As one of only three veterinary doctors in his country, Amara Leno has little time for rest. Dr Leno is the Chief Surveillance Officer and Data Manager with the Ministry of Agriculture and Food Security, Livestock and Veterinary Services Division in Sierra Leone. Not only does he have his own research projects, but he is the country’s data manager for transboundary animal diseases as well as being the officer responsible for the import and export of veterinary antimicrobials.
Antimicrobial resistance (known as AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability and death.
As
the antimicrobial resistance (AMR) focal point, Dr Leno is keen to stop the
overuse of antimicrobials in livestock practices so as to reduce the chances of
AMR in the wider population. “By misusing or over-using antimicrobials, we
all suffer. By allowing pathogens to become drug-resistant, we put ourselves
and our animals at risk – our existences are inter-dependent.”
In 2017 the Government of
Sierra Leone conducted a situational analysis which found that the country had
limited information on the use of antimicrobials and any resistance to them.
And there was no national guidance on appropriate antimicrobial use in both
humans and animals. Added to this was the problem of a shortage of veterinary
officers and veterinary drugs, including antibiotics; treatment of sick
livestock tended to be done by field livestock officers who had only basic
training in veterinary medicine.
Dr Leno is a champion of the One Health approach to AMR, which engages the human health, animal health and environmental health sectors. Its goal is to prevent and control AMR by bringing together different stakeholders to work together in the design, implementation and monitoring of programmes, policies, legislation and research to mitigate AMR and improve health and economic outcomes.
Dr
Leno admits that he is not an academic researcher. As a civil servant in a
government ministry, he is not part of an academic institution. However, he is
always eager to conduct research. “TDR has made it possible for me to conduct
rigorous studies and generate powerful insights that my country is using to
improve surveillance of antimicrobial use in the agricultural and human health
sectors. In this way, TDR is expanding access to research for implementers,
decision-makers, frontline health workers and communities who have a vested
interest in using the evidence to make an impact on health.”
His recent research, which was part of TDR’s Structured Operational Research and Training Initiative (SORT IT), sought to determine the quality of reported data on antimicrobial use. His research findings prompted policy-makers to mandate country-wide weekly reporting of antibiotic use in livestock, training on data collection in all districts and the establishment of district reporting hubs.
As
a result, all 14 (100%) districts now report livestock data (compared with
three before), and 88% of 527 expected weekly reports were received (compared with
1% in previous years). Data quality has also improved, enabling an analysis of
antimicrobial use under routine programmatic conditions.
Through
Dr Leno’ efforts, the monitoring of antimicrobial use in the agriculture sector
has been enhanced and health systems against AMR have been strengthened.
“By
embracing a One Health approach which involves everyone from farmers to
Ministry of Health officials, we have built a critical mass of researchers,
published policy relevant papers and improved the surveillance of antimicrobial
use,” Dr Leno said. “This research has allowed us to focus on the animal which
will, ultimately, help us tackle AMR in Sierra Leone for generations to come.”
For more information,
please contact Dr Rony Zachariah at zachariahr@who.int.