Act Now on AMR: Why Programmes Like CwPAMS and SPARC Make a Difference
Examining the impact of CPA’s programmes in tackling AMRÂ
by Esther Obiri-Yeboah, CwPAMS Programme Manager & Bridget Kebirungi, SPARC Programme Manager
Antimicrobial resistance (AMR) is one of the largest global health threats today, undermining the effectiveness of essential treatments and placing millions of lives at risk.
Already directly responsible for 1.27 million deaths annually – a burden higher than that of HIV/AIDS or malaria – the threat of AMR is that of a silent pandemic, and its effects are felt most acutely in resource-limited settings. The World Health Organisation’s (WHO) Global Antimicrobial Resistance and Use Surveillance System (GLASS) reports that resistance to life-saving medicines in these areas is critically high and rising.
The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme is an initiative that seeks to address this challenge. By building strategic, pharmacy-led partnerships that foster bidirectional learning between UK NHS health institutions and those in eight low- and middle-income countries (LMICs) in Africa, the programme empowers pharmacists to tackle AMR and save lives by promoting the prudent, safe use of medicines and enhanced infection prevention strategies. CwPAMS is delivered under the technical leadership of the Commonwealth Pharmacists Association (CPA) with grant management by Global Health Partnerships.
Through our work in CwPAMS, which began in 2019, we identified a common critical resource gap: an absence of reliable systems to track antimicrobial use and resistance, meaning national health authorities lack the monitoring infrastructure to respond appropriately to AMR threats. Designed and led by the CPA since 2022, the Surveillance and Prescribing Support for Antimicrobial Stewardship Resource Capacity Building (SPARC) programme has actively worked across 18 LMICs in Africa and Asia to address these challenges by strengthening the systems required for effective antimicrobial stewardship (AMS).
Programmes like CwPAMS and SPARC are essential, cost-effective solutions that challenge the AMR emergency head-on, empowering frontline healthcare workers to save lives and turn back the tide against this threat.
How CwPAMS Builds Resilience: Workforce Capability Building and Health System Strengthening
The enduring value of CwPAMS lies in its approach to strengthening workforce resource and the infrastructure of health systems. This approach directly addresses the inequalities noted by GLASS, which stresses the urgent need to address AMR by investing in health systems to ensure access to timely, high-quality treatment. Additionally, the programme’s unique bidirectional Health Partnership model fosters long-term, cross-border, mutually beneficial collaborations – this is key to countering the syndemic of resistance and weak infrastructure which plagues fragile health ecosystems.
CwPAMS’ Global Health Fellowships are a core mechanism for the programme’s sustainability. The Chief Pharmaceutical Officer for England’s Global Health Fellowship (for UK-based workers), the Africa Leadership Fellowship in AMS (‘ALF-A’; for those based in Africa), and UK-ALF-A (for both) have empowered pharmacists and other health professionals as AMS leaders through an integrated bundle of technical, leadership and behaviour change educational activities, and a robust mentorship system.Â
The Fellows have become embedded agents of change in their communities. For instance, in Malawi, a limited number of Fellows have since trained over 640 healthcare workers in AMS and have led the formation or strengthening of multiple AMS Committees, building a sustainable network of expertise. This emphasis on workforce capability building ensures country ownership of CwPAMS’ interventions, which will be sustained long after programme funding ends.
In keeping with the GLASS finding that countries with limited surveillance often report higher levels of AMR, the programme seeks to systematically strengthen surveillance and diagnostic capacity. The establishment or reinforcement of 78 AMS Committees across participating countries is one example of CwPAMS’ facilitation of the governance structure necessary to bring about this change.
A compelling case study comes from Uganda, where the partnership between Lira Regional Referral Hospital (LRRH) and University Hospitals Dorset NHS Foundation Trust has revitalised microbiology services, resulting in the production of LRRH’s first antibiogram and the development of local AMS guidelines. LRRH’s newfound understanding of resistance patterns at a regional level subsequently informed and improved national antibiotic procurement decisions, and the programme has supported the development of Uganda’s first National Antibiotic Policy.
The Case of SPARC: Turning Evidence into Action and Structural Reform
The SPARC programme works to strengthen surveillance, laboratory capacity, prescribing support, digital health infrastructure, and workforce capability with a vision to catalyse structural AMS reform in participating countries.
SPARC’s Data for Action workstream has supported 11 countries to conduct and interpret the results of point prevalence surveillance, which enables health facilities to quantify antimicrobial use patterns. This has shifted AMR from a ‘suspected issue’ to one backed by clear, facility-level evidence that health leaders can act on. Over 90% of health workers trained through SPARC reported that the course met or exceeded their expectations. These figures matter because they signal more than satisfaction – they indicate ownership, which is the foundation of sustained behaviour change.
Complementing these efforts, the Prescribing Companion App has become one of the programme’s most widely adopted digital tools. Actively implemented across 18 SPARC partner countries and accessed in over 200 countries worldwide, the App provides free, offline access to national and global AMS guidelines and prescribing resources for both human and animal health. For frontline workers, it has removed one of the most persistent barriers to AMS: lack of access to reliable, evidence-based prescribing information. Health workers consistently report that the App improves clinical confidence, speeds up decision-making, and reduces inappropriate antibiotic use.
In Malawi, the programme introduced the Electronic Medicines Management System (eMMS) to transform the medicines supply data chain. Under manual systems, data entry took 12 minutes per patient, often resulting in delays and incomplete records. eMMS is helping transform medicines data from paper-based records to digital, decision-ready information, allowing facility leaders to identify shortages faster, prevent stockouts, and steward antibiotics more responsibly.
In Kenya and Zambia, SPARC has strengthened One Health surveillance, linking human and animal health data in keeping with the WHO’s focus on this area. This enabled the review and submission of Kenya’s national AMR surveillance report to WHO GLASS, while in Zambia, we are designing a national AMR surveillance data platform – an unprecedented level of coordination across ministries, laboratories, and veterinary services.
AMR control does not happen in policy documents; it happens in consultation rooms, wards, pharmacies, and laboratories. In Kenya, over 40 clinicians have been trained to lead facility AMS Committees across 12 counties, supported by new national AMS modules and prudent use guidelines for animal health. Elsewhere, close to 40 microbiologists in Zambia received hands-on mentorship to support their AMS work, and the programme developed materials including a Microbiology Mentorship Guide, standard operating procedures, and job aids to support improved practice.
These examples show how SPARC helps to build long-lasting capacity across the entire health system – rather than temporary interventions which vanish when immediate funding ends.
Why AMR Initiatives Must Continue to Be Funded
The global community has agreed, through the 2024 United Nations General Assembly, to substantially reduce AMR by 2030. However, we cannot reduce what we cannot see, and we cannot sustain change with fragmented, episodic interventions.
Initiatives like CwPAMS and SPARC have been so effective because they offer a model of collaborative, data-driven investment tailored to local needs, ensuring the global fight against AMR is waged effectively and where the need is greatest. In doing so, they have demonstrated that data-driven AMS is possible at a national scale, even in resource-constrained settings.Â
However, to consolidate and extend progress, more needs to be done. The foundation is already in place: the time for sustained investment is now.
As part of our observance of World AMR Awareness Week 2025, CPA is inviting people to sign our open letter calling on healthcare leaders and policy makers to Act Now on AMR.
Click the button below to read and sign the open letter.
About the authors
Esther Obiri-Yeboah
Programme Manager, CwPAMS
A certified project management professional and a pharmacist by training, Esther manages CPA’s flagship CwPAMS programme, overseeing the building of strategic pharmacy-led partnerships between UK- and African-based hospitals.
Before joining CPA, she accumulated experience at a diverse range of organisations, including the pharmaceutical multinational, Sanofi, and the eyeglasses social enterprise, VisionSpring.
About the authors
Bridget Kebirungi
Programme Manager, SPARC
Bridget is a seasoned health professional with a clinical background in nursing and an established track record in programme management. For nearly a decade, she has successfully led the design and implementation of health programmes in low-resource settings, with a particular focus on antimicrobial resistance, non-communicable diseases, and sexual and reproductive health.
Bridget joined CPA in 2022, playing a pivotal role as Project Manager for the Prescribing Companion App before being promoted to the role of SPARC’s Programme Manager. Before joining the CPA, she held key roles within Uganda’s Ministry of Health and various non-governmental organisations.
About CPA's AMR programmes and the Fleming Fund
The Department of Health and Social Care (DHSC)’s Fleming Fund is a UK International Development programme supporting more than 30 countries across Africa, Asia-Pacific and the Caribbean to tackle 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.