Strategy aims to accelerate implementation of national action plans on antimicrobial resistance, committed to by WHO Africa states eight years ago
African nations have endorsed a regional strategy to accelerate action against antimicrobial resistance (AMR). The strategy was adopted at the 73rd session of the World Health Organization (WHO) Regional Committee for Africa in Botswana’s capital Gaborone on August 29, 2023.
WHO member states had adopted the Global Action Plan on AMR in 2015, and had committed to develop, implement, and monitor antimicrobial resistance national action plans (AMR NAPs).
The strategy endorsed in Gaborone aims to accelerate the implementation of AMR NAPs.
Addressing AMR is integral to achieving the United Nations-mandated Sustainable Development Goals (SDGs) by 2030 according to WHO. For example, AMR increases treatment costs. This means attaining universal health coverage will become more challenging.
Reducing child and infant mortality under SDG 3 calls for effective antibiotics, but antibiotic resistance is now one of the major threats to newborn health globally.
Some 4.95 million people worldwide died of AMR-related diseases in 2019. Of these, 1.27 million were directly attributable to bacterial resistance in sub-Saharan Africa according to the most comprehensive estimates released in a 2022 study and reiterated in the regional strategy presented at Gaborone on August 29.
AMR could kill 4.1 million people across Africa by 2050 unless serious actions to address the threat are taken, WHO has warned.
The continent’s economic growth would also be impacted since African countries could lose up to five per cent of their gross domestic product as a result of AMR.
According to WHO Africa, 45 of the 47 member countries have AMR action plans. Of these, 33 plans have been endorsed by national authorities.
But the implementation of the action plans has been poor, according to WHO Africa.
Less than half of WHO Africa member nations have adopted the WHO Access, Watch, Reserve (AWaRe) classification of antibiotics in their national essential medicines lists (EML). This is vital for ensuring access and reducing AMR.
Lack of political commitment, inadequate antimicrobial surveillance including insufficient laboratory capacity and limited capacity for the implementation of antimicrobial stewardship interventions are among the key factors behind poor implementation, according to WHO Africa.
Limited access to resources and erratic use of antimicrobials have magnified AMR infections in Africa, according to the African Union.
The regional antimicrobial resistance strategy prescribes key interventions to enhance implementation in line with the “One Health” approach.
AMR has been recognised as a One Health issue owing to its significant linkages with the health of humans, animals and environment.
The strategy aims to strengthen coordination and governance of action against AMR, improve awareness and understanding, step up surveillance of AMR and antimicrobial use, and reinforce applicable national regulations and laws.
By endorsing the strategy, WHO member states have committed to work towards a target by 2030 to have functional “One Health AMR governance mechanisms”. This includes defined roles and responsibilities across sectors and established accountability arrangements, thus achieving priority AMR interventions.
As priority, member states are now expected to ensure effective regional and national multi-sectoral coordination and partnership on AMR by engaging stakeholders from the human, animal and environmental sectors.
Member states will also work towards ensuring effective enforcement of antimicrobial regulations and laws by 2030.
These include those related to quality control, use and distribution of antimicrobial medicines. This is essential to address the emergence of substandard and falsified antimicrobials and inappropriate use of antimicrobials in the WHO Africa Region.
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