Background: Antimicrobial resistance (AMR) is a global health threat. AMR surveillance is crucial for understanding and controlling the spread of AMR. Surveillance systems can inform clinicians, guide health policymakers, and support effective AMR interventions. AMR surveillance data from former Soviet region countries are often limited, resulting in gaps in up-to-date knowledge. Methods: This systematic review was registered under the PROSPERO protocol CRD42024537799 and followed the PRISMA guidelines. Data from five databases (PubMed, MEDLINE, Embase, CINAHL, and CyberLeninka) and official sources were searched according to the inclusion criteria. Results: In total, 30 publications describing AMR surveillance and National Action Plans (NAPs) were included. Among the 15 countries, 14 (93.3%) have either developed a NAP or are in the process of implementing one; and 7 (46.7%) countries have a standardized AMR surveillance system. Almost all countries have reference laboratory centers, but nine (60%) countries have established standard testing methods in all sites. Only three (20%) countries have fully implemented quality assessment. There is an increasing tendency to involve and report AMR data to international networks, and countries will strengthen their AMR systems by adhering to international standards. The subgroup analysis revealed that Central and Western Asian countries are less developed in terms of AMR surveillance, which may encourage proactive engagement in AMR governance in these regions. Conclusions: This review is crucial for understanding the current efforts and improving AMR surveillance in former Soviet countries. The findings are promising and indicate that AMR surveillance is established in all reviewed countries, although at different levels.

Background/Objectives: Antimicrobial consumption (AMC) surveillance and antimicrobial stewardship (AMS) constitute effective strategies to combat the increasing antimicrobial resistance rates worldwide. Post-Soviet countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan) implemented various elements of AMC surveillance and AMS to different extents. The limited quantity and quality of data from post-Soviet countries make it difficult to assess health system performance; therefore, this region is a blind spot in global AMR monitoring. This systematic review assesses and characterises AMC surveillance and AMS implementation in post-Soviet countries. Methods: Evidence was compiled via a search in PubMed, Google Scholar, Embase, CyberLeninka, and Scopus. The eligibility criteria included AMC surveillance- and AMS-related papers in human health within defined regions and timelines. Some literature from the official websites of international and national health organisations was included in the search. Results: As a result of the searches, screening, and critical appraisal, three peer-reviewed publications and 31 documents were selected for analysis. Eleven out of fifteen countries with updated national action plans for combating antimicrobial resistance have defined AMC surveillance and AMS as strategic objectives. All 15 examined countries submitted antimicrobial consumption data to international networks and reported the existence of approved laws and regulations on antibiotic sales. However, disparities exist in the complexity of monitoring systems and AMS implementation between high-income and low-income countries in the region. Conclusions: This review provides key insights into the existing AMC surveillance and AMS implementation in former Soviet countries. Although the approach of this review lacks quantitative comparability, it provides a comprehensive qualitative framework for national-level AMC surveillance and AMS system assessment.

SUMMARY: Antimicrobial resistance (AMR) is a public health threat that requires a coordinated and multi-sectoral approach. AMR is largely underexplored in Central Asia, a region shaped by the Soviet legacy. This narrative review aimed to synthesize evidence on the AMR landscape from articles published in five countries: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. A structured search of peer-reviewed and gray literature was conducted, covering AMR prevalence, consumption patterns, knowledge, awareness, practices, stewardship interventions, and AMR governance. Key findings revealed that all five countries in the region have retained the rigidly centralized public health system, which was formerly known as the Sanitary Epidemiological Service during the Soviet era. This has led to fragmented surveillance and poor AMR monitoring. Up to 70% of Enterobacterales spp. were resistant to third-generation cephalosporins, and up to 58% of Staphylococcus species exhibited macrolide resistance. Consumption of Watch group antibiotics ranged from 53% to 68%, with a broad preference for injectables. Self-medication was found to be common, with rates ranging between 26% and 40% among the general public. High levels of patient demand coincided with medical errors, affecting up to 80% of antibiotic prescriptions. Only a limited number of antimicrobial stewardship studies were found, highlighting the insufficient integration of stewardship practices into routine healthcare delivery. Central Asian countries continue to face significant challenges because of the persistence of poor surveillance, high antibiotic consumption, and inadequate implementation of AMS because of long-standing legacies and systemic weaknesses. Addressing these gaps demands structural reforms, integrated surveillance systems, targeted education, and robust stewardship programs as urgent priorities.

Introduction. Antimicrobial resistance remains a major global health challenge, requiring coordinated national responses that extend beyond microbiological surveillance to encompass governance, access to care, diagnostics, and stewardship. In Kazakhstan, existing evidence has predominantly focused on resistance patterns and antimicrobial consumption, with limited assessment of how national antimicrobial resistance strategies translate into people-centred health system outcomes. Aim. To assess Kazakhstan’s national response to antimicrobial resistance using the WHO People-Centred AMR Framework, with emphasis on the alignment between governance structures, surveillance systems, and people-centred outcomes in human health. Methods. A narrative literature review covering January 2015–December 2025 was conducted in PubMed, Scopus, Web of Science, Google Scholar, eLIBRARY.RU and CyberLeninka, complemented by grey literature searches of national and WHO sources. The last search was performed on 15 December 2025. Records were screened by two reviewers and thematically synthesised using the WHO People-Centred AMR Framework. Results. Forty-two documents were included in the analysis. Kazakhstan has established a formal AMR governance structure, updated national action plans, and integrated the WHO AWaRe classification into the essential medicines list. However, surveillance coverage remains geographically limited, and facility-level feedback mechanisms are inconsistently implemented. Antibiotic consumption is characterised by a high proportion of Watch and Reserve group agents, and non-prescription use persists in community settings. Diagnostic capacity is partially operational but not uniformly embedded in routine clinical workflows. Infection prevention and antimicrobial stewardship programmes demonstrate developing capacity, with gaps between policy commitments and operational implementation. Conclusions. Kazakhstan’s AMR response is institutionally structured and policy-aligned but faces operational and integration challenges. Strengthening routine surveillance feedback, diagnostic accessibility, and behaviour-oriented stewardship interventions is essential to enhance people-centred outcomes and reduce inappropriate antimicrobial use. Введение. Антимикробная резистентность (АМР) остаётся одной из ключевых глобальных угроз общественному здоровью и устойчивости систем здравоохранения. Эффективный национальный ответ требует скоординированного национального ответа, выходящего за рамки микробиологического эпиднадзора и охватывающего управление, доступность медицинской помощи, диагностику и программы рационального применения антимикробных препаратов. В Республике Казахстан исследования преимущественно сосредоточены на микробиологических аспектах и анализе потребления антибиотиков, тогда как национальный ответ на проблему антимикробной резистентности с позиций пациентоориентированной модели здравоохранения изучен недостаточно. Цель исследования. Оценить национальный ответ Республики Казахстан на проблему антимикробной резистентности с использованием WHO People-Centred AMR Framework с анализом согласованности управленческих механизмов, систем эпиднадзора и практических результатов для пациентов. Методы. Проведён нарративный обзор литературы за период с января 2015 по декабрь 2025 гг. Поиск осуществлялся в базах данных PubMed, Scopus, Web of Science, Google Scholar, eLIBRARY.RU и CyberLeninka, а также дополнялся анализом источников «серой» литературы (национальные ресурсы и материалы Всемирной организации здравоохранения). Последний поиск выполнен 15 декабря 2025 года. Отбор публикаций осуществлялся двумя исследователями, после чего материалы были синтезированы тематически с использованием WHO People-Centred AMR Framework. Результаты. В анализ было включено 42 документа. В Казахстане сформирована формальная система управления в области противодействия антимикробной резистентности, обновлены национальные планы действий и интегрирована классификация ВОЗ AWaRe в перечень основных лекарственных средств. Вместе с тем охват системой эпиднадзора остается географически ограниченным, а механизмы обратной связи на уровне медицинских организаций внедрены неравномерно. Потребление антибиотиков характеризуется высокой долей препаратов групп Watch и Reserve, при этом в амбулаторном...