The past three years have seen a remarkable global health initiative that has significantly enhanced Ethiopia’s antimicrobial resistance (AMR) surveillance and healthcare infrastructure. This has been the collaborative effort of the Ohio State Global One Health LLC (GOHi) working in unison with Ethiopia’s Tikur Anbessa Specialized Hospital (TASH), Zewditu Memorial Hospital (ZMH), and the U.S. Centers for Disease Control and Prevention (CDC). The initiative falls under the umbrella of the Global Action in Healthcare Network (GAIHN). This integrated laboratory and infection prevention and control (IPC) program has served as a capstone in educating the masses about antimicrobial resistance and the importance of IPC practices.
To observe a meaningful shift in staff behavior was a remarkable laurel for the hospitals with hospital professionals demonstrating an improved compliance with IPC protocols. This positive change was especially seen in high-risk units such as Adult and Neonatal Intensive Care Units. The shift is always towards aligning daily practices with internationally accepted standards. This includes introducing contact precautions for patients colonized with multidrug-resistant organisms (MDROs). The absolute outcome? The quality of patient care has visibly improved and it showed in a reduced number of healthcare-associated infections (HAIs) and less mortality rates.
GOHi’s lab support spectrum is broad – spanning from essential supplies and technical training to competent personnel – this directly benefited the diagnostic capabilities. An enhanced diagnostic ability further expanded antimicrobial susceptibility testing (AST). By setting global best practices like optimal isolate storage, usage of dedicated equipment, and dual-bottle blood cultures in motion, the hospitals successfully declined specimen contamination rates.
This drastic decrease in the contamination rates, for instance, from 37% to a mere 15% at ZMH, increased lab reliability. This, in turn, enhanced clinician trust and the number of sample submissions rose significantly – a dramatic surge from 93 to a whopping 1,880 at TASH and from 585 to 986 at ZMH. Moreover, the labs at both hospitals accomplished ISO accreditation – a landmark achievement that validated their functioning quality and set a precedent for future research and national benchmarking.
Where IPC used to be a mandatory requirement, it has now evolved to become an ingrained part of the hospital culture – a shared value. The continuous efforts have made health professionals realize the threats posed by AMR and the importance of safe work environments. With an increased reliance on accurate lab diagnostics, medical professionals make informed antimicrobial prescribing.
While GOHi’s work has left indelible marks within the pilot facilities, it has also begun to shape AMR strategies on a broader scale. The contributions to Ethiopia’s national surveillance program are commendable, with enhanced quality and volume marking TASH as the top contributor. With innovative interventions like colonization screening and transmission-based precautions brought to light for the first time in Ethiopia, they are now held as precedents for nationwide implementation in resource-limited healthcare systems.
The GOHi-led AMR project stands as a testament of a scalable and evidence-based model for improving IPC and microbiology services in low-resource settings. It demonstrates the profound impact that comprehensive international partnerships can have on national health priorities and global health security.