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Strengthening laboratory capacity to combat antimicrobial resistance in Uzbekistan: a collaborative mentoring program

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Antimicrobial resistance (AMR) is widespread in Central Asia, as new data from Central Asian and European surveillance of antimicrobial resistance (CAESAR) network. Such findings highlight the need for coordinated action and increased investment in laboratory strengthening, including quality assurance, laboratory networks, properly equipped reference laboratories, and standardization methodologies.

The good news is that the world has established a program to address these challenges Health Regional Office of the Organization for Europe. Better labs for better health (Better Labs) – launched in 2012 – is a cross-sectoral approach that seeks to ensure sustainable quality improvements for all health laboratories.

The AMR Center, Uzbekistan’s national reference laboratory, has joined the Better Labs 2018 program. The center diagnoses, identifies and monitors the occurrence of drug-resistant bacteria. It plays a key role in training and maintenance laboratories in the surveillance network in Uzbekistan.


Well-functioning, sustainable laboratory services that operate in accordance with international principles of quality and safety are crucial for strong health systems and the improvement of public health, which affects individuals

– Dr. Joanna Zwetyenga, Laboratory Technical Officer, Better Labs for Better Health, WHO Regional Office for Europe


Photo: WHO Photo Office for Uzbekistan

A key element of Better Labs ’approach is mentoring. Better Labs has trained international mentors to support laboratory staff in using the WHO A tool for the gradual implementation of laboratory quality. This online tool provides a step-by-step plan that guides medical laboratories on how to apply a quality management system in accordance with international standards. The tool also provides detailed explanations on how to implement quality requirements in line with customer satisfaction. This ensures a reliable diagnosis that in turn generates accurate data and directs clinicians to provide timely and appropriate treatment.

Boltaeva Manzura Nishanovana, Head of the Department of Pathology of Young Children, Republican Specialist Scientific and Practical Medical Center for Pediatrics of Uzbekistan says: What I like most about this program [Better Labs AMR Mentoring] is to help us maintain standards of diagnosis and treatment of severe cases from our provinces. There has been a significant improvement in our seamless interaction / collaboration with the lab. We were able to achieve even better treatment outcomes for our patients. Previously, hospital stays lasted as long as 15-20 days, and now because of the quality [laboratory test] the results improved, we were able to ensure that patients were treated for 7-8 days and then discharged in better health. In other words, reducing the number of nights spent in bed has made our work much easier. “

The laboratory supports efforts to suppress AMR by identifying the pathogen responsible for the patient’s infection. Once tonce the organism has been identified and isolated, antimicrobial susceptibility testing is a crucial step in determining the optimal antimicrobial therapy for the patient.


“Reliable microbiological analysis and capable national reference laboratories supporting national laboratory networks are important for monitoring AMR in countries, analyzing resistance trends and measuring the impact of interventions”

– Dr. Danilo Lo Fo Wong, Regional Adviser, AMR Control Unit, WHO Regional Office for Europe.


Photo: WHO Photo Office for Uzbekistan

On March 2, 2020, the National Accreditation Center of Uzbekistan accredited the Research Institute of Epidemiology, microbiology and infectious diseases of the Ministry of Health of the Republic of Uzbekistan and the Clinic of the Center for Antimicrobial Resistance (AMR Center) in Tashkent against international standards for medical laboratories (Oʻz DSt ISO 15189: 2019). The entire accreditation process lasted six months during which the first two national mentors for Uzbekistan were trained

Dr. Gulnora Abdukhalilova, head of the AMR Center, said: “Mentoring Program for AMR Center was timely. Thanks to the competent assistance of WHO experts during mentoring visits, the quality of microbiological diagnostics has improved at the AMR Center. The introduction of a quality management system in medical laboratories means the provision of high quality services to the public. That is the motto of the AMR Center team. ” The first successful accreditation of laboratories in Uzbekistan represents a milestone for the successful collaborative support of the AMR and Better Labs for Better Health teams from the WHO Regional Office for Europe, the WHO Office for Uzbekistan and the mentor.

As noted by Zulfia Atadjanova, National Program Officer at the WHO Office for Uzbekistan,this project is a great example of integration between WHO programs (AMR and Bafter the lab) at the country level. It also shows how we contribute to each other’s area to achieve better results. “

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