Situation analysis of National Action Plans for AMR containment in SEAR - PowerPoint Presentation

1. Situation analysis of National Action Plans for AMR containment in SEAR

2. SEAR, a region at highest risk globally for emergence and spread of AMRAntimicrobial resistance is a global public health concern that has significant health and financial consequencesQualitative risk analysis suggests that this Region is probably at the highest risk globally for the emergence and spread of AMRAntimicrobial drugs are used extensively in the livestock and aquaculture sectorsby 2030, India will be the fourth largest consumer of antimicrobials in livestock and Indonesia will show largest relative increase in antimicrobial consumption between 2010 and 2030Region has developed comprehensive policies and adopted several Regional Committee resolutions on prevention and containment of AMRBy early 2018, all 11 Member states had developed their multisectoral NAPs on AMR and initiated activities across different strategic objectives(A) Largest five consumers of antimicrobials in livestock in 2010. (B) Largest five consumers of antimicrobials in livestock in 2030 (projected)(C) Largest Increase in antimicrobial consumption between 2010 and 2030(D) Largest relative increase in antimicrobial consumption between 2010 and 2030

3. Enabling countries to assess development and measure progress of NAP AMR implementation to achieve sustained operations of AMR containment programmesSEAR/HIM has developed a situation analysis tool to conduct a system-wide analysis of programmes for prevention and containment of AMR Through guided discussions, progress is reviewed jointly by national stakeholders and WHO, in collaboration with FAO, OIE and UNEP representatives.Progress of implementation is assessed against 8 focus areas and 30 indicators as a proxy for strategic interventions/ programmesEach indicator is graded along five phases based on level of implementation:First phase (exploration and adoption): Process of designing AMR containment programme initiatedSecond phase (programme installation): Programme implementation decided; initial activities under way Third phase (initial implementation): Change or intervention initiatedFourth phase (full operation): Successful model of the programme scaled upFifth phase (sustainable operation): Highest grade of operational efficiency attainedSEAR AMR SITUATION ANALYSIS TOOL FOCUS AREASNAP being in line with GAP-AMR governanceRaising of awarenessNational AMR surveillance systemRational use of antimicrobials and surveillance of use/sales (community-based)Infection, prevention control and AMR stewardshipResearch and innovationOne Health engagementOverarching coordination mechanisms for One health engagement

4. Overall progress of NAP AMR implementation*Progress assessed for 20 indicators based on Situation Analysis tool 2016; Situation Analysis was not conducted in DPRK in 2016 and so progress not compared in 2018 ** Progress assessed for 30 indicators (10 newly introduced indicators) based on Situation Analysis tool 2016Overall, significant progress has been made in AMR prevention and containment initiatives in the Region; confirmed by the change in median progress between 2016 and 2018

5. Status of implementation of key interventions in SEAR, 2018Sanitation-hygiene programs in community settings (10)Establishing a functional NRA or DRA (10) Awareness in general public (9), education and training (9) Development of multisectoral NAP-AMR & governance structure (8)Regulations of finished products & APIs (8 countries) National lab network (7)Surveillance of use & sale in humans (7) Regulation of OTC sales (7)Implementation of the nationally coordinated AAW (7)Vaccination as a strategy to prevent infection (6)Overarching coordination mechanism (3) Inclusion & engagement of relevant sectors (3)Platform for sharing AMU data (3)Initial implementation and aboveIPC in health-care settings remained the sameEarly warning systems (none)National policy/regulatory framework for controlled release of AR and AMR in the environment (none) Platform for sharing of AMR data across sectors (none)Awareness and education programs for the environment sector (none)No initial implementation or no change

6. NAP AMR implementation in SEAR: the big pictureSignificant progress has been made in AMR prevention and containment initiatives in the Region in the last two yearsInterventions aligned with existing efforts, such as sanitation and hygiene programmes, demonstrated better results, even though the quality, extent and robustness of these initiatives was yet to be established through systematic monitoring and evaluationIn most cases, implementation posed challenges and will require effective operational plans to help overcomePrevious investments to strengthen public health laboratories in disease surveillance have provided an important launch pad for initiating a laboratory network in most countries Progress made in establishing governance mechanisms as part of the NAP-AMRs, forming the basis for future advancement and consolidation of multisectoral and collaborative actionIn general, there has been less progress across different focus areas and indicators in the animal health sector. This could impact One Health engagement and effective multisectoral collaboration Lack of awareness, policies, standards and guidelines, have critically hampered introduction and implementation of interventions such as AMR surveillance, IPC in health care facilities, HAI surveillance and AMSPMost countries in the Region are yet to put together a strategic research agenda that is relevant to the current policies and programmes and address implementation challenges in the way of AMR containment efforts in the Region