Korea International Cooperation Agency Research Articles

Asianizing the Integrated Approach for Development Cooperation: Scaling-Up Dynamics of KOICA’s Peace-Development Nexus Projects in Lao PDR and Cambodia

Abstract This study explores the significance of mainstreaming an integrated approach to development in enhancing development cooperation. It underscores the Asianization of this integrated approach by scrutinizing a unique path that harmonizes global guidelines for integrated approaches within Asia’s regional context. Serving as the focal case study, the Korea International Cooperation Agency (KOICA)’s Peace Village Development Projects in Cambodia and Lao PDR illuminate how projects can evolve into integrated programs. This evolution draws on universalist lessons within the contextualist epistemological framework for scaling up. The research establishes that comprehensive needs and capacity assessments, in conjunction with the active participation of various stakeholders, are crucial for the effective design and implementation of these projects, which engage mixed scaling-up processes. KOICA’s integrated strategy serves as a dynamic catalyst for social inclusion and the optimization of sectoral outcomes, offering a mechanism for scaling up that contributes to the formation of ‘an organically societized Asia.’

Cost-Effectiveness Analysis of a Community Emergency Transport System for Maternal Care in Northern Ghana

Maternal mortality is a function of economic underdevelopment. Obstetric complications are the major cause of maternal mortality. Early detection, rapid transportation and prompt care utilizing Emergency Obstetric and Newborn Care (EmONC) can help end preventable maternal mortality. However, poor referral transportation limits utilization of lifesaving EmONC in least developed countries. Korea International Cooperation Agency supported Ghana to implement a 5-year Primary Health Care project in Upper East region in 2016. This project had a Community Emergency Transport System (CETS) component. CETS was implemented using customized ‘motorking’ tricycle ambulances to strengthen maternal referral transportation. We conducted cost-effectiveness analysis to determine CETS’ value-for-money (VfM). The incremental cost-effectiveness ratio (ICER) and incremental net-benefit (INB) were estimated. The study perspective was societal. The comparator was traditional transportation system (TTS). The cost-effectiveness threshold was Ghana’s GDP for 2020 (USD2,254.15/GH₵11,045.34). The study respondents were women with pregnancy experience in 2020 within the project area who utilize a referral transport. Respondents were randomly selected from CETS and TTS areas. Primary and secondary data were collected at households and health facilities respectively. Data was analyzed with STATA 15.0. The ICER computed was GH₵559.69 (USD114.22). CETS was deemed cost-effective because ICER was below the cost-effectiveness threshold. The net-benefit was GH₵31,456.96 (USD6,419.79). The INB was less than zero (-2002.61) implying CETS was not cost-effective. There was a conflict between ICER and INB on VfM of CETS. Affordability should be considered in Policy adoption. Keywords: Community emergency transport system, Cost-effectiveness, Ending preventable maternal mortality, Northern Ghana, Traditional transport system.

Impact evaluation of KOICA MNCH project in Jimma Ethiopia using a difference in differences analysis

Abstract Background The maternal mortality ratio in Ethiopia is 412, which is higher than its neighboring countries. To address this issue and improve the health of women of childbearing age, the Maternal Neonatal and Child Health (MNCH) project was implemented in Jimma zone, Oromia, Ethiopia with support from the Korea International Cooperation Agency (KOICA). The objective of this study is to measure the impact of the project on maternal health in Jimma, Ethiopia. Methods The study employed DID analysis to measure the impact of the project on five key variables, including ANC 4, institutional delivery, satisfaction with MCH-related services, pregnancy-related knowledge, and delivery-related knowledge. A total of 789 participants were randomly selected for the baseline survey from both the intervention and control groups in 2017. The same groups were surveyed again one year later using the same study design for the endline survey. Results The study found that the trends in ANC4 and the level of satisfaction with the MCH service provided were similar in both the intervention and control groups. However, significant impacts were observed in terms of institutional delivery, pregnancy-related knowledge, and delivery-related knowledge. The odds ratio for institutional delivery was 2.83 (p < 0.01) for women in the intervention group compared to the control group. Similarly, the odds ratio for pregnancy-related knowledge was 0.67 (p < 0.01), and the odds ratio for delivery-related knowledge was 1.70 (p < 0.01) for women in the intervention group compared to the control group. Conclusions The study concludes that the KOICA MNCH project partially achieved its objective, as the intervention had a positive impact on institutional delivery and maternal knowledge levels. However, the insignificant impact on ANC4 and the level of satisfaction with MCH services suggest the need for further intervention to fully address maternal health issues in Ethiopia. Key messages • This study is significant because it has provided empirical evidence that maternal health projects implemented in the Jimma Zone of Ethiopia can positively impact various aspects of maternal health. • The results of this study can serve as a valuable reference for policymakers and healthcare professionals involved in designing and implementing maternal health interventions.

Leaders need to be led: complementary followership in the context of community-driven development program

ABSTRACT Leadership has often been recognised as a major driver for successful team effectiveness. However, even weak leadership may lead to good team performance, and it is worth studying how weak leadership can be helped and complemented by followership. To investigate the paradoxical mechanism behind leadership – followership practices, we examined (1) multidimensional figures of leadership and followership using the multifactor leadership questionnaire (MLQ) and (2) the impacts of the combinations of leadership and followership on team performances both during and after a community-driven development (CDD) program. To that end, this study examines a rural CDD case implemented by the Korea International Cooperation Agency and the Myanmar Ministry of Agriculture, Livestock, and Irrigation. The analyses present some common patterns of how weak leadership and strong followership can lead to better performance than other combinations of leadership and followership. We conclude with theoretical and practical conditions of “complementary followership”, i.e., the complementary combinations of leadership and followership in group performance.

Analysis of Factors Influencing the Trust Levels of Kyrgyzstan Residents, Using Neural Network Analysis

Objective: Kyrgyzstan, located in Central Asia, is a country which has a strong will to achieve national development. The aim of this study is to measure the levels of trust of local residents, a highly important factor in national development, and to derive suggestions for improving it. To this end, the primary means employed is to target the residents of Kyrgyzstan and measure the levels of trust they have towards each other. Methods: The study uses data relating to aid projects for rural development that Korea’s Good Neighbors International organization (GNI) is jointly carrying out in Kyrgyzstan along with the Korea International Cooperation Agency (KOICA), a Korean aid provider. In order to carry out the aid project to Kyrgyzstan, these organizations conducted a baseline survey at the initial stage, and the results of this study were used for analysis. As regards the analytical method used in this study, neural network analysis was employed for the questionnaire survey data of 583 people in Kyrgyzstan that was used for the baseline survey. Results: Neural network analysis, a component of the big data analysis method, has recently been in the academic limelight. The analysis revealed that ethnicity had the greatest influence on the trust levels of Kyrgyzstan residents, followed by gender and education level, in that order. Conclusions: From this, it can be seen that multifaceted efforts are needed to increase the levels of trust of peoples other than ethnic Kyrgyzstanis, as they occupy a central position in Kyrgyzstan.

Positive Impact on Public Perception toward Commune Health Stations (CHSs) in Rural Areas of Tyuen Quang Province, Vietnam, Following the Application of the Development Program for the Capacity-Building of CHSs.

This study aims to discover whether or not the capacity-building intervention through implementing the "Rural Area Development Program" in Tuyen Quang province, in partnership with the Korea International Cooperation Agency (KOICA) and the Vietnamese Department of Health", would positively affect the perception of the public toward the communal health stations (CHSs). To address this, three specific indicator-related satisfaction levels were examined regarding the infrastructure, the professional skills, and the service attitude of the medical personnel of the three CHSs toward outpatients. This cross-sectional study was conducted with 100 participants from three rural CHSs (Binh Yen, Vinh Loi, and Thang Long Communes). As a researcher-directed survey, a structured questionnaire was adopted to gauge the outpatient satisfaction levels in relation to the three indicators from the CHS medical milieu toward the patients and the medical services received. Descriptive and inferential analyses were performed to determine the perceptions of outpatient satisfaction relating to the three indicators. A higher satisfaction rate was found (overall 89-100% descriptive data with three indicators, as well as significant satisfaction differences in inferential data based on F-ratio and p-value) between the three regions with the three indicators, and two major data showed that the commune with a higher or more significant satisfaction rate or difference was Binh Yan > Vinh Loi > Thang Long. Collectively, this study clearly indicates the positive impact of CHSs capacity-building by implementing the Development Program in Tuyen Quang province with KOICA in relation to the public perception toward CHSs through significantly increased satisfaction levels-specifically, the infrastructure, the professional skills, and the service attitude of the medical milieu from the three CHSs toward outpatients.

Challenges and Achievements in Fighting Infectious Diseases to Promote Sustainable Maternal and Child Health in Kenya - Multiplex Immunodiagnosis Solution for HIV, HBV, Syphilis among Fertile Women in Kenya -

In Kenya, the ‘Linda Mama Program’, a free care program for pregnant women, is being implemented, but as of 2017, maternal deaths per 100,000 live births reached 342, and the infection rate such as AIDS, hepatitis B, and syphilis is high. Diagnosis is being made centering on a quick simple test (rapid diagnosis), but the reliability is low, so an accurate and quick diagnosis method is needed. Through the Innovative Technology Program (CTS) of Korea International Cooperation Agency (KOICA), we developed a multi-immune diagnostic device and multi-diagnostic kit that can diagnose AIDS, hepatitis B, and syphilis, which can be tested with minimal education at schools and local public health centers in addition to hospitals. The sensitivity and specificity of the diagnostic kit were each 90% or more, which was improved by more than 20% compared to the rapid diagnostic kits. The supply of cost-competitive diagnostic devices and test kits will enable continuous monitoring of AIDS, hepatitis B, and syphilis infections among women of childbearing age between the ages of 15 and 49, thereby contributing to the improvement of maternal and child health.

Promoting global citizenship and multiculturalism in higher education: the Korea International Cooperation Agency’s global volunteering in the Asia Pacific region (Promoviendo el multiculturalismo y la ciudadanía global en la educación superior: el voluntariado global de la Agencia de Cooperación Internacional de Corea en la región de Asia Pacífico)

ABSTRACT The Korea International Cooperation Agency’s Pacific Asia Society Youth Corps (KOICA-PYC) is a global volunteer organization that has dispatched college students to the Asia Pacific region for more than the past two decades. This study explores how executive board members of the KOICA-PYC evaluate Korean college students during their summer vacations. This study specifically asks how the executive board members view their college students’ development of ideas regarding the social and cultural development of global society through volunteer experiences in the greater Asia Pacific region and how these experiences increase their understanding of global citizenship. The findings show that the participants perceived both positive influences from and challenges to the promotion of global citizenship and multiculturalism. This study discusses the nexus between global citizenship and cultural dominance, as well as the prospects of multicultural education in Korea. It also provides implications for larger issues of culture and education in contemporary global society, calling on future scholars to pay close attention to the meanings of global volunteer work in their own geographical and regional contexts.

Multi-Agency Collaboration Leading to WHO EMT Classification: The Korea Disaster Relief Team

Background/Introduction:The Korea Disaster Relief Team (KDRT) was established in 2008 to systemize Korea’s overseas medical emergency response. Following multiple international deployments since 2008, KDRT embarked on its journey to achieve WHO Emergency Medical Team (EMT) Global Classification in 2017.Objectives:To outline the key success factors in KDRT’s work to reach classification as a Type 1 Fixed EMT.Method/Description:As the Korean government dispatches KDRT, a multi-agency collaboration is essential to respond to overseas disasters. To this end, KDRT leveraged a formal collaborative approach, assigning specific roles for EMT development and deployment to several national agencies: The Republic of Korea Ministry of Foreign Affairs, the Ministry of Health and Welfare, the Ministry of National Defense, the Korea International Cooperation Agency, Korea’s National Medical Center, and the Korea Foundation for International Healthcare. This network prepared KDRT for WHO EMT Verification and developing Standard Operation Procedures for the EMT Type 1. Based on this SOP, KDRT repeated simulations for each element to strengthening capabilities and enable deployment ensuring strong coordination with national and international partners in response.Results/Outcomes:After initiating KDRT’s journey towards EMT classification 2017, KDRT formalized cooperation with multiple agencies, and codified these roles and responsibilities in formal/published SOPs. Finally, the KDRT was verified by WHO in June 2022.Conclusion:This study provides a process within the operating system limited to the Republic of Korea, the country of the KDRT. However, it also can be used as a collaborative reference case in the EMT development and verification process.

Evolving boundaries of CSR: South Korea’s PPP-ODA in international development

ABSTRACT Public-private partnerships (PPPs) have become a widely recognized phenomenon in recent years, along with the rising emphasis on the private sector involvement in solving social problems both locally and globally. Against this backdrop, this study focuses on the expanded role of corporate social responsibility (CSR) in the Korean official development assistance framework. Private stakeholders’ expected roles and responsibilities in the area of international development cooperation have been augmented. The article explores the various factors driving this phenomenon from the perspectives of the public and private sectors. The case study of Korea International Cooperation Agency (KOICA) is carried out by analyzing the identified factors in the context of KOICA’s PPP strategy. The study found that the motives of the private sector to participate in KOICA’s global CSR program is less likely to be satisfied under the current arrangement whereas the public sector is highly motivated to attract and engage businesses in delivering PPP projects abroad. The study suggests policy implications such as incorporating non-financial performance indicators in evaluation criteria, resolving administrative challenges, and increasing the budget for PPP programs.

Increasing yield and farm income of upland farmers: The case of Panay Island Upland Sustainable Rural Development Project in the Philippines

The 17th Sustainable Development Goal aims to enhance the international cooperation between developed and least-developed countries, and the Official Development Assistance (ODA) program is the largest source of external support in the attainment of this goal. The purpose of this study is to evaluate the effects of the Panay Island Upland Sustainable Rural Development Project (PIU-SRDP), an ODA project supported by the Korea International Cooperation Agency (KOICA) in partnership with the Department of Agriculture and the Local Government Units of project municipalities in the Philippines. We focused on Phase II of the PIU-SRDP, which implemented randomly various agriculture-based income-generating projects, aimed at improving the sustainable productivity of low-income farming households. Based on a spatial and intertemporal variations of the project, we exploit a difference-in-difference approach using household-level data. The results suggest that the project significantly increased the rice yield and farm income of beneficiaries. With the opposing views about the true impacts of ODA programs, our study shows evidence of the positive effects of an ODA project on farmer-beneficiaries. This study provides insights for future engagement and implementation of related community-based ODA, agriculture, and rural development projects.

Public Officials and Operators’ Perceptions on the Implementation of the Four Modern Rice Processing Complexes (KOICA RPCs) in the Philippines: An Evaluation Study

This evaluation study identified the different perceptions of public officials from the government sector and operators (Management Board/Team and other employees) regarding the implementation of the four modern rice processing complexes (KOICA RPCs) in the Philippines funded by the Republic of Korea through the Korea International Cooperation Agency (KOICA). The KOICA RPC project was suitably implemented in the country (from project planning to approval, operation, monitoring, and evaluation) based on the insights and observations of public officials and operators. It was discovered that evaluations and assessments were carried out prior to the start of the project commenced. To guarantee that the project was implemented effectively, both government and private sector implementers followed the RPC Operational Guidelines and Policies. The findings revealed that the project’s operating guidelines need to be reviewed or revisited in order to meet the identified areas for improvement (especially in the sustainability aspect of the RPC operation). Furthermore, the respondents (both public officials and operators) determined that the RPCs require further financial, technical, and administrative support in order to improve their performance and ensure the project’s long-term viability. This study will assist implementers in better understanding each other’s perspectives on the operation and execution of the KOICA RPC project in the country. It will also encourage active participation and improve relationships among project stakeholders, resulting in stronger, more efficient, and successful future collaboration and partnership.

DEVELOPMENT OF PRİORİTİES AND PROSPECTS OF RENEWABLE ENERGY SOURCES IN AZERBAIJAN

DEVELOPMENT OF PRİORİTİES AND PROSPECTS OF RENEWABLE ENERGY SOURCES IN AZERBAIJAN

The diplomatic roles of Korean state-run sport for development programs

The Korean government established the Korea International Cooperation Agency (KOICA) in April 1991 as an agency of the Ministry of Foreign Affairs (MOFA) to design and execute most of its official development assistance (ODA) grants. Since then, KOICA has administered two forms of Korean sport grants: sport aid projects (e.g. the construction of sport facilities and provision of sport equipment) and sport technical cooperation programs (sport volunteering and Taekwondo coaching programs). Drawing on Murray’s (2018) categorization of sport diplomacy, as well as Foucauldian discourse analysis, we examine how KOICA sport initiatives have, over three decades, operated to support the government's foreign policy and diplomatic goals. The findings reveal that KOICA sport initially prioritized elite sport development in an approach akin to traditional sport diplomacy. Now, however, it appears to have adopted global sport for development (SFD) strategies with a focus on social development, in line with a new sport-oriented, public diplomacy approach. Through the combination of these two strategies, the role played by KOICA sport as a diplomatic tool of the Korean state has become more sophisticated.

Application of Seawater Plant Technology for supporting the Achievement of SDGs in Tarawa, Kiribati

Pacific island countries, including Kiribati, are suffering from a shortage of essential resources as well as a reduction in their living space due to sea level rise and coastal erosion from climate change, groundwater pollution and vegetation changes. Global activities to solve these problems are being progressed by the UN's efforts to implement SDGs. Pacific island countries can adapt to climate change by using abundant marine resources. In other words, seawater plants can assist in achieving SDGs #2, #6 and #7 based on SDGs #14 in these Pacific island countries. Under the auspice of Korea International Cooperation Agency (KOICA), Korea Research Institute of Ships and Ocean Engineering (KRISO) established the Sustainable Seawater Utilization Academy (SSUA) in 2016, and its 30 graduates formed the SSUA Kiribati Association in 2017. The Ministry of Oceans and Fisheries (MOF) of the Republic of Korea awarded ODA fund to the Association. By taking advantage of seawater resource and related plants, it was able to provide drinking water and vegetables to the local community from 2018 to 2020. Among the various fields of education and practice provided by SSUA, the Association hope to realize hydroponic cultivation and seawater desalination as a self-support project through a pilot project. To this end, more than 140 households are benefiting from 3-stage hydroponics, and a seawater desalination system in connection with solar power generation was installed for operation. The Association grows and supplies vegetable seedlings from the provided seedling cultivation equipment, and is preparing to convert to self-support business from next year. The satisfaction survey shows that Tarawa residents have a high degree of satisfaction with the technical support and its benefits. In the future, it is hoped that SSUA and regional associations will be distributed to neighboring island countries to support their SDGs implementations.

An archaeology of korean sport for international development discourse in Korea International Cooperation Agency (KOICA)

ABSTRACT In April 1991, South Korea began its full-fledged participation in international development with the establishment of the Korea International Cooperation Agency (KOICA). Since then, KOICA has implemented a variety of overseas sport volunteer programmes, Taekwondo-specific programmes and sport aid projects in the Global South. Our analysis aims to identify the rules of Korean-specific discursive formations framing these KOICA programmes, which generate particular iterations of the Korean sport for international development discourse. Six different sets of KOICA documents published from 1991 to 2017 were collected and analysed using Foucault’s (1972) archaeology and its categories of rules of formation of objects, enunciative modalities, concepts and strategies. The findings reveal that elite sport and elite athletes in recipient countries were visible as objects. Korean instructors were given the subject position of legitimate expert through the formation of enunciative modalities. Two concepts, input-oriented volunteering and output-oriented volunteering, incorporated values of compassion and a spirit of sharing and respect along with personal achievement. Lastly, the transfer of Korean (sport) development knowledge and experience emerged as sport-oriented and non-sport-oriented strategies. The conclusion offers critical reflections that distinguish Korean sport for international development from Western SFD through a focus on the relationship between former colonies, and on Taekwondo as a symbolic national tool for SFD.

Integration of multiple geospatial applications and intelligence for responding to COVID-19 in Ghana.

We describe the use of integrated geospatial applications for the provision of access to timely and accurate data on samples, visualisation of Spatio-temporal patterns of cases and effective communication between field sample collectors, testing laboratories, Regional Health directors and Government Decision Makers. This study describes how an integrated geospatial platform based on case location and intelligence was developed and used for effective COVID-19 response during the initial stages of COVID-19 in Ghana. Collector for ArcGIS, ArcGIS Survey123. successful development and deployment of integrated geospatial applications and analytics. The Collector for ArcGIS app was customised to collect COVID-19 positive cases location information. Survey 123 was introduced as a COVID-19 contact tracing application to digitise the case-based forms and provide real-time results from the laboratories to GHS and other stakeholders. The laboratory backend allowed the testing laboratories access to specific information about each patient (sample) collected by the fieldworkers. The regional supervisors' backend web application provided accessing test results for confidentiality and timely communication of results. Geospatial platforms were successfully established in Ghana to provide timely results to Regional Health Directors and Government decision-makers. This helped to improve the timeliness of response and contact tracing at the district level. The development and deployment of the application, COVID-19 pandemic response and writing workshop by the Ghana Field Epidemiology and Laboratory Training Programme (GFELTP) was supported with funding from President Malaria Initiative - CDC, and Korea International Cooperation Agency (on CDC CoAg 6NU2GGH001876) through AFENET and the United States Agency for International Development (USAID) through Results for Development (R4D).

Perception of the Risk Factors in Official Development Assistance (ODA) Construction Project Management: Focused on Comparison between Project Owner and Construction Manager in KOICA Grant Projects

This study identified the most critical empirical risk factors at three sequential phases in a preconstruction period and investigated different perceptions of those risk factors by project owners (Korea international cooperation agency officers, KOICA) and construction managers (CM). It was found that the most prioritized empirical risk factors were evenly distributed in the three phases of the preconstruction period. Furthermore, the bidding phase of the Official Development Assistance (ODA) construction project had more high-ranking factors than the other phases; therefore, risk management in this phase needs particular attention. This study demonstrated the different perceptions of some risk factors, which are statistically significant, by various practitioners from the project owner (KOICA) and CM, on five factors based on occurrence and severity through a nonparametric test. KOICA placed higher awareness than CM on the nine critical risk factors, which are mostly technical survey and cost estimation related factors except one, which is a procurement-related factor. This study will encourage professional practitioners in KOICA ODA construction project management to enhance their risk management function based on the most critical risk factors and ensure their efficient cooperation.

Double-edged cohesion: Multidimensional impacts of community governance’s cohesion in community-driven development

ABSTRACT While often pursued as a desirable state for a society or community, group cohesion can be a double-edged sword. When it comes to Community-Driven Development (CDD), in which community members are expected to collaborate to ensure their co-prosperity, group cohesion would be a matter of not only “WHETHER or not it is needed” but also “WHEN/WHERE/HOW MUCH it is needed”. This study examines a rural CDD case implemented by the Korea International Cooperation Agency (KOICA) and the Myanmar Ministry of Agriculture, Livestock and Irrigation (MOALI). The analyses imply some common patterns of village cohesion for successful CDD performance: complementary communication roles shared by multiple leaders; the coexistence of physical and mental preparedness; balance between optimistic and realistic prospects; a long-term horizon for planning and implementation; introspective attribution of challenges; and constructive divergences and coordination in goal setting. We conclude with theoretical and practical conditions of multi-dimensionally balanced group cohesion in community development.

The Increasing Burden of Antimicrobial Resistance in the Who Eastern Mediterranean Region: Can We Reduce Emergence and Spread to Revert the Trend?

The rapid rise in antimicrobial resistance (AMR) is a global crisis that threatens major health gains made since antibiotics were discovered and will significantly delay progress towards sustainable development goals. To better guide the regional response to AMR, we described the burden and trends of AMR in the Eastern Mediterranean region, assessed the challenges to address and identified opportunities for control.We analyzed data reported from countries in the region to the global antimicrobial resistance surveillance system on bloodstream infections (BSIs) caused by resistant pathogens from 2017-2019; data from seven nationally representative prevalence surveys on antimicrobial prescriptions among hospitalized patients, and two regional surveys to assess the capacities of the national infection prevention and control (IPC) and antimicrobial stewardship (AMS) programmes.Among 14 reporting countries in 2019, the median proportion of BSIs caused by resistant pathogens was highest for carbapenem resistant Acinetobacter spp (CRAsp) at 70.3% (IQR 62.4%-80.8%), and lowest for carbapenem resistant E.coli (CREC) at 4.6% (IQR 1.8%-18.2%). There was an increasing trend in the median proportion of BSIs caused by CRAsp from 71.4% in 2017 to 74.5% in 2019, from 55.3% in 2017 to 65.4% in 2019 for K. pneumoniae resistant to third generation cephalosporins (3GC), from 36.6% in 2017 to 45.8%.2% in 2019 for Methicillin- resistant staph aureus (MRSA), and from 24.2% in 2017 to 37.5% in 2019 for carbapenem resistant K. pneumoniae (CRKP). A smaller increase was noticed for E.coli resistant to 3GC from 58% in 2017 to 59.5% in 2019, and CREC from 6.1% in 2017 to 7.1% in 2019. Ten of 20 (50%) countries had a prescription only sale policy for antibiotics and 13 of 22 countries (60%) had a national IPC programme structure. The burden of resistant pathogens causing BSIs is dangerously high and increasing in the region. However, few countries have capacities of AMS and IPC programmes to prevent emergence and spread. Enhanced surveillance, IPC and AMS are more critical than ever to slow down the deadly spread of AMR that threatens health security in the region. Political commitment, leadership, and high-level coordination are urgently needed to combat AMR. Funding Information: 1. BMG funds (Bundesministerium fuer Gesundheit) Federal Ministry of Health in Germany 2. US CDC 3. Korea International Cooperation Agency 4. Robert Koch Institute, Germany Declaration of Interests: None declared. Ethics Approval Statement: The data reported in this article was reported to WHO by national surveillance systems that comply to their national requirements in terms of ethical clearance. Countries shared anonymous aggregated data without identifiers collected through routine surveillance and provided formal approval to WHO to utilize the reported data.