Building resilience: Leveraging the integrated disease surveillance and response strategy for antimicrobial resistance surveillance in Tanzania

Antimicrobial resistance (AMR) poses an escalating threat to global public health, undermining the effectiveness of essential treatments and placing additional strain on healthcare systems, especially in low- and middle-income countries like Tanzania. While Tanzania has made progress through the establishment of laboratory-based AMR sentinel sites under a One Health framework, the current system remains limited in scale, data sharing, and coverage across healthcare levels. Integrating AMR surveillance into the existing Integrated Disease Surveillance and Response (IDSR) strategy offers a practical and scalable solution to address these gaps. The IDSR framework, established by the World Health Organization Regional Office for Africa and the U.S. Centers for Disease Control and Prevention, provides a robust platform for early detection, reporting, and coordinated response to priority health threats. This paper explores the rationale, mechanisms, and potential benefits of aligning AMR surveillance with IDSR in Tanzania, including broader data capture, improved laboratory capacity at peripheral levels via adopting the Laboratory-Hub-Spoke Model (LHSM), strengthened One Health collaboration, and real-time decision-making. Drawing on lessons from regional contexts and identifying key implementation challenges, the integration is proposed as a strategic approach to building a resilient and responsive AMR surveillance system in Tanzania and similar settings.