The Impact of CwPAMS in Malawi
A testimonial from the Malawi Ministry of Health
by Dr Collins Mitambo, National Antimicrobial Resistance Coordinator, Malawi Ministry of Health
The Ministry of Health, Malawi, recognises the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme as a transformative initiative that has significantly strengthened the country’s response to antimicrobial resistance (AMR). Building on gains from phase 1.5 of the programme and extending through phase 2.5, CwPAMS has played a critical role in embedding antimicrobial stewardship (AMS) practices within Malawi’s health system, all while fostering sustainable partnerships, leadership development, and evidence-informed clinical practice.
Through a strong focus on capacity building, the programme equipped healthcare workers with practical skills in AMS, infection prevention and control (IPC), and detection of substandard and falsified medicines; over 450 healthcare workers were directly trained, with an additional 1,500 reached through nationally adopted AMS training materials. Importantly, CwPAMS institutionalised sustainability through a train-the-trainer approach, empowering 30 national trainers and ensuring continued knowledge transfer beyond the programme’s lifespan. Gender equality and social inclusion principles were also consistently integrated, ensuring equitable participation across cadres and regions.
Additionally, CwPAMS made notable contributions to institutional strengthening. AMS Committees were established and operationalised across multiple health facilities, supported by the development and implementation of AMS Action Plans. The rollout of updated treatment guidelines and routine use of point prevalence surveys strengthened data-driven decision-making and improved monitoring of antibiotic use. These interventions directly influenced clinical governance and reinforced stewardship as a core component of quality healthcare delivery.
A key success of the programme was its investment in leadership development, particularly among pharmacists. Through the Africa Leadership Fellowship in AMS (ALF-A) and the UK-ALF-A Fellowship, Malawian pharmacists were empowered as AMS champions within multidisciplinary teams. This leadership focus enhanced professional confidence, fostered cross-border learning, and elevated the role of pharmacists in clinical decision-making and policy dialogue.
The hub-and-spoke model further amplified impact by enabling centralised facilities to mentor and support others, ensuring diffusion of best practices across the health system, including into community pharmacy settings. As a result, AMS and IPC practices became more consistently applied, contributing to improved prescribing behaviours, better adherence to treatment guidelines, and an increased use of microbiology to guide targeted therapy.
At the national level, learnings from CwPAMS helped inform Malawi’s National Action Plan on AMR. They were also integrated into District Implementation Plans, strengthening alignment between facility-level practice and national policy. The programme also reinforced the long-standing collaboration between Malawi and UK health institutions, demonstrating the value of equitable partnerships and bidirectional learning in addressing global health challenges.
“CwPAMS has been instrumental in translating AMS from policy into daily clinical practice.
“By strengthening capacity, leadership, and data use at all levels of the health system, the programme has laid a strong foundation for Malawi’s sustained response to AMR.”
Dr Collins Mitambo
National AMR Coordinator
Ministry of Health, Malawi
In addition, the contributions of NHS volunteers, accounting for over 87 volunteering days, enhanced mutual learning and skills exchange, further enriching programme outcomes.
As CwPAMS phases out in December 2025, the Ministry of Health acknowledges its lasting impact in institutionalising stewardship practices, strengthening national AMR systems, and building a skilled and motivated workforce. The lessons and structures established through the programme will continue to guide Malawi’s efforts to safeguard the effectiveness of antimicrobials for future generations.
About CwPAMS and the Fleming Fund
The UK Department of Health and Social Care (DHSC)’s Fleming Fund is a UK International Development programme partnering with more than 30 countries across Africa, Asia-Pacific and the Caribbean to tackle antimicrobial resistance (AMR),a leading contributor to deaths from infectious diseases worldwide. The Fleming Fund invests in strengthening AMR surveillance systems through a portfolio of country grants, regional grants, and fellowships managed by Mott MacDonald, and global projects managed by DHSC.