National Action Plans on AMR

3 things I wish I knew before developing a National Action Plan on AMR

Ghana is considered a leading country on the African continent for handling antimicrobial resistance due to the work done and the approach they have taken in developing the National Action Plan on Antimicrobial Resistance.

Edith Gavor, Pharmacist and Program Manager at Ghana National Drugs Program, answers here a few questions on Ghana's work and lessons learned so far.

Edith Gavor.

What was your role in developing a National Action Plan for Ghana?

– The National Action Plan for Ghana was developed by a platform, the National Policy Platform for Antimicrobial Resistance, NPAR. The activities and meetings were coordinated by me initially. The coordination has now been taken over by a joint tripartite secretariat, when the NPAR was expanded to include the Food and Agriculture Organization (FAO) and World Organization for Animal Health (OIE).

What structures were initially in place in Ghana to tackle antibiotic resistance?

– There were a number of agencies and institutions, including academic and research institutions, who were undertaking various activities. Some advocacy efforts were also done especially by non-governmental organizations.

– However, except for infection control policies in the Ghana Health Service and the Ministry of Health, there was no specific policy on antimicrobial resistance in place.

What were the first steps you needed to take to initiate the development of the National Action Plan for Ghana?

– The first step was to bring stakeholders together with the view to bring synergy into their efforts, sharing ideas and setting a common agenda for tackling the antimicrobial resistance challenge. This is what is now called the Platform, which is an expanded Platform with the FAO and the OIE joining. The initial Platform was supported by ReAct.

– A Technical Working Group, a sub-committee of the Platform, did a situational analysis from which a policy on antimicrobial resistance was developed. Based on this policy the National Action Plan was subsequently developed.

What ministries did you engage with? And how did you do it?

– The Ministry of Health was the lead Ministry with all its agencies actively involved. The other ministries engaged are the Ministry of Food and Agriculture, the Ministry of Fisheries and Aquaculture Development, the Ministry of Environment Science Technology and Innovation (MESTI). Some major agencies of these ministries are also part of the Platform.

– All these ministries, agencies and departments (MDAs) were approached directly, through their Chief Directors first, and then their Ministers. They were visited and engaged at information sessions, and then invited to be part of the Platform. The approach was easier with the Ministry of Food and Agriculture because the Minister there used to be the Minister of Health when the platform was initially created.

What was the most challenging for you in the process?

– The most challenging part was getting through to the Chief Directors and the Ministers and getting their commitment to the cause of antimicrobial resistance. Once the Chief Directors were involved and committed the doors were open to the rest of the ministries.

– There were also a lot of administrative hurdles to overcome every step of the way but these are generally part of the system in Ghana.

What key factors helped you move forward on those challenges?

– It was essential to get across enough information to the officials. So a number of strategies were used. There were the initial visits, invitations to attend information sessions, informal engagements, external advocacy in the media. Those that gave the broader  global trend and not just the Ghana context were effective. We also disseminated the research done on Ghana.

What do you think are the key lessons learned for Ghana that other countries could benefit from knowing?

– It is essential to involve as many stakeholders as much as possible, at all stages of engagements, right up to the development of the National Action Plan. We had to undertake stakeholder mapping to determine how to engage various stakeholders. This was a good guide for us from the start.

– I realized also that it is essential to get a lead champion or coordinator, or a small group, who are dedicated to the antimicrobial resistance activities, and who are also able to work together administratively. It is also necessary to have a small group of core technical experts who can be resource persons and easily approachable to take up technical assignments on short notice when needed.

Three key pieces of advice before you start develop a National Action Plan

1. To understand all stakeholders interests. We realized later that some had certain interests that was not reflected in the stakeholder mapping. It was not easy to foresee such different interests until specific circumstances arose.

2. I would have wanted more dedicated time to engage members of the Platform in order to get more inputs from them instead of undertaking some assignments myself.

3. To involve FAO right from the start at country level.

Read more about Ghana’s work on creating a National Action Plan on antimicrobial Resistance in the ReAct Toolbox.