Abstract

SummaryThe complex problem of antimicrobial resistance (AMR) is spread across human health, animal health, and the environment. The Global Action Plan (GAP) on AMR and context-specific national action plans (NAPs) were developed to combat this problem. To date, there is no systematic content analysis of NAPs from countries of the Association of Southeast Asia Nations (ASEAN). As the validity periods of most NAPs are ending, an analysis now will provide an opportunity to improve subsequent iterations of these NAPs. We analysed the current NAPs of ten ASEAN countries. We explored their objective alignment with GAP and performed content analysis using an AMR governance framework. Themes were broadly classified under five governance areas: policy design, implementation tools, monitoring and evaluation, sustainability, and One Health engagement. We identified policy priorities, useful features of NAPs, and specific areas that should be strengthened, including accountability, sustained engagement, equity, behavioural economics, sustainability plans and transparency, international collaboration, as well as integration of the environmental sector. Enhancement of these areas and adoption of best practices will drive improved policy formulation and its translation into effective implementation.

Highlights

  • Antimicrobial resistance (AMR) is a serious global public health threat

  • The One Health concept was reflected through involvement of multisectoral stakeholders in the design and implementation in all national action plans (NAPs)

  • Four objectives in Global Action Plan (GAP) were described in all NAPs

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Summary

Introduction

Antimicrobial resistance (AMR) is a serious global public health threat. Inability to achieve returns on research and development (R&D) investments has resulted in ‘market failure’ for development of new antimicrobials [1]. New economic models may stimulate antimicrobial development, but this alone is insufficient. AMR, both evolutionary and inevitable, is accelerated by many interrelated factors, which span across human health, animal health, and the environment [2,3]. To address the multifaceted AMR problem, the World Health Organization (WHO) endorsed a Global Action Plan (GAP) in 2015, urging member states to develop their own context-specific, One Health approach-based, national action plans (NAPs) on AMR [7]. By 2018, over 100 countries developed their NAPs based on GAP, while 67 had initiated the process [8]

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