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Commonwealth Partnerships for Antimicrobial Stewardship Scheme

Working together to improve the detection and monitoring of resistant infections at the hospital level, taking measures to reduce infection and ensuring antibiotics' effective use.

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The Fleming Fund

The Fleming Fund is a UK aid programme, helping low- and middle-income countries tackle antimicrobial resistance (AMR). Its aim is to improve the surveillance of AMR and generate relevant data that is shared nationally and globally.

The Scheme

Antimicrobial resistance (AMR) is a growing threat and occurs when microorganisms survive exposure to a medicine, such as antibiotics, antimalarials or antivirals, that would normally kill them. Our misuse and overuse of antibiotics are largely accelerating this global problem.

The Commonwealth Partnerships for Antimicrobial Stewardship scheme, funded by the UK Department for Health and Social Care’s Fleming Fund, has provided funding to 12 Commonwealth partnerships. Multidisciplinary teams travel to Ghana, Tanzania, Uganda and Zambia to work in partnership with local health workers to tackle the growing challenge of AMR.

A total of £600,000 has been awarded to partnerships as part of the Fleming Fund, a wider commitment by the UK Government to spend up to £265 million of UK aid to support low and middle-income countries to enhance their surveillance of AMR by 2021.

The projects are running from March 2019 to April 2020. Undertaking regular short-term visits, the partnerships leverage the expertise of UK health institutions and technical experts to strengthen the capacity of the national health workforce and institutions to address predefined AMR challenges.

The following partnerships have been awarded grants:

Ghana (5 projects)

  • Norfolk and Suffolk NHS Foundation Trust; The Assemblies of God Hospital, Saboba; London and Northwest University Healthcare NHS Trust
  • UK Faculty of Public Health (FPH); Ghana Public Health Association; East Cheshire NHS Trust
  • North Middlesex University Hospital NHS Trust; Korle-Bu Teaching Hospital (KBTH); Pharmaceutical Society of Ghana (PSGH)
  • University College London Hospitals NHS Foundation Trust; University of Health and Allied Sciences (UHAS); London School of Hygiene and Tropical Medicine; Volta Regional Hospital
  • Healthcare Improvement Scotland; Ghana Police Hospital; Keta Municipal Hospital; University of Strathclyde

Tanzania (1 project)

  • Northumbria Healthcare NHS Foundation Trust; Kilimanjaro Christian Medical Centre (KCMC)

Uganda (5 projects)

  • Cambridge University Hospitals NHS Trust; Makerere University and Mulago National Referral and Teaching Hospital; Infectious Diseases Institute
  • University of Salford; Pharmaceutical Society of Uganda; AMR National Taskforce, Ministry of Health; Tameside and Glossop Integrated Care NHS Foundation Trust
  • The University of Manchester; Gulu Regional Referral Hospital; Manchester University NHS Foundation Trust; Health Education England
  • Nottingham Trent University; Makerere University School of Public Health; Buckinghamshire Healthcare NHS Trust (BHT)
  • London School of Hygiene and Tropical Medicine (LSHTM); Makerere University College of Health Sciences and Infectious Diseases Research Collaboration (IDRC); University College of London Hospitals NHS Trust Foundation (UCLH)

Zambia (1 project)

  • University of Sussex Brighton and Sussex Medical School (BSMS); University Teaching Hospital (UTH), Lusaka; Brighton and Sussex University Hospitals NHS Trust; University of Zambia (UNZA)

The Details

Grant size and duration:
  • Grant duration is from February 2019 – June 2021
  • Funding of £30,000 – £75,000 is available for established health partnerships.
  • Funding of £10,000 – £30,000 is available for new health partnerships.
Eligibility criteria:
  • A health partnership is a long-term arrangement between a health institution in the UK with a similar, counterpart institution in a low or middle-income country. The lead institutions must be formally recognised as a health education institution, regulatory organisation or NHS (if the UK) or public/not-for-profit (if overseas) hospital. This can include Professional Associations and whilst an academic institution or professional association can act as the official lead for a grant, there must be clear joint leadership from an NHS hospital.
  • A key component of any project is the use of UK NHS staff who will volunteer their time to support and train low or middle-income country staff.
  • Staff salary contributions for project management and monitoring & evaluation in the UK or overseas are allowed.
Programme indicators:
  • Institutions and workforce demonstrate improved knowledge and practice related to IPC, AMS and prescribing practice
  • Evidence on effective AMR interventions and tools to support this are being used by national partners.
  • NHS staff demonstrate improved leadership skills and a better understanding of the global context of AMR in their work.


Despite great advances in modern medicine we are facing a post-antibiotic apocalypse if we do not act now.

Professor Dame Sally Davies - Chief Medical Officer, England

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Antimicrobial Resistance causes


deaths globally

Why Antimicrobial Resistance?

AMR poses a catastrophic threat to us all and yet until recently it has remained a neglected area of global health.

A number of factors can increase the spread of resistant microorganisms. For example, antimicrobial drugs are often used unnecessarily, which increases the risk that microorganisms can become resistant, survive and multiply. In 2016, 490,000 people developed multi-drug resistant TB, and drug resistance is starting to complicate the fight against HIV and malaria as well.

The independent Review on antimicrobial resistance estimated that,

at least 700,000 deaths each year globally are attributable to drug resistance to infections including bacterial infections, malaria and HIV/AIDS.

Unless action is taken, it is thought the burden of deaths from AMR could balloon to 10 million lives each year by 2050 and cost the global economy up to $100 trillion US Dollars.

It is estimated that 5000 deaths are already caused every year in the UK alone because antibiotics no longer work for some infections.

Rising drug resistance is a global hazard and if we do not tackle it, every day procedures such as caesarean sections, cancer therapy, and hip replacements will become extremely dangerous.

Antimicrobial resistance poses a catastrophic threat to us all and yet until recently it has remained a neglected area of global health. At THET we believe that working in partnerships is the best way to strengthen health systems both at home and overseas.

Ben Simms - Chief Executive Officer, THET

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