Antimicrobial Awareness Week 2021: How to develop a template for community action on AMR

ReAct Asia Pacific is engaging community stakeholder groups to mainstream action on antibiotic resistance

By Philip Mathew
Published: Thursday 18 November 2021

The issue of antibiotic resistance (ABR) still remains invisible for the general public and the information on community-level drivers of ABR has not been collected and compiled. There is minimal incentive for governments and policy-makers to move forward on this issue.

I work for an organisation called ReAct Asia Pacific. We are working to develop pilot programmes, harvest learnings / insights from the implementation of ABR interventions on the ground and design tools for use by various community stakeholder groups.

We have designed an indicator framework to look at the issue of ABR through a ‘One Health’ lens, helping to quantify the drivers of ABR and look at the ground-level impact of the action plans.

Most of the National Action Plans (NAP) by countries were framed in response to the Global Action Plan on Antimicrobial Resistance published by the World Health Organization (WHO).

The mandates of several NAPs are ending in the next one year and multiple countries have started the process of framing the second edition of their action plan.

The approach taken by the first edition has mostly been top-down and local governance systems and communities were not involved in an optimal manner.

A bottom-up strategy is needed to complement the action plans, to make sure that there is sustainability and local resource mobilisation happening for ABR interventions.

We have started a qualitative evaluation of the ground-level impact of the first edition of NAPs in Vietnam and Bangladesh.

The studies showed that the NAPs have been unable to make a significant impact on the ground. Also, the novel coronavirus disease (COVID-19) appears to have taken away the political capital available for ABR interventions.

Various sectors continue to work in silos, even when the global narrative has been transformed over the years to advocate a more transdisciplinary approach to tackle complex issues like ABR.

The countries need to incorporate this understanding while framing the next edition of NAPs. Otherwise, it will remain as an exercise on the top.

We have also organised meetings with civil society and academia in these countries to disseminate the findings of the research.

This has been done to ensure they are aware of these issues and act as accountability mechanisms at the country level.

ReAct Asia Pacific has also been providing technical support to develop and implement state action plans in India. This year, we organised startup meetings in the states of Telangana and Meghalaya and the Union Territory of Puducherry.

The meetings were aimed at gauging the appetite for state action plans. 

They also aimed at sensitising the various stakeholder groups at the state-level about the various interventions which are possible to contain ABR, especially in the background of COVID-19.

We also organised follow-up meetings to assess the progress of the existing state action plans and offer technical support wherever required.

It is important that the ABR community in India understands the entire value chain better to look at entry points for ABR action. This is because India is a hub for antibiotic manufacturing.

The understanding of the antibiotic value chain has interfaces with several ABR drivers.

These include optimal supply chain systems, optimal access to quality assured antibiotics, antibiotic pollution from pharmaceutical manufacturing and disposal of expired / unused antibiotics.

ReAct Asia Pacific has been working to design a visual guide to understand the antibiotic value chain — right from Active Pharmaceutical Ingredients to the disposal of antibiotics in hospitals and community settings.

The work, titled Journey of an Antibiotic, can help the policy community to understand the scope of ABR interventions and ways to strengthen the value chain.

Engaging students on the issue of ABR has been a priority for us, as they can be champions for behavioural change in the wider community.

We continued to engage college and university students through our ASPIC initiative and broadened the mandate to include school students too.

This year saw the publication of a training manual on ABR for high-school students, apart from a comic book directed at children.

We also facilitated an open letter to the WHO Executive Board on the need to have a policy to engage young people on the ABR issue and create a ‘ring-fenced fund’ for the same at the global level.

ReAct Asia Pacific has tried to fulfil its mandate by highlighting the need to prioritise ABR actions and bring in the ‘behavioural change’ perspective into action plans.

Philip Mathew is a public health researcher and a consultant with ReAct Asia Pacific 

Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth

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