A record number of countries (163) responded to the latest annual global survey of implementation of the Global Action Plan on addressing antimicrobial resistance (AMR) administered jointly by WHO, FAO and OIE (the “Tripartite”). However, more than 90% of those countries noted that COVID-19 had had a negative impact on development and implementation of national plans to tackle AMR. Challenges included reduced funding, lack of support for coordination meetings, as well as deferred activities in data collection, capacity building, and campaigns.
The data from the survey highlight an urgent need to expedite the prioritization, costing, implementation and monitoring of AMR activities and to build capacity to ensure the effective functioning of multisectoral coordination structures. It also flags an overall need to strengthen political commitment, to make more resources available, and build awareness about AMR.
Key data and updates from the 2021 survey – human health indicators
- AMR governance in countries: Only 50% of countries have a functional AMR multisectoral coordination mechanism to help prioritize, cost, implement and monitor AMR national action plans.
- AMR national action plans: 2021 TrACSS data suggest that 86% of the 163 responding countries have developed multisectoral AMR national action plans, but only 20% of the countries are actively monitoring their implementation.
- Cross-cutting work: More than 60% of the countries have linked their AMR national action plans to other health topics and plans, including (in descending order): food safety, TB, HIV, health security, WASH, STIs, immunization, malaria, environmental plans.
- Raising awareness on AMR: 56% of countries conduct limited and small-scale AMR awareness campaigns.
- Education and training on AMR (human health): Over 78% of the countries responding are providing at least some pre-and in-service training on AMR to health-care workers, but only 9% have formally incorporated AMR in the curricula.
- Surveillance systems to monitor resistance: Some 72% of the responding countries have systems to collate data nationally for common bacterial infections in hospitalized and community patients, and in 53% of countries there is a standardized national AMR surveillance system aligned with Global Antimicrobial Resistance and Use Surveillance System (GLASS) requirements. Around 107 countries are enrolled in the GLASS, with 64 and 59 countries reporting data on the two AMR SDG indicators – respectively bloodstream infection caused by E. coli resistant to 3rd generation cephalosporins and bloodstream infection caused by and methicillin-resistant Staphylococcus aureus (MRSA).
- Monitoring systems for antimicrobial consumption and use: While 91% of countries noted that they have laws and regulations on the prescription and sale of antimicrobials for human use, only 55% of them have systems that monitor sales of antimicrobials at the national level, and use at sub-national level. 23% of countries have no systems in place to monitor antimicrobial use in human health.
- National AMR lab network in human health: 70% of countries have a National Regulatory Authority or a National Reference Laboratory that has issued national guidelines for antibiotics susceptibility testing (AST), bacterial isolation and identification based on international standards and for use within the bacteriology lab network. Meanwhile, 56% of the countries note that their bacteriology labs participate in an international EQA process. Only 30% report having advanced capacity with an NRL that supports the bacteriology network through a systematic approach to cascade training, supportive supervision and National EQA programme.
- IPC in human healthcare: Just 35% of countries have national IPC programmes in place based on WHO IPC core components, that are being implemented nationwide, and regularly evaluated. 54% of the countries have developed national IPC programmes or plans, but they are not being implemented, or implemented only in selected health facilities.
- Antimicrobial stewardship in human health: Only 33% of countries have guidelines and practices to optimize the use of antimicrobials that are being implemented nationwide in most health facilities, with surveillance results used to update treatment guidelines and essential medicines lists.
- Adoption of WHO’s “AWaRe” classification of antibiotics: Currently, 36% of the countries (compared to 26% last year), have adopted the AWaRe (Access, Watch, Reserve) classification of antibiotics in their national essential medicines list. Knowledge about “AWaRe” is high.