Global Response to Antimicrobial Resistance Inadequate

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06/08/2023

University of Leeds news

For immediate release

Global response to antimicrobial resistance ‘insufficient’

Governments around the world must do more to tackle the growing threat of drug-resistant infections, new research suggests.

National action plans to tackle the threat from antimicrobial resistance (AMR), which occurs when bacteria, viruses, fungi and parasites stop responding to medicines designed to treat them, were developed by more than 100 countries.

The plans focus on designing policies to curb AMR and devising tools to implement the policies – but they do not adequately factor in monitoring and evaluation.

The new research, carried out by experts at the universities of Leeds, Edinburgh and Hamburg, is the first large-scale analysis of these plans. They were designed after encouragement from the World Health Organisation, which has declared AMR one of the top 10 public health threats facing humanity.

Lead author Jay Patel, undergraduate dental student in the University of Leeds’ School of Dentistry, said: “Our analysis showed that countries were highly focused on designing AMR policies, and thinking about what tools would be required to implement those, but they generally did not consider how they would monitor and evaluate the impact of those efforts.

“This suggests that the international response may be inadequate to meet the scale and severity of AMR. This is particularly concerning in low and middle-income countries, where action plan activities often lack sustainable funding – relying instead on funds from foreign donors and philanthropies.

“The available evidence also suggests that simply developing a national action plan may not necessarily mean a country is more prepared to respond to the threat of AMR.

“Our study shows that the global response to AMR, and preparedness for the predicted challenges of AMR, require improvement in all locations around the world.”

The research team says governments across the world must strengthen their responses to AMR.

What is antimicrobial resistance?

AMR refers to changes in microbes, particularly bacteria, that cause the drugs used to treat infections to become less effective. AMR has emerged as a defining challenge for global public health in the 21st century. In 2019 alone, AMR was a factor in 4.95 million deaths worldwide – more than half of deaths due to bacterial infections.

Without action, AMR could render many routine antibiotics ineffective, claiming tens of millions of lives annually.

In 2017, the World Health Organization encouraged member states to develop national action plans stipulating how countries would tackle AMR. More than 100 countries have produced action plans, with several being implemented – but there had been no global analysis of the contents of these plans.

Published in The Lancet Infectious Diseases, this new research is the first to comprehensively assess international AMR efforts and national action plans and generate comparable quantitative results across countries and regions.

The 114 action plans, which were created in 2020-21, were evaluated against 54 elements, such as education, stewardship, and accountability, and each awarded a score out of 100. A mean score out of 100 for each country’s plan was then taken from these results.

Countries and action plan scores are shown in the table below

Norway

85

Croatia

60

Indonesia

53

Rwanda

45

Paraguay

36

USA

84

Tanzania

59

Timor-Leste

52

Cyprus

44

Afghanistan

35

UK

83

Zimbabwe

59

Ethiopia

51

Egypt

44

Uruguay

34

Sweden

78

Canada

58

North Korea

51

South Africa

43

Costa Rica

34

Denmark

76

Ghana

57

India

51

Sudan

43

Mauritius

33

Germany

76

Portugal

57

Sri Lanka

51

Ecuador

43

Maldives

33

Japan

75

Saudi Arabia

57

Kenya

51

Nepal

43

Fiji

32

Australia

75

Slovenia

57

Laos

50

Turkey

43

Mongolia

31

Switzerland

75

Mozambique

57

Colombia

49

UAE

43

Libya

31

France

74

Iran

57

Slovakia

49

Bhutan

42

Turkmenistan

31

Malaysia

73

Finland

56

Madagascar

49

Papua NG

42

Ukraine

29

South Korea

73

Iceland

56

Serbia

48

Pakistan

41

Sierra Leone

29

Thailand

72

Uganda

56

Iraq

48

Argentina

40

Barbados

28

Netherlands

71

Estonia

56

Cuba

48

Eritrea

40

Micronesia

28

Philippines

71

Liberia

56

Lithuania

47

Cambodia

39

Spain

71

Bahrain

55

Eswatini

47

Tunisia

39

Austria

70

Mexico

55

Czech Republic

47

Bangladesh

39

Ireland

69

Malawi

55

Luxembourg

47

Oman

39

Singapore

66

Russia

55

North Macedonia

46

Malta

38

Greece

65

Nigeria

55

Chile

46

Cameroon

38

Italy

65

Morocco

54

Georgia

45

Montenegro

38

China

64

Burkina Faso

54

Brazil

45

Tajikistan

38

Belgium

63

Zambia

54

Namibia

45

Nicaragua

38

Latvia

63

Myanmar

53

Poland

45

Brunei

37

Peru

61

Jordan

53

Lebanon

45

Vietnam

36

The findings

The study found that across all plans, there was a greater focus on policy design and implementation tools, but efforts to monitor and evaluate activities are generally poorly-considered.

Of all areas evaluated, accountability and feedback mechanisms were the joint-lowest scoring, followed by education.

Training and professional education across human health, veterinary, and agricultural sectors were insufficient in many countries, with several lacking a sustainable workforce strategy to deliver antimicrobial stewardship policies.

Countries scored well on participation, demonstrating a shared awareness that AMR can only be successfully addressed through engagement with multiple sectors spanning human, animal and environmental health. Infection prevention and control was frequently recognised as a critical objective.

Norway’s response was the highest scoring with 85, followed by the USA with 84 and the UK with 83. The lowest scoring countries were Ukraine and Sierra Leone with 29 points each, and Barbados and Micronesia with 28 points.

Further information

/Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full

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