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Global bodies are calling for immediate action against antimicrobial resistance (AMR).1 To make meaningful change, we need clear intentions and procedure. Policy will be essential to guide decisions and achieve sustainable outcomes.
THE WHO PRESCRIPTION
Tackling antimicrobial resistance will require a combination of 'multisectoral coordination and sector-specific responses.'1,2 Alert to this issue, in 2015 WHO's decision-making forum, the World Health Assembly, set out a Global Action Plan (GAP).1
The goal of this plan is 'to ensure, for as long as possible, continuity of the ability to treat and prevent infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them’. WHO calls for us to follow a 'one-health' approach. To achieve this, five strategic objectives have been identified:1
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Just like Pfizer’s PRESERVE strategy, WHO’s GAP underscores the importance of coming
together. In both, the objectives laid out are part of global strategy and might feel far removed from the everyday. But the sentiment in these principles can be applied on a daily basis. If we start by taking achievable steps together, we will make a difference.
NATIONAL ACTION PLANS
After the release of GAP in 2015, all WHO members states were urged to develop their own national action plan within two years.2
Similar to GAP objectives, all local plans should incorporate society-wide engagement and
education, prevention and reduction measures, improved access to health facilities,
professionals and technologies, sustainable long-term investment, and incremental targets for intervention and progress.2
Although individual countries have committed to developing such plans, their mere existence will not be enough. For national plans to produce impactful change, they must inspire targeted and sustainable actions to improve antimicrobial use.2,3
This year, a study found that 122 (64%) of the 192 WHO Member State countries have put a
national plan in place. Strategies to optimise antimicrobial use follow common themes: policy
and strategic planning, medicines management, technology for optimised prescribing, behaviour context and culture, operational delivery and monitoring, and patient and public engagement.3
Another study tracked the impact of a national action plan on antibiotic resistance in a teaching hospital in China from 2015 to 2018. After the plan was introduced in 2016, the rate of resistance to all antibiotics declined by 5.3% and culture-positive rate (e.g. bacteria identified in samples) declined by 9.8% – showing that, when done well, national plans can make a real difference to the issue at hand.4
To be successful, a national plan needs a governance structure. Technical experts, policymakers and national health authorities should be involved in implementing antimicrobial resistance activities at all levels of the health system. Funding and dedicated leadership are also important to build advocacy and implement national plans.2
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