Turning plans into action for antimicrobial resistance (AMR) Working Paper 2.0: Implementation and coordination
Overview
Since the Global Action Plan on Antimicrobial Resistance (AMR) was adopted in 2015, more than half the world’s countries have developed their own national action plan (NAP) to tackle AMR, establishing AMR coordination committees or equivalent to deliver them. But implementing NAPs at scale is proving a difficult task, especially in the resource-constrained settings of low- and middle-income countries (LMICs).
This paper was developed to support AMR coordination committees and others tasked with addressing AMR at country level to offer practical guidance on implementation. Drawing on the published literature and the operational experience and expertise of different LMICs, the paper explains the importance of building on existing plans and initiatives in relevant areas (such as IPC, immunization, medicines regulation and supply and laboratory strengthening programmes). Although there are some AMR specific areas which may be new, many of the most important components of the AMR plan are activities that are already being carried out but that need to be scaled up and made more AMR sensitive. In reality, AMR is another imperative for action in essential public and animal health functions. In this context the role of the AMR coordination committee is to pull together the relevant strands of work, engage with the right individuals and ensure that the key functions to address AMR are appropriately included in key strategies, plans and budgets. The paper points to six key strategies for success and offers a series of practical tips and suggestions on how to implement each one.
These six strategies are: establishing AMR coordination committee roles and responsibilities; prioritizing AMR activities; getting AMR into government plans and budgeting processes at all levels; engaging stakeholders; tailoring the AMR message for different audiences; and making the case for investment. While each of these strategies is important in its own right, to support NAP implementation effectively they must be done together, in a purposeful and coordinated way.
Background Documents
Background documents in the form of three country case studies (Ghana, Nepal and Nigeria) were commissioned by the WHO AMR Secretariat to contribute to the development of this working paper. The Centre for Disease Dynamics, Economics & Policy (CDDEP) was contracted by WHO to develop the case studies.
A One Health approach was taken, to assess entry points for AMR activities, as human and animal health are interdependent and bound to the health of the environments in which they are situated. Also considered was the role of, and opportunities to engage with, development partners on AMR within each country.
The case studies reviewed the scope for scaling up action related to AMR through existing and future projects and programmes. The information gained from this piece of work enabled a greater understanding of the challenges and options for seeking investment in AMR in developing countries and informed the development of the working paper.
