Antimicrobial resistance (AMR) represents a major threat to human health with significant global economic and security implications. In 2015, WHO Member States unanimously approved a Global Action Plan to tackle AMR (GAP-AMR). The goal of GAP-AMR is “to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them”.
Surveillance is an essential tool to inform policies and infection prevention and control responses. Importantly, it is the cornerstone for assessing the spread of AMR and to inform and monitor the impact of local, national and global strategies. On 22 October 2015, WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS), the first global collaborative effort to standardize AMR surveillance. Endorsed by the Sixty-eighth World Health Assembly in resolution WHA68.7, GLASS was created to support the second objective of the GAP-AMR initiative to “strengthen knowledge through surveillance and research”, and to continue filling knowledge gaps, with the aim to inform strategies at all levels.
SCOPE
GLASS provides a standardized approach to the collection, analysis, interpretation and sharing of data by countries and seeks to actively support capacity building and monitor the status of existing and new national surveillance systems. Furthermore, GLASS promotes a shift from surveillance approaches based solely on laboratory data to a system that includes epidemiological, clinical, and population-level data. GLASS has been conceived to progressively incorporate data from surveillance of AMR in humans, such as monitoring of resistance and the use of antimicrobial medicines, including AMR in the food chain and in the environment.
STRUCTURE
The various types of AMR-related surveillance activities led by GLASS are grouped into a series of technical modules. These modules comprise surveillance activities built on routinely-available data (for example, patient samples collected for clinical purposes or national sales of antimicrobials) and focused activities targeted at generating information for specific purposes, based on the needs of countries and regions. GLASS is also engaged in the design and implementation of surveys and studies aimed at helping countries to achieve a better quality and representativeness of their data. Furthermore, GLASS provides support, including evidence-based guidelines and technical documents, to assist countries and regions to build capacity and take appropriate and timely corrective actions.
PARTNERSHIPS
GLASS works across all three levels of WHO – headquarters and regional and country offices – and is supported by the WHO AMR Surveillance and Quality Assessment Collaborating Centres Network (WHO AMR Surveillance CC Network). It enjoys strong commitment from participating countries and close collaboration with AMR regional networks such as the Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR), the European Antimicrobial Resistance Surveillance Network (EARS-Net), the Latin American Network for Antimicrobial Resistance Surveillance (Rede Latinoamericana de Vigilancia de la Resistencia a los Antimicrobianos [ReLAVRA]), and the Western Pacific Regional Antimicrobial Consumption Surveillance System WPRACSS.
GLASS Data Visualization Dashboard
GLASS Surveillance Activities
The various types of AMR-related surveillance activities led by GLASS are grouped into technical modules (see figure opposite)
ROUTINE SURVEILLANCE
GLASS-AMR provides a standardized approach to the collection, analysis and sharing of national AMR data in samples collected routinely for clinical purposes for a set of pathogens that cause common bacterial infections in human. GLASS-AMC provides a common and standardized set of methods for measuring and reporting antimicrobial consumption (AMC) at country, regional and global levels. Both technical modules collect data on the implementation of the respective national surveillance systems.
FOCUSED SURVEILLANCE
GLASS-EAR, the emerging AMR reporting (EAR) module, supports the timely detection, reporting, risk assessment and monitoring of emerging resistance. GLASS-FUNGI focuses on the surveillance of invasive fungal bloodstream infections caused by Candida spp.
SURVEYS AND STUDIES
EGASP offers an enhanced approach to sentinel gonorrhoea surveillance of men with urethral discharge and suspected urogenital infections. The One Health technical module offers an integrated multi-sector surveillance programme based on the extended-spectrum beta-lactamase (ESBL)-Escherichia coli (‘Tricycle’) project. PPS-AMU proposes a method for the conduct of point prevalence surveys (PPS) of antibiotic use (AMU) at the hospital level, and the BURDEN technical module presents studies estimating the public health impact of AMR
GLASS Reports
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Laboratory Strenghthening
GLASS and WHO Collaborating Centres are working on building national laboratory capacities in countries through a range of activities. Laboratory-based diagnostic tests for AMR usually involve the laboratory identification of the infectious organism, its drug susceptibility, and sometimes serology testing and molecular analyses. Increased laboratory capacity and rapid, accurate diagnostic testing in countries would significantly impact on global AMR surveillance and diagnostic stewardship. Diagnostic stewardship is defined as including the various stages of the diagnostic process in clinical microbiology and laboratory management. GLASS and WHO Collaborating Centres will provide technical support to countries for the development and operation of national reference laboratories, such as external quality assurance, quality management, continuous training for the performance of AMR testing, as well as for the reporting and interpretation of AMR results. Several tools are listed below to support laboratory functions. Additional tools are currently under development by GLASS to support the strengthening of national reference laboratories in resource-limited settings. |
GLASS 2020 Member State Consultation
GLASS 2020 Member State Consultation Event Page
3rd High level technical consultation and meeting on surveillance of antimicrobial resistance and use for concerted actions
Online technical discussions: 22 October 2020 - 31 March 2021 +++ On-going discussions +++
Virtual Meeting: 26-29 April 2021
GLASS Related