Update on NAP AMR in the Region: Situation Analysis 2016 and Situation Analysis 2018
To tackle the AMR challenge in the Region, WHO has been working with the Member States to develop their national action plans on antimicrobial resistance (NAP AMR). Since 2010, WHO along with FAO and OIE in a global Tripartite partnership for One Health has strived to provide a strategic vision, ensuring sharing of responsibilities to address health risks at the human-animal-environment interface. The Tripartite coordinated development of a common multipronged regional action plan in support of countries, highlighting priority issues of governance and multisectoral coordination, capacity-building, gaps in knowledge and strengthening of systems.
As a first step in implementing AMR prevention and containment efforts in the Region, a situational analysis was initiated by the Regional Office in 2016. The findings culminated in a roadmap providing clear guidance on initiatives that Member States need to put in place to achieve sustainable AMR containment. By mid-2017, all 11 Members States had prepared NAPs and initiated programmes.
In 2018, two back-to-back follow-up meetings were held in Bangkok to assess progress and identify gaps and challenges in NAP implementation in the Region and suggest actionable recommendations. The meetings brought together country-led intersectoral teams, comprising representatives from the national drug regulatory authority (DRA), national referral laboratory, AMR stewardship programme (AMSP) and national officers in charge of the human and animal health sectors and environment sectors from the Member States, in addition to technical experts from FAO.
The tool used for the situational analysis and monitoring of AMR was the same as that used by the Regional Office in 2016 with some advancement. It was used to conduct system-wide analysis of AMR prevention and containment programmes, focusing on seven areas from the 2016 tool (NAP aligned with the GAP AMR governance; awareness-raising; national AMR surveillance system; rational use of antimicrobials and surveillance of use/sales; infection prevention and control (IPC) and AMR stewardship; research and innovation; and One Health engagement. Further, it added the eighth focus area of overarching coordination mechanisms for One Health engagement.
The 2018 situational analysis and review of implementation was carried out using the participatory methodology of guided discussion and conducted jointly by national stakeholders and WHO in collaboration with FAO, OIE, and UNEP representatives. The tool assessed the progress of NAP-AMR implementation based on 30 indicators as a proxy for strategic interventions/programmes across eight focus areas. These included 20 initial indicators (from the 2016 situational analysis tool) and 10 newly introduced indicators. Recommendations were made including sustaining progress through stronger multisectoral collaboration, including the creation of platforms that can enable joint planning, exchange of surveillance information and sharing of resources.
