Abstract
BackgroundAntimicrobial resistance (AMR) poses an increasing public health threat to low- and lower-middle income countries. Recent studies found that in fact poor governance and transparency correlate more strongly with AMR than factors such as antibiotic use. While many African countries now have national action plans (NAPs) on AMR, it is unclear whether information is publicly available on their implementation, surveillance and financing.MethodsHere, the transparency of information related to AMR national action plans in 15 African countries is assessed, based on a governance framework for AMR action plans. Public availability is assessed for AMR documents, progress reports, AMR surveillance data, budget allocations, as well as bodies and persons responsible for implementation of NAPs. Government websites and search engines were perused using search terms related to the studied criteria and countries.ResultsResults show that most countries have a national action plan publicly available. AMR surveillance data was available for a few countries, but systematic progress reports and funding allocations were absent in all but one country. Information on a body mandated to coordinate NAP implementation was available for most countries, but their functionality remain unclear. Most countries have nominated at least one person responsible for AMR nationally. In general, information was often fragmented and frequently available on external, non-government websites. It appears that commitments on AMR made in the often comprehensive NAPs are rarely met in a timely manner, exhibiting rather weak accountability for AMR results. The article provides concrete policy recommendations on how transparency and accountability may be improved with little effort.ConclusionsMaking information available can enable stakeholders such as civil society to demand accountability for results and lead to much needed specific actions on curbing AMR in countries.
Highlights
Antimicrobial resistance (AMR) poses an increasing public health threat to low- and lower-middle income countries
While a national action plan (NAP) document was available for most countries (11/15), other information was only found in a fragmented manner or hardly at all
The findings presented in this study are considered timely and policy relevant as they suggest that transparency, and progress on AMR NAP implementation seems to be precariously lagging in many countries and accountability is urgently needed to ensure that NAP commitments are met in the future
Summary
Antimicrobial resistance (AMR) poses an increasing public health threat to low- and lower-middle income countries. Recent studies found that poor governance and transparency correlate more strongly with AMR than factors such as antibiotic use. Evidence of successful and comprehensive national AMR policies and programs in LMICs to date is scarce [6,7,8,9]. This is not least due to fragmented health systems in many lowand middle-income countries, which often lack sufficient governance mechanisms and financial resources. Availability and quality of data on AMR in many African countries is low [15] and AMR preparedness in sub-Saharan African countries has been found to be rather low [18]
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