WAAW 2025: Sri Lanka’s One Health journey in combating antimicrobial resistance — from commitment to collective action

Antimicrobial resistance (AMR) poses one of the greatest threats to global health, food security and sustainable development. It undermines decades of medical progress and endangers the effectiveness of life-saving treatments.

In low- and middle-income countries, the challenge lies in striking a delicate balance between ensuring equitable access to essential antimicrobials and simultaneously preventing their misuse across human, animal and environmental sectors.

Sri Lanka, a lower-middle-income island nation in South Asia, has taken bold and systematic steps to translate the One Health vision into practice, demonstrating how collaborative governance and evidence-based policymaking can drive meaningful progress against AMR.

Building policy foundation

Sri Lanka launched its first National Strategic Plan for AMR (2017–2022) and established the National Focal Point for Combating AMR under the Ministry of Health, providing the institutional backbone for the country’s response. This plan laid the groundwork for a national commitment that extended beyond the health sector.

Building on these foundations, Sri Lanka developed its second National Action Plan for AMR (2023–2028), accompanied by a two-year costed operational plan (2023–2025) to guide implementation. The new plan focuses on strengthening AMR surveillance systems, enhancing laboratory capacity, advancing antimicrobial stewardship, improving infection prevention and control, promoting research, environmental safety and evidence-based policymaking.

Grounded in the One Health approach, the plan acknowledges the interdependence of human, animal, agricultural and environmental health. To ensure coordinated action, multi-sectoral mechanisms have been established, bringing together the Ministries of Health, Agriculture, Livestock, Fisheries and Environment, alongside professional bodies, academia, and development partners. This collaborative structure has been key to maintaining policy coherence and shared accountability in AMR containment.

Strengthening surveillance, diagnostics

Robust surveillance lies at the heart of Sri Lanka’s AMR containment strategy. The country has made significant progress in expanding its National AMR Surveillance Network, covering both human and animal health laboratories.

With technical support from the World Health Organization (WHO), the Fleming Fund and the Food and Agriculture Organization (FAO), Sri Lanka is strengthening its capacity to detect, monitor and report resistance trends.

Laboratory networks are being equipped to improve microbial identification and antimicrobial susceptibility testing, while data integration and analysis are increasingly informing national policy decisions, hospital-based stewardship activities and global platform (GLASS and InFARM).

The Ministry of Health is also scaling up infection prevention and control programmes and diagnostic stewardship initiatives to ensure that antimicrobial use is guided by laboratory evidence rather than empirical prescription. These measures are essential to reduce unnecessary antimicrobial use and to preserve the efficacy of existing treatments.

Promoting awareness and behavioral change

Behavioural change is a cornerstone of Sri Lanka’s AMR response. Each year, the country actively participates in World AMR Awareness Week (WAAW) through the Clean Sri Lanka national campaign, a multi-sectoral initiative that reaches communities, schools and professionals alike.

For WAAW 2025, the campaign promotes awareness under the global theme “Act Now: Protect Our Present, Secure Our Future”, along with the key message “Antimicrobials: Handle with Care”. These messages are being amplified through joint communication efforts led by the Ministry of Health in collaboration with the other one health stakeholders through a Media briefing session.

The campaign targets diverse groups including healthcare workers, veterinarians, farmers, pharmacists and the general public. It encourages rational antimicrobial use, vaccination, hygiene, biosafety and biosecurity.

In schools, awareness programmes are integrated into health promotion activities, fostering early understanding among children about the importance of responsible antimicrobial use.

At the community level, health officers, including Medical Officers of Health, Public Health Inspectors and Public Health Midwifes conduct outreach programmes and local campaigns to promote preventive practices, safe food handling and environmental hygiene, all of which contribute to reducing infection risk and antibiotic demand.

One Health in action

The One Health concept has moved beyond policy in Sri Lanka to become a practical framework for action. The country’s AMR initiatives increasingly involve joint training, surveillance and research across human, animal and environmental sectors.

For instance, environmental monitoring programmes plan to assess antimicrobial residues in water sources and effluents from healthcare facilities and farms.

In the animal health sector, farm-level monitoring of antimicrobial use and training of veterinarians promote responsible prescription practices. Engagement with the food and fisheries sectors ensures that food safety standards align with AMR containment goals.

This inclusive, systems-based approach reinforces the principle that AMR is not confined to hospitals; it is a shared societal responsibility. The integration of One Health thinking into education, research, and field operations marks a critical step toward sustainable containment.

Looking ahead: Investing in systems and people

Despite notable progress, challenges persist. Ensuring sustainable financing, workforce capacity and consistent engagement with the pharmaceutical and food industries remain priorities. Behavioural change, though improving, requires continuous effort supported by community engagement and professional accountability.

The next phase of Sri Lanka’s AMR strategy aims to institutionalise antimicrobial stewardship programs across healthcare settings, strengthen data-driven decision-making, and enhance regulatory frameworks governing antimicrobial importation and distribution. In parallel, building a culture of responsible antimicrobial use, supported by surveillance data, education, and leadership.

International collaboration continues to play a vital role. Sri Lanka’s engagement with regional networks and partners such as WHO, FAO, WOAH and the Fleming Fund provides valuable technical and policy support, ensuring alignment with global standards while addressing local realities.

The AMR crisis demands urgent and collective action. Sri Lanka’s experience demonstrates that progress is possible when policies are grounded in science, collaboration, and accountability. As global discussions move toward the development of an international AMR treaty and new financing mechanisms, lessons from Sri Lanka’s integrated, One Health based model can offer guidance for other nations navigating similar challenges.

Building resilient systems rooted in One Health collaboration is not only essential to protect our present; it is an investment in securing a safer, healthier, and more sustainable for future generations.

Dr Hamsananthy Jeevatharan is consultant community physician, National Focal Point for Combating AMR, Ministry of Health and Mass Media, Sri Lanka. Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth.