Surveillance of antimicrobial resistance by a global network of WHO collaborating centres

Antimicrobial resistance remains one of the most pressing threats to health globally, with inappropriate antimicrobial use and inequitable access to quality-assured medicines compounding the challenge. In 2015, the World Health Organization (WHO) launched the Global Antimicrobial Resistance Surveillance System to strengthen global surveillance and provide data to inform responses. In support, in 2016 WHO established the AMR Surveillance and Quality Assessment Collaborating Centres Network, a global group of expert institutions that provide technical support and help WHO Member States build surveillance capacity. Between 2016 and 2025, the Network expanded from 18 to 36 institutions across 20 countries and its technical scope has grown to cover antimicrobial use surveillance, emerging antimicrobial resistance, fungal antimicrobial resistance and national action plans. This paper presents a process evaluation of the network, focusing on its development between 2016 and 2025, its contribution to tackling antimicrobial resistance and the challenges faced. Information from documentation and structured interviews indicate that the network played a central role in developing surveillance standards, strengthening laboratory and epidemiology capacity, and helping countries implement surveillance. Challenges persist: network representation is uneven across geographical regions, coordination of resources is limited, and the network's impact is incompletely documented. To maximize its potential, the network must improve output tracking, expand membership from low- and middle-income countries and create subnetworks for specific topics and regions. The analysis offers lessons on how WHO collaborating centre networks can serve as strategic enablers of actions on global health, provided they are adequately supported and integrated into broader implementation frameworks.