Isomorphic dynamics in national action plans on antimicrobial resistance

2021 ◽  
Author(s):  
Olivier Rubin ◽  
Louise Munkholm
Keyword(s):  
Antimicrobial Resistance ◽  
Action Plans

scholarly journals Strengthening implementation of antimicrobial resistance national action plans

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Anderson ◽  
K Schulze ◽  
A Cassini ◽  
D Plauchoras ◽  
E Mossialos
Keyword(s):  
Antimicrobial Resistance ◽  
Policy Design ◽  
Animal Health ◽  
Monitoring And Evaluation ◽  
Basic Structure ◽  
Infection Prevention And Control ◽  
Action Plans ◽  
Governance Framework ◽  
Food And Agriculture ◽  
Food And Agriculture Organization

Abstract Antimicrobial resistance is one of the major challenges of our time. Countries use national action plans as a mechanism to build engagement among stakeholders and coordinate a range of actions across human, animal, and environmental health. However, implementation of recommended policies such as stewardship of antimicrobials, infection prevention and control, and stimulating research and development of novel antimicrobials and alternatives remains inconsistent. Improving the quality of governance within antimicrobial resistance national action plans is an essential step to improving implementation. To date, no systematic approach to governance of national action plans on AMR exists. To address this issue, we aimed to develop the first governance framework to offer guidance for both the development and assessment of national action plans on AMR. We reviewed health system governance framework reviews to inform the basic structure of our framework, international guidance documents from WHO, the Food and Agriculture Organization, the World Organisation for Animal Health, and the European Commission, and sought the input of 25 experts from international organisations, government ministries, policy institutes, and academic institutions to develop and refine our framework. The framework consists of 18 domains with 52 indicators that are contained within three governance areas: policy design, implementation tools, and monitoring and evaluation. Countries must engage with a cyclical process of continuous design, implementation, monitoring and evaluation to achieve these aims.

scholarly journals A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sanjeev Singh ◽  
Esmita Charani ◽  
Sarada Devi ◽  
Anuj Sharma ◽  
Fabia Edathadathil ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
The State ◽  
Action Plans ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Threat

Abstract Background The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. Strategies Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. Conclusion Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.

scholarly journals Benchmarking national action plans on antimicrobial resistance in eight selected LMICs: Focus on the veterinary sector strategies

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Ebiowei Samuel F Orubu ◽  
Indorica Sutradhar ◽  
Muhammad H Zaman ◽  
Veronika J Wirtz
Keyword(s):  
Antimicrobial Resistance ◽  
Action Plans

scholarly journals The global governance of antimicrobial resistance: a cross-country study of alignment between the global action plan and national action plans

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Louise Munkholm ◽  
Olivier Rubin
Keyword(s):  
Antimicrobial Resistance ◽  
Global Governance ◽  
Action Plan ◽  
World Health ◽  
Action Plans ◽  
Vertical Alignment ◽  
Member States ◽  
Horizontal Alignment ◽  
Global Action ◽  
Global Action Plan

Abstract Background Antimicrobial resistance (AMR) is a growing problem worldwide in need of global coordinated action. With the endorsement of the Global Action Plan (GAP) on AMR in 2015, the 194 member states of the World Health Organization committed to integrating the five objectives and corresponding actions of the GAP into national action plans (NAPs) on AMR. The article analyzes patterns of alignment between existing NAPs and the GAP, bringing to the fore new methodologies for exploring the relationship between globally driven health policies and activities at the national level, taking income, geography and governance factors into account. Methods The article investigates the global governance of AMR. Concretely, two proxies are devised to measure vertical and horizontal alignment between the GAP and existing NAPs: (i) a syntactic indicator measuring the degree of verbatim overlap between the GAP and the NAPs; and (ii) a content indicator measuring the extent to which the objectives and corresponding actions outlined in the GAP are addressed in the NAPs. Vertical alignment is measured by the extent to which each NAP overlaps with the GAP. Horizontal alignment is explored by measuring the degree to which NAPs overlap with other NAPs across regions and income groups. In addition, NAP implementation is explored using the Global Database for Antimicrobial Resistance Country Self-Assessment. Findings We find strong evidence of vertical alignment, particularly among low-income countries and lower-middle-income countries but weaker evidence of horizontal alignment within regions. In general, we find the NAPs in our sample to be mostly aligned with the GAP’s five overarching objectives while only moderately aligned with the recommended corresponding actions. Furthermore, we see several cases of what can be termed ‘isomorphic mimicry’, characterized by strong alignment in the policies outlined but much lower levels of alignment in terms of actual implemented policies. Conclusion To strengthen the alignment of national AMR policies, we recommend global governance initiatives based on individualized responsibilities some of which should be legally binding. Our study provides limited evidence of horizontal alignment within regions, which implies that regional governance institutions (e.g., WHO regional offices) should primarily act as mediators between global and local demands to strengthen a global governance regime that minimizes policy fragmentation and mimicry behavior across member states.

scholarly journals A call for action to the biomaterial community to tackle antimicrobial resistance

2020 ◽  
Vol 8 (18) ◽  
pp. 4951-4974
Author(s):  
Thomas J. Hall ◽  
Victor M. Villapún ◽  
Owen Addison ◽  
Mark A. Webber ◽  
Morgan Lowther ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Action Plans ◽  
Disease Treatment

The global surge of antimicrobial resistance (AMR) is a major concern for public health and proving to be a key challenge in modern disease treatment, requiring action plans at all levels.

Antimicrobial Resistance and Stewardship in National Action Plans

2016 ◽  
Vol 8 (2) ◽  
pp. 57-71 ◽  
Author(s):  
Mohammed Sadak ◽  
Emma Cramp ◽  
Diane Ashiru-Oredope
Keyword(s):  
Antimicrobial Resistance ◽  
Action Plans

Recent Breakthroughs in Various Antimicrobial Resistance Induced Quorum Sensing Biosynthetic Pathway Mediated Targets and Design of their Inhibitors

2020 ◽  
Vol 23 (6) ◽  
pp. 458-476
Author(s):  
Mohit Kumar ◽  
Mridula Saxena ◽  
Anil K. Saxena ◽  
Sisir Nandi
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Quorum Sensing ◽  
Biosynthetic Pathway ◽  
Antimicrobial Agents ◽  
Economic Status ◽  
Action Plan ◽  
World Health ◽  
Action Plans ◽  
The World

Objective: The world is under the grasp of dangerous post-antibiotics and antimicrobials attack where common infections may become untreatable, leading to premature deaths due to antimicrobial resistance (AMR). While an estimated 7,00,000 people die annually due to AMR, which is a public health threat to all communities in different parts of the world regardless of their economic status; however, this threat is serious in low- and middle-income countries having lack of sanitation and health infrastructure. The 68th World Health Assembly endorsed the Global Action Plan on antimicrobial resistance. Consequently, many countries started drafting and committing to National Action Plans against AMR. As strong as National Action Plans are in terms of prescribing rational use of antimicrobials, infection control practices, and related public health measures, without strong healthcare systems, these measures will have a limited impact on AMR in developing countries. Methods: The major reason for AMR is microbial quorum sensing (QS) that may strengthen the microbial community to generate inter-communication and virulence effects via quorum sensing mechanisms. Global stewardship to combat antimicrobial resistance aims to develop anti-quorum sensing compounds that can inhibit the biosynthetic pathway mediated different quorum sensing targets. Results: It may pave an effective attempt to minimize microbial quorum sensing mediated antimicrobial resistance. The present review describes QS mediated various potential target enzymes, their connection to AMR, and finds out the corresponding QS biosynthetic target inhibitors. Conclusion: These potential inhibitors can be derivatized to design and develop next-generation antimicrobial agents.

scholarly journals 25.H. Workshop: Challenges in tackling antimicrobial resistance: economic and policy responses

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Antimicrobial Resistance ◽  
Environmental Health ◽  
One Health ◽  
Action Plan ◽  
National Level ◽  
World Health ◽  
Successful Implementation ◽  
Action Plans ◽  
Policy Responses ◽  
Human Animal

Abstract Antimicrobial resistance (AMR) is driven by inter-related dynamics in the human, animal, and environmental health sectors and one of the most significant and complex current public health issues of our time. Without effective antimicrobials even common infections may become life-threatening and many treatments such as surgical procedures and chemotherapy will not be possible. There is widespread consensus that the response to AMR requires multiple actions, including improving awareness and understanding of AMR, strengthening the knowledge and evidence based through surveillance and research, reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures, optimising the use of antimicrobials in human and animal health and stimulating research and development (R&D) in novel antimicrobials and alternatives. International and national efforts to combat AMR have grown steadily over the last two decades. Two major landmark developments include the launch of the World Health Organisation (WHO) Global Action Plan on AMR in 2015, which asks all countries to develop national action plans by 2017, and the United Nations (UN) General Assembly agreeing a political declaration on AMR in 2016 where countries committed to work at national, regional, and global levels to develop and implement multisectoral national action plans in accordance with the 'One Health' approach. The European Commission also published a One Health action plan against antimicrobial resistance in 2017. However, despite progress at international level, there remains inconsistent progress and implementation of recommended policies to tackle AMR at national level. The UN Interagency Coordination Group on Antimicrobial Resistance (IACG) recently concluded that currently the greatest challenge in AMR is not designing a national action plan but implementing it. The contrasting cultures, behaviours and incentives of each sector and relevant stakeholders is what makes the successful implementation of AMR national action plans so challenging. The purpose of this workshop will be to discuss the evidence and thinking on the different facets of the complex problem of tackling AMR for academics and policy-makers. These discussions will be informed by a forthcoming book jointly published by the European Observatory on Health Systems and Policies and the Organisation for Economic Co-operation and Development titled 'Challenges in Tackling Antimicrobial Resistance: Economic and Policy Responses'. The workshop will focus on five key questions; How can implementation of AMR national action plans be strengthened? What is the evidence on the rise of AMR and its health and economic impact? How can AMR be most effectively addressed in community healthcare settings? How can the discovery of new antibiotics be reinvigorated to replace those rendered ineffective by resistance? Can more use be made of vaccines to tackle AMR? Key messages Antimicrobial resistance is a complex issue which requires actions across the human, animal, environmental health sectors taking a 'One Health' approach. Improving the quality of governance within antimicrobial resistance national action plans is an essential step to strengthening implementation.

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