Info Service on Health Issues (Oct17/10)
26 October 2017
Third World Network
Dear friends and colleagues,
Conference Identifies Challenges and Actions to Tackle AMR in Africa
is a posting sent out by the South Centre on an Action on Antibiotic
Resistance (ReAct)conference identifying challenges and actions to
tackle antimicrobial resistance in Africa.
ReACT Conference Identifies Challenges and Actions to
Tackle AMR in Africa
The Action on Antibiotic Resistance (ReAct) Africa has
published a report of its Annual Conference held in Nairobi,
Kenya in September. The conference brought together participants
from 14 African countries, India and Sweden, to share
experiences and updates on the progress that African countries
have made in developing and implementing AMR National
Action Plans. ReACT is a leading scientific
and advocacy organisation that has championed the fight
against AMR for many years; it is headquartered in Sweden
and has a global outreach.
The theme for the conference was 'Moving beyond the development
of National Action Plans on Antimicrobial Resistance to
implementation'. Conference participants came from government
Ministries (especially Health and Agriculture), NGOs and
academia. The countries represented included Ethiopia,
Ghana, Kenya, Malawi, Mozambique, Nigeria, South Africa,
Uganda, Zambia, Cameroon, Liberia, Rwanda, Zimbabwe.
Below is a section of the report, which is on key outcomes
and recommendations on national action plans as well as
issues relating to awareness raising, surveillance, stewardship,
research and development, and monitoring and evaluation.
To access the full report, visit
EXTRACT FROM REPORT OF ReACT AFRICA CONFERENCE (SEPT.
Action Plans require collaborative efforts with involvement
of all relevant stakeholders across human, animal, agriculture
and environmental sectors in the process of development.
Failure to do this pose challenges for the buy in needed
for implementation. This process of NAP development
should be government led, as the NAP is ultimately a
government document and commitment. Where a relevant
AMR Policy instrument will be needed to facilitate and
enable implementation, it should be developed at the
implementation is resource intensive beyond what African
countries are able to afford or invest and will require
the global community to find ways of supporting through
different initiatives that might include setting up
a Conservation Fund and involvement of HICs and multilateral
countries may need to develop an AMR policy and a legal
framework that will support implementation. Failure
to do this might result in many activities and strategies
failing to be implemented. It is important to consider
and check country specific legal structures.
National Agendas include running activities and projects
focused on achieving SDG goals. AMR activities can be
streamlined, mainstreamed and included in already existing
country efforts on SDGs as a way of getting more value
from these projects but also as one mechanism of gaining
political will and mobilising funds at the national
the integrity of the implementation process outside
of political influences is critical and allows for objective
monitoring and evaluation.
regulatory frameworks that include enforcement should
be not be excluded. Finally, explore targeted incentives,
unique to these sectors, to conjure change behavior.
awareness on AMR through culturally-sensitive public
campaigns that "put a face" to AMR and address
behaviour change i.e. a mix of traditional media and
an exploration of innovative synergies with e.g. faith-based
organizations, local celebrities etc.
various stakeholders, including farmers, feed-millers,
veterinary practitioners, doctors, prescribers, pharmacists,
policy makers and consumers.
a network across countries (regionally is possible)
of AMR focal point persons as a "support group"
that shares experiences at various stages of the implementation
for AMU and AMR at all levels of One-Health paradigm
in local and National settings should be adopted and
networks at different levels of healthcare system should
be coordinated through one agency or department.
laboratory capacities, standards, policies, infrastructure
an objective evaluation that grades the functionality
and comprehensiveness of the current Surveillance Programs
in place. A few countries like Kenya, South Africa,
Zambia, Malawi, and Ghana have however joined the Global
AMR Surveillance System (GLASS).
and consult academic institutions with research capacities
and explore how they could be involved in surveillance
surveillance to understand both available products on
the market and consumption data should be routine.
containment and surveillance efforts should include
quality if antimicrobials.
marketing surveillance of antibiotics is especially
important to assure the quality of products beyond registration.
Any failures should be communicated not only nationally
but regionally and to the WHO Quality Assurance Program.
setting up AMS programs, coordination of these programs
across sectors will be vital.
antibiotic stewardship through empowering and educating
key-point persons at decentralized-government institutions,
hospitals and lower-level stakeholders such as community
workers, healthcare workers, retail-pharmacists, public
health officers in other disciplines and technicians.
AMR Stewardship (AMS) committees within existing stewardship
committees e.g. Medicines and Therapeutic Committees
(MTC) avoiding creation of new structures and spreading
thin the same staff to sit on these committees.
Infection, Prevention, and Control:
a focal point person that continuously monitors adherence
to guidelines as an Infection Preventative Measure (IPC)
IPC to include AMR in more established existing preventive
programs such as HIV, Tuberculosis, and Malaria.
IPC programs to be implemented in the animal, environment
and agriculture sectors beyond the human sector and
collect actionable data that promote good IPC practices.
IPC programs are not common in the non-human sector
and most NAPs do not contain such an IPC module.
Research & Development:
collaboration among continent-based R&D laboratories
and global research efforts on new antibiotics, vaccines
and diagnostics as well as innovation of practice in
tackling ABR. Research to include the potential alternatives
to antibiotics such as probiotics, traditional medicines
to the government agreed principles that relate to R&D
as outlined in the UNGA Declaration should form a basis
of all R&D initiatives including promoting delinkage
on the current projections of the growth of the pharmaceutical
industry in Africa, projected to be a 40 US billion
industry by 20300. African governments will need to
invest in R&D and engage in global discussion on
R&D to ensure that that African public health priorities
and needs are addressed.
Action Plans need to highlight and focus on ensuring
the quality of antimicrobials through promotion and
adherence to GMPs. Action priorities here include: Improving
transport and storage of legitimate medicines, promoting
verifiable GMP among registered products, tackling the
production of falsified and substandard products, strengthen
regulatory authorities, and ensure regulatory transparency,
increase awareness on the topic with policy makers and
AMR interventions and programs to accurately develop
an economic case for AMR containment to policy makers
at national level as well as with international development
Monitoring and Evaluation:
and Evaluation should cut across all strategic areas
of the GAP adapted in the NAPs. Indicators should be
carefully selected, communicated and allow for comparison
within the country, region and globally and in line
with WHO, OIE and FAO recommendations. They should equally
are a number of programs running under the SDG agenda
with indicators already. The existing indicators should
be taken into consideration and integrated where applicable
in the NAP M&E Framework.
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