News and Opinions  –  2021

ReAct and ICARS to develop policy guides and tools for low resource settings

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To initiate implementation of National Action Plans on AMR - through intervention research projects or other activities - is very challenging in low- and middle-income countries. This has become very clear in the dialogue that both ReAct and ICARS have had with countries in the African region. Now the two organizations are joining hands in a project focusing on this - the challenges to implement National Action Plans in low resources settings. Learn more about the collaboration and its 6 objectives to move from words into action.

Photo: Jozua Douglas, Pixabay.

Earlier both ReAct and ICARS have independently established different programs focusing on antimicrobial resistance in low- and middle-income countries now the two will collaborate in a joint project.

Many countries would benefit from instruments that can support them in developing situational analyses – situational analyses that are prioritizing needed actions within the existing settings and prerequisites. To address the gap, ReAct Africa, in collaboration with ICARS, aim to develop and disseminate a Guide to conduct a comprehensive AMR (Antimicrobial Resistance) country analysis with context-specific and applied tools – to support implementation of National Action Plans on AMR in low- and middle-income countries. Zambia will be the pilot country.

Mirfin Mpundu, Director, ReAct Africa.

Dr. Mirfin Mpundu, Director of ReAct Africa, says:

“We are indeed very appreciative and motivated. This collaboration with ICARS provides an opportunity to address the numerous challenges that African countries face in implementing National Action Plans.

The outcomes of this partnership will be exceedingly useful as we continue our work on antimicrobial resistance, both with a local, regional, and global perspective. There is still so much to do and with the support from partners like ICARS we can continue to address antimicrobial resistance – in particular the needs of low- and middle-income countries – using implementation and intervention research.”

Dr Robert Skov, Scientific Director of ICARS says:

“ICARS believes that we can support NAP implementation through contextualized intervention and implementation research projects, and that providing support and practical guidance through ReAct’s existing toolbox – amongst other means – will support countries in developing initiatives based on local situations and priorities.

We are excited to partner with ReAct to collaborate on this important initiative, and to engage with national and sub-national actors to provide contextualized tools that neither organisation could develop alone.”

6 objectives for the ReAct and ICARS project collaboration to help address challenges of implementing National Action Plans on AMR in low- and middle-income countries:

1. ReAct Toolbox

To understand how the ReAct Toolbox is currently used to support implementation of National Action Plans on AMR by low- and middle-income countries and inform improved and complementary resources to support this implementation.

2. Identify needs for tools, processes and guidance in low resource settings

To identify needs for revised and consolidated tools, processes and guidance that will address challenges for low- and middle-income countries and provide evidence-based solutions for successful implementation of National Action Plans on AMR.

3. Zambia as case study to map barriers for implementing National Action Plans on AMR

To map barriers and the current situation for implementing National Action Plans using Zambia as case study, with the goal of integrating input from other countries in the region to develop a standardized approach for conducting a situational analysis (the standardized approach will form part of a Guide for other low- and middle-income countries, under objective 4).

4. Create and validate Guide Document to help low- and middle-income countries

To create and validate a Guide Document that can be used by low- and middle-income countries to facilitate implementation of National Action Plans on AMR, which will contain specific action plan process descriptions and include existing tools and where needed, revised, or newly developed context-specific tools.

5. Disseminate material to relevant countries

To disseminate the developed materials to support countries to better prioritize resources and actions to address their National Action Plans, including countries in current and future ICARS demonstration projects.

6. Create a practical Guide on AMR National Action Plan implementation for low resource settings

Ultimately, the project aims to leverage on the core principles of both organizations in addressing the challenge of antimicrobial resistance by creating a practical Guide on AMR National Action Plan implementation which will address the challenges that are currently faced. This collaborative output will play a significant role in tackling the silent global pandemic of antimicrobial resistance.

In 2015, at the World Health Assembly WHO formed a resolution on Antimicrobial Resistance – mandating countries to develop context-specific, One Health approach-based National Action Plans on Antimicrobial Resistance. This was following the recognition that to mitigate against the challenge of antimicrobial resistance, political will, and global action, working across human and animal health sectors was required.

There however remains a large implementation gap worldwide, particularly amongst low- and middle-income countries. The challenges include:

  • political will
  • financial resources
  • lack of human resource capacity
  • inadequate IT infrastructure and more.
  • Another significant challenge in implementation of National Action Plans on AMR, is that low- and middle-income countries lack clear, contextual, systematic, and realistic directions to move forward.
  • The starting point is not always clear within the low- and middle-income countries landscape as most guidance documents are at a high/global level and do not provide a roadmap of transforming National Action Plans into contextual solutions for specific regions, such as within Africa.

Competing priorities due to high levels of diseases such as tuberculosis, malaria, HIV/AIDS and many diarrhoeal diseases add to these challenges. The COVID-19 pandemic has further worsened the situation.

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