The Pan American Health Organization (PAHO) is helping Caribbean countries build stronger laboratory systems to detect antimicrobial-resistant bacteria, a crucial step for effective treatment.

The situation in the Caribbean is no exception. Limited laboratory capacity has long delayed diagnosis and forced clinicians to rely on broad-spectrum antibiotics. But that is starting to change.

Through the UK Government’s Fleming Fund, the Pan American Health Organization (PAHO) is upgrading microbiology laboratories in ten Caribbean countries. The initiative, Strengthening Antimicrobial Resistance Response in the Caribbean, focuses on enhancing diagnostic capacity and strengthening surveillance, improving the region’s ability to respond to antimicrobial-resistant infections.

Faster laboratory turnaround means doctors treating critical infections such as sepsis or pneumonia, situations where patient lives are at risk, will receive results in time to make life-saving treatment decisions.

“In the past, results could take a week to reach a doctor. By then, the patient might have been discharged… or worse,” said Dr. Pilar Ramon-Pardo, Chief of PAHO’s Antimicrobial Resistance Special Program. “Instead of a week, now we’re looking at a 48-hour turnaround. That’s a monumental change for patient care in the Caribbean.”

A leap forward in diagnostic capability

Under the program, each of the ten participating Caribbean countries (Belize, Dominica, Grenada, Guyana, Haiti, Jamaica, Montserrat, Saint Lucia, Saint Vincent and the Grenadines, and Suriname) is receiving direct support for at least one national or main hospital microbiology laboratory.

In addition, two regional reference laboratories — the Best-dos Santos Public Health Laboratory (BDS-PHL) in Barbados and the Caribbean Public Health Agency (CARPHA) Laboratory in Trinidad and Tobago — are being strengthened to provide advanced testing, quality assurance, and regional training.

New equipment includes automated platforms for bacterial identification and antimicrobial susceptibility testing (AST), advanced technologies for detecting and confirming outbreaks, dedicated freezers for safe sample storage, and all the essential reagents and consumables needed for routine microbiology work.

Labs also receive standardized culture media and quality control strains (ATCC) to ensure testing is reliable, as well as diagnostic kits and reagents for identifying key pathogens like E. coli, Klebsiella pneumoniae, and Staphylococcus aureus, which frequently cause serious infections and are increasingly showing resistance to multiple antibiotics.

“In terms of impact on our daily work, these new systems will transform how we manage serious infections. Faster and more reliable results mean clinicians can start target treatment sooner, improving antibiotic use and patient outcomes,” according to Haze John, Senior Medical Technologist at the Milton Cato Memorial Hospital Laboratory in St. Vincent and the Grenadines.

With these tools, clinicians can isolate pathogens from clinical samples, run rapid blood culture analyses, and perform molecular tests to confirm and track what infections are resistant to what antibiotics. PAHO has also trained laboratory personnel to run and operate the new systems and integrate them into national workflows.

“Having much more refined data supports medical staff and informs those building the formulas of available antibiotics. This data is useful for policymakers as well as directing our antimicrobial stewardship activities,” says Eric Carbon, Manager of the Dominica National Laboratory in the island nation of Dominica.

In the Caribbean, limited capacity in diagnostics has long forced doctors to treat patients empirically, that is, prescribing broad-spectrum or last-resort antibiotics without knowing whether an infection was bacterial or resistant. This practice reduces treatment effectiveness and accelerates the spread of drug resistance.

“The Caribbean was far behind in laboratory capacity,” according to Dr. Pilar Ramon-Pardo. “With this project, PAHO has provided state-of-the-art diagnostic equipment and training. It’s like going from roller skates to an airplane.”

Building surveillance and data systems

PAHO’s efforts are part of a broader strategy in collaboration with CARPHA and the UK Health Security Agency (UKHSA). This partnership supports training, quality assurance, and data-sharing through the Latin American and Caribbean Network for Antimicrobial Resistance Surveillance (ReLAVRA+), which connects national laboratories and harmonizes methodologies.

Coordinated by PAHO, ReLAVRA+ is a regional platform to generate, analyze, and share AMR data from the Americas. The platform also serves as a counterpart to the WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS).

To complement the hardware, PAHO has provided software and digital tools to collect and analyze laboratory data, supporting national surveillance and enabling the Region to improve its reporting.

“These countries will now have their own high-quality AMR data for decision-making and for contributing to global surveillance,” said Dr. Ramon-Pardo. “Until now, the Caribbean was one of the few regions with little representation in global AMR databases.”

According to the World Health Organization’s 2025 Global Antibiotic Resistance Surveillance Report, between 2018 and 2023, antibiotic resistance rose in over 40% of the monitored antibiotics with an average annual increase of 5-15%. Resistance is also more common and worsening in places where health systems lack capacity to diagnose or treat bacterial pathogens.

Resistance is most common where diagnostic and surveillance systems are weakest — precisely what PAHO’s initiatives aim to address. Through programs like ReLAVRA+ and the Fleming Fund partnership, the Caribbean is closing the diagnostic gap and protecting its populations from the dire consequences of antimicrobial resistance.

World Antimicrobial Resistance Awareness Week 2025

The progress in the Caribbean coincides with World Antimicrobial Resistance Awareness Week 2025 (18–24 November), a global campaign led by WHO to raise awareness of AMR and promote urgent action against drug-resistant pathogens. This year’s theme, “Act Now: Protect Our Present, Secure Our Future,” reflects the need for coordinated efforts. By strengthening diagnostic and surveillance systems, PAHO and its partners are helping Caribbean countries respond effectively today and protect public health for the future.