ReAct Africa

RAN Conference 2023 Summary

ReAct Africa and South Centre co-hosted the 6th AMR Annual Conference in partnership with International Centre for Antimicrobial Resistance Solutions (ICARS), Global Antibiotic Research and Development Partnership (GARDP), AMR Policy Accelerator and support from The Swedish International Development Cooperation Agency (SIDA), the Fleming Fund and the Ministry of Health Zambia through Zambia National Public Health Institute (ZNPHI). The conference was hosted in Lusaka, Zambia from 14th -16th August, 2023 under the theme "Leave No One Behind: Advancing One Health Antimicrobial Resistance National Action Plans Implementation in Africa".
The hybrid conference had an attendance of 156 physical participants from 38 countries; 29 African and 9 international as well as a total of 136 virtual participants, reflecting registrations from 67 countries worldwide.

Participants comprised of representatives from the Quadripartite (FAO, WHO, WOAH & UNEP), Africa CDC, Ministry representatives from various countries, AMR focal persons, representatives from the human, animal, agricultural and environmental sector, media representatives, students, members of civil society, and researchers from across the African continent.

Photo: Panel discussion with quadripartite representatives. From left to right: Mohamed Sirdar (WOAH), Levis Kavagi (UNEP), Ali Yahaya (WHO Afro) and Mark Obonyo (FAO)

Conference Objectives

  1. To bring together AMR experts, CSOs, academia, government ministries, research institutions, intergovernmental institutions to discuss regional successes, challenges, approaches to addressing AMR and the next steps in NAPs review and implementation.
  2. To assess the progress of AMR NAP implementation, including the integration of activities, governance issues, financing, and ongoing challenges.
  3. To examine entry points and strategies for synergizing efforts for various stakeholders and corresponding linkages to facilitate a One Health approach in AMR NAP implementation.

Expected Outcomes

  1. Strengthened partnerships among AMR experts, civil society organizations, academia, government ministries, research institutions, and intergovernmental institutions to address AMR in Africa using a One Health approach.
  2. Enhanced understanding and awareness of the current status, challenges, and opportunities in implementing AMR NAPs across African countries.
  3. Facilitate networking opportunities among participants, promoting future collaborations and partnerships in the field of AMR.
  4. Identification and promotion of best practices, lessons learned, and innovative strategies in AMR NAP implementation, as shared by participating countries and stakeholders.
  5. Synergies and linkages among various stakeholders will be identified, promoting a unified One Health approach to the implementation of AMR NAPs.
  6. Development of a comprehensive conference report summarizing key discussions and recommendations.

The event fostered in-depth dialogues and collaborative exchanges. Spanning multiple sessions over three days, the conference delved into the intricacies and challenges of AMR, with a unique focus on the One Health approach – a holistic methodology that understands human health is closely linked to animal and environmental health. Official opening remarks were delivered by the Zambian Ministry of Health Permanent Secretary and ZNPHI Director. Followed by remarks from Dr. Viviana Munoz from the South Centre and the Director ReAct Africa Dr. Mirfin Mpundu, setting the stage for a comprehensive exploration of National Action Plans (NAPs) in the context of One Health.

The conference delved into the development and progress of NAPs, spotlighting successful endeavors and challenges encountered in countries like Mali, Rwanda, Angola and Comoros. Within the global context, the intersection between AMR and pandemic preparedness and response was also explored, and across both global and domestic contexts, the missed opportunities in securing AMR NAP funding in Africa also received attention. The breakout sessions offered valuable platforms for in-depth insights and dynamic discussions on various aspects of AMR action, such as access issues, hospital-based antimicrobial stewardship, and lessons on integrating AMR into water, sanitation and hygiene (WASH) and infection prevention and control programs. Topics such as “Lighting Talk” presentations by youth AMR champions, the integration of environment and waste management in AMR strategies, and the intersection between AMR and gender as well as vulnerable populations rounded out the meeting’s agenda. This multifaceted conference not only enriched our understanding of the complex landscape of AMR in Africa but also brought to the fore the pressing issues that require immediate action.

Key takeaways

  • The conference stressed the critical role of local actions that align with global strategies to combat AMR. A unified multi-sectoral approach that spans human, animal, and environmental health was identified as vital for a holistic One Health approach. In addition to international bodies like the WHO, the conference encouraged the engagement of other agencies to diversify and strengthen initiatives against AMR.
  • Political will and high-level engagement were underlined as essential for prioritizing AMR programs both locally and globally. Regulatory frameworks, particularly international instruments on pandemic prevention and preparedness, including but not limited to the International Health Regulations 2005, that need revisiting to make them more inclusive of AMR concerns. Additionally, lessons from the Global Health Index report were highlighted to intensify efforts towards pandemic preparedness, making sure countries at all income levels are well-equipped to handle AMR challenges.
  • Community-based preventive interventions and active engagement of marginalized populations in AMR control measures were noted as key components. Empowering community health workers as AMR ambassadors at the grassroots level is crucial for bridging the gap between communities and health institutions. In addition, involving the faith sector as a key entry point to the community in Africa was also emphasized.
  • The role of data-driven decision-making was elevated, urging the leverage of existing structures like Africa CDC for robust surveillance and policy guidance.
  • The potential for locally generated solutions, particularly those emanating from pandemic response experiences, was recognized. These should be supported and scaled up by global health agencies.
  • The need for robust laboratory diagnostic networks and integrated regional surveillance was highlighted, given their critical role in AMR management.
  • Financing emerged as a critical topic, specifically aimed at addressing the “great divide” by ensuring that AMR funding strategies consider the distinct challenges faced by different African regions.
  • The conference also emphasized the urgent need for capacity building among health workers at the grassroots level to understand the complexities of AMR.
  • Strengthening governance systems to effectively monitor and regulate antimicrobial use was seen as a crucial step in fostering accountability. Multi-stakeholder collaborations involving public and private sectors were urged to accelerate AMR control efforts. Engaging lawmakers to shape policies and regulations became evident as another vital component. Harmonization of National Action Plans, especially between the global north and the global south, was advocated to address the unique challenges faced by different African countries.
  • The conference underscored the need for a gender-inclusive AMR strategy, recognizing the differential impact of AMR on men and women. This involves assessing the unique vulnerabilities, needs, and strengths of different genders and ensuring policies and programs reflect these considerations. Cultural sensitivity and local customs must also be considered when promoting AMR awareness and practices.
  • Research and evidence-based policies, in partnership with international research institutions, were highlighted as essential for a comprehensive AMR strategy.
  • The conference also stressed the need for youth engagement, leveraging their energy, creativity, and digital skills for awareness and innovation.
  • The role of integrating AMR strategies into existing WASH (Water, Sanitation, and Hygiene) programs was recognized as essential for holistic health benefits. Other practical considerations included optimizing supply chains for AMR-related drugs and diagnostics and promoting local manufacturing capabilities.
  • The conference underscored the importance of incentivizing private sector involvement to develop AMR solutions tailored to Africa’s distinct challenges. Alongside this, the event highlighted the necessity for neighboring African countries to collaborate and share best practices to harmonize AMR combatting efforts across the continent.

The conference’s reactive nature ensured that emerging questions, especially those emphasizing the environmental impact of pandemics and the balance between curative and preventive approaches, were adequately addressed. Integral to our discussions was the consensus on how Africa can take the lead in pandemic preparedness. Emphasizing the need for Africa to adopt innovative health security strategies, the call for greater collaboration, resilience, and proactivity resonated throughout the event. It was acknowledged unanimously that a concerted effort towards the One Health approach and fostering strong synergies is the way forward. As we reflect on the insights from this conference, it becomes abundantly clear that there is an immediate and pressing need for resources, both financial and technical, to address AMR comprehensively. It’s not just about health; it’s about ensuring a sustainable future for Africa. ReAct will continue to work toward being a catalyst for transformative change, ensuring that as we advance in the fight against AMR, truly no one is left behind.