools, technologies, and methodologies that can be implemented in the field to improve healthcare delivery in crisis situations.

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