(57) Status of The Implementation of National Action Plans—All Countries, 2021

Publication Number: 388

Status of the implementation of national AMR action plans—all countries, 2021
Background
Antimicrobial resistance (AMR) is a growing global concern. At the 2015 World Health Assembly (WHA), member states pledged to implement national AMR action plans (NAAPs) through a multi-sectoral One Health approach. However, the status of NAAP implementation is unclear.
Methods
We analyzed WHA members’ responses to the 2018-2019 and 2020-2021 surveys, coordinated by three United Nations agencies, regarding the implementation of their NAAPs (at: www.amrcountryprogress.org). We focused on items related to progress in the development and implementation of the NAAP, then assessed specific activities that reflect a One Health approach including surveillance in humans and animals, and stewardship efforts. We further examined responses to items about the impact of the COVID-19 pandemic on NAAPs.
Results
Of 194 member states, 163 (84%) responded to the 2020-2021 survey. Of members responding, 140 (86%) reported having developed AMR plans, and 95 (58%) reported plan implementation underway. Eighty-seven (53%) and 70 (43%) of respondents indicated that they have a standardized national surveillance system for monitoring AMR in humans and animals respectively. Prescribing practices and appropriate antibiotic use in human health are nationally monitored in 56 (34%) countries. Forty-three (26%) and 38 (23%) of respondents offer antimicrobial stewardship training in healthcare and in veterinary settings respectively. Sixty-six (40%) indicated that they have a nationwide AMR awareness campaign targeting stakeholder groups. A negative impact of the COVID-19 pandemic on the NAAP was reported by 135 (83%) of respondents. Of the 141 countries that responded to both surveys (2018-2019 and 2020-2021), 19 (13%) reported decreased efforts in the implementation of the NAAP.
Conclusions
Many countries have national action plans to address the threat of antimicrobial resistance, but further work remains. Less than half of the countries that responded to the latest survey conduct surveillance to monitor antimicrobial resistance in isolates from both human and animal sources. Building infrastructure to conduct integrated surveillance in humans, animals, plants, and the environment remains a priority. One Health approach—even during pandemics—is needed in most countries to slow the emergence and spread of antimicrobial resistance.