Harmonising cross-sector data for One Health surveillance

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Gilgit-Baltistan, a region in Pakistan, has faced a high burden of antimicrobial resistance (AMR) across its human, animal, and environmental health sectors. Structural limitations have caused inadequate surveillance, hindering the national response to drug resistance.

The Fleming Fund Country Grant Pakistan, led by DAI, partnered with the Government of Gilgit-Baltistan to develop a dedicated One Health AMR Dashboard to address systematic gaps and catalyse change in healthcare policy.

Above image: One Health AMR Dashboard training (credit: DAI).

Strategic oversight

National surveillance reports from Gilgit-Baltistan highlighted rising resistance to priority pathogens, yet existing systems lacked a consolidated method for data interpretation and use. The storage of surveillance information in isolated manual formats across facilities and departments has prevented cross-sector comparisons and restricted strategic oversight.

Valuable AMR data was generated in laboratories, but fragmented reporting systems prevented routine analysis at the provincial level. Governance relied on partial updates rather than substantial evidence, with digital infrastructure constraints, inconsistent validation processes, and analytical capacity further limiting effective data use.

Although the existing National Action Plan for the Containment of AMR provided strategic direction, the region needed to translate policy commitments into coordinated surveillance practice. “Without a cohesive surveillance system, AMR governance remained reactive, not proactive. The need for a structured, One Health–aligned platform became increasingly clear,” said Zahid Hussain, Deputy Director, Health Department in Gilgit-Baltistan.

Dashboard data analysis

Launched in October 2025, the One Health AMR Dashboard allows provincial authorities in Gilgit-Baltistan to review consolidated data across sectors for the first time. The platform integrates regional data from human, livestock, aquaculture, and environmental health sectors – aligned with national and global reporting standards and surveillance architecture.

With automatic aggregation of pathogen trends, drug resistance profiles, specimen analysis, and geographic summaries, the platform presents data with interactive filtering and real-time visualisation of AMR trends - across time periods, pathogens, antibiotics, facilities, and locations.

Alongside supporting the development of system design and national reporting, the Fleming Fund has also helped build technical capacity: providing training sessions for surveillance site and AMR sector officials, mentoring to strengthen the Dashboard’s data analysis and use, and support around technical and hosting limitations.

“The Fleming Fund Country Grant in Pakistan played a catalytic role in ensuring that the dashboard moved beyond technical development towards institutional integration,” added Zahid.

Structural shift: Institutionalising data

Developed in consultation with the Gilgit-Baltistan government, the One Health platform supports effective AMR management, providing data insights to:

• Identify resistance patterns across sectors.
• Review cross-sector contributions under the One Health framework.
• Support stewardship and infection prevention priorities.
• Monitor laboratory surveillance needs and emerging pathogen trends.

The open-source, user-friendly interface with downloadable outputs is designed for integration with other health information systems and promotes long-term adaptability and scalability. All One Health sectors in Gilgit-Baltistan contribute data through the platform, and it is actively used by the Steering Committee and Technical Working Groups, enabling an evidence-based review.

"Although the system is newly operational, its routine use in governance forums represents a structural shift in how AMR evidence is reviewed and interpreted; anchored in a central database rather than fragmented reporting,” said Dr Qandeel Laraib, Research Officer, Environment Protection Agency in Gilgit-Baltistan. “The objective was not merely to visualise data, but to institutionalise data-driven decision-making for One Health practices in tackling AMR.”

National-provincial integration

The Dashboard supports policy development, cross-sector coordination, and evidence-informed planning by embedding analytical functionality within governance mechanisms. By introducing expertise previously lacking, it enhances transparency and accountability in AMR surveillance, while ensuring capacity and ownership reside within government structures.

Hosted by Pakistan’s National Institute of Health (NIH), the Dashboard ensures seamless operation and robust system reliability, thereby establishing national–provincial integration. The Gilgit-Baltistan Health Department owns the platform and has an appointed ‘AMR Focal Person ’ overseeing coordination and sector engagement.

“By making trends visible and comparable, the system has improved confidence in surveillance processes and advanced routine data use within the region, placing harmonised evidence at the core of AMR policy,” said Dr Iqbal Aziz, AMR Focal Person in Gilgit-Baltistan.

“Institutionalising the dashboard within provincial structures, the initiative has increased accountability and routine data review. Cross-sector participation reinforces the One Health approach and encourages shared responsibility across departments,” added Dr Aziz.

Sustained alignment

The Dashboard demonstrates that targeted technical assistance, combined with government ownership and strategic hosting, can convert surveillance data into durable assets for governance. Due to its embedded use and analytical capacity, the Dashboard offers a scalable model for strengthening integrated AMR surveillance across Pakistan and supporting sustained progress even after external assistance concludes.

“Future efforts will focus on further improving data validation processes, enhancing analytical skills among users, and deepening integration with national reporting systems to ensure sustained alignment," said Zahid. “Stakeholders have expressed strong interest in continued capacity support to maximise the system and its long-term impact.”

“The Gilgit-Baltistan One Health AMR Dashboard represents a significant step towards institutionalising integrated surveillance in a geographically challenging region,” said Dr Ismat Ali, Deputy Director, Livestock Department in Gilgit-Baltistan. “By transforming fragmented data into structured, cross-sector evidence, the initiative has strengthened governance, coordination, and accountability under the One Health framework.”

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