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Toolbox

Policy

The POLICY focus area of the Toolbox describes the practical steps to develop or strengthen policies on antibiotic resistance.

Antibiotic resistance is a multi-sectorial problem, involving population health, animal welfare, environmental, ecological, sociological and economic dimensions. To manage the problem, policies that address antibiotic resistance and effectively coordinate a national and international response are needed.

Global Action Plan on Antimicrobial Resistance

At the 67th World Health Assembly, the World Health Organization was asked to develop a Global Action Plan on Antimicrobial Resistance. The plan was written based on several multi-stakeholder consultations and was adopted at the 68th World Health Assembly in May 2015. The Global Action Plan encourages all Member States to increase their commitment to comprehensively tackle the full spectrum of the antimicrobial resistance issue. The Global Action Plan outlines 5 strategic objectives:

  • to improve awareness and understanding of antimicrobial resistance;
  • to strengthen knowledge through surveillance and research;
  • to reduce the incidence of infection;
  • to optimize the use of antimicrobial agents; and
  • to develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.

Many of the essential components that are needed for a comprehensive response to control antibiotic resistance have been known for a long time. However, little of this knowledge has so far successfully been translated into action. In most countries, it remains a challenge to coordinate actions between different stakeholders and sectors.

What does the POLICY focus area cover?

The POLICY focus area of the Toolbox aims to help policy makers and other stakeholders in their work to develop and implement policies that address antibiotic resistance.

  • National action plans gives an overview of the importance of coordinated national action and some potential challenges in the process.
  • Develop and implement a plan provides a step-wise guide for planning, implementing and evaluating a national action plan on antibiotic resistance.
  • Elements of a plan presents possible components to include in an action plan framework, and resources/tools to help implement these components.
  • Examples from the field describes policy initiatives related to antibiotic resistance.

The guiding narrative text is accompanied by “Selected resources” that may be used directly or adapted to your particular setting. Browse through then pick and choose what material is most helpful for you!

Selected Resources

Resource Description
Antibiotic resistance – the need for global solutions Article on the need for coordinated global initiatives, which must not only address the need for new drugs but also expand access to antibiotics.
Access to effective antimicrobials: a worldwide challenge Article that describes the importance of functioning antibiotics. It assesses the disease burden resulting both from antibiotic resistance and limited access to antibiotics, and discusses the potential effect of vaccines to decrease the need for antibiotics.
Drug Resistant Infections: A Threat to Our Economic Future Infographic from the World Bank highlighting the economic consequences of AMR.
Tackling Drug-Resistant Infections Globally: final report and recommendations The final report from the Review on Antimicrobial Resistance, commissioned by the UK government, provides an overview of the antibiotic resistance problem and provides options for action within different sectors of relevance to resistance. A number of supporting documents and other publications from the Review can be found on the same page.
When the Drugs Don’t Work – Antibiotic Resistance as a Global Development Problem (PDF) Report from ReAct that describes the negative impact of antibiotic resistance on global and national efforts to eradicate poverty, spur economic growth, reduce inequality, improve global public health, reduce hunger and protect the environment (Sustainable development goals 1, 2, 3, 5, 6, 8, 10, 12, 14 and 15).
Briefing paper: Tackling Antibiotic Resistance for Greater Global Health Security This briefing paper for Chatam House provides an overview of the problem and how it relates to global health security, and also discusses current initiatives and options for action.
Antimicrobial Resistance in the Western Pacific Region: a Review of Surveillance and Health Systems Response Report by WHO (Western Pacific Regional Office) that provides in-depth situational reviews and technical discussions of surveillance, monitoring of use and the health systems response for addressing antimicrobial resistance in the region.
International Policy Overview: Antibiotic Resistance  Review of antibiotic resistance policies and evidence for effective policy measures and interventions. Also includes a selection of national efforts.
Policies to Address Antibiotic Resistance in Low- and Middle-Income Countries A review of antibiotic resistance policies in LMICs around the world, including a discussion of the specific challenges that these countries face.
Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis Systematic review (open access) on the effect of interventions restricting antibiotic use in food animal production. Provides evidence that restricting use lowered the presence of antibiotic resistant bacteria in the animals. The appendix lists all studies (2MB) included in the review and provides a quality assessment.
Antimicrobial policy interventions in food animal production in South East Asia This article describes key policies for tackling antimicrobial resistance (in relation to food animal production) in the South East Asia Region.
EMA and EFSA Joint Scientific Opinion on measures to reduce the need to use antimicrobial agents in animal husbandry in the European Union, and the resulting impacts on food safety (RONAFA) A Joint Scientific Opinion from EFSA and EMA, upon request from the European Commission, on measures to reduce use of antimicrobial agents in the food animal sector.
1.
ReAct - Action on antibiotic resistance. When the Drugs Don’t Work - Antibiotic Resistance as a Global Development Problem [Internet]. 2019. Available from: https://www.reactgroup.org/wp-content/uploads/2019/02/When-the-Drugs-Don%E2%80%99t-Work-Antibiotic-Resistance-as-a-Global-Development-Problem-Feb-2019.pdf
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World Bank. Drug Resistant Infections: A Threat to Our Economic Future [Internet]. Washington (DC), U.S.A.; 2017. Available from: http://www.worldbank.org/en/topic/health/publication/drug-resistant-infections-a-threat-to-our-economic-future
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Goutard FL, Bordier M, Calba C, Erlacher-Vindel E, Góchez D, de Balogh K, et al. Antimicrobial policy interventions in food animal production in South East Asia. BMJ [Internet]. 2017 Sep 5 [cited 2018 Sep 5];j3544. Available from: http://www.bmj.com/lookup/doi/10.1136/bmj.j3544
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Tang KL, Caffrey NP, Nóbrega DB, Cork SC, Ronksley PE, Barkema HW, et al. Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis. The Lancet Planetary Health [Internet]. 2017 Nov 1;1(8):e316–27. Available from: http://www.sciencedirect.com/science/article/pii/S2542519617301419
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The Review on Antimicrobial Resistance, chaired by Jim O’Neill. Tackling Drug-Resistant Infections Globally: final report and recommendations [Internet]. 2016. Available from: https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf
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EMA Committee for Medicinal Products for Veterinary Use (CVMP) and EFSA Panel on Biological Hazards (BIOHAZ), Murphy D, Ricci A, Auce Z, Beechinor JG, Bergendahl H, et al. EMA and EFSA Joint Scientific Opinion on measures to reduce the need to use antimicrobial agents in animal husbandry in the European Union, and the resulting impacts on food safety (RONAFA). EFSA Journal [Internet]. 2017 [cited 2017 Apr 5];15(1). Available from: http://doi.wiley.com/10.2903/j.efsa.2017.4666
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Buckland Merrett GL. Briefing paper: Tackling Antibiotic Resistance for Greater Global Health Security [Internet]. Chatham House. 2013 [cited 2016 Jul 7]. Available from: https://www.chathamhouse.org/publications/papers/view/194381
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World Health Organization - WHO. Global Action Plan on Antimicrobial Resistance [Internet]. Geneva, Switzerland: World Health Organization; 2015 [cited 2016 Jan 11]. Available from: http://apps.who.int/iris/bitstream/10665/193736/1/9789241509763_eng.pdf?ua=1
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Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, et al. Antibiotic resistance—the need for global solutions. The Lancet Infectious Diseases [Internet]. 2013 [cited 2015 Apr 21];13(12):1057–98. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24252483
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World Health Organization - WHO. Antimicrobial Resistance in the Western Pacific Region: a Review of Surveillance and Health Systems Response [Internet]. Geneva, Switzerland: World Health Organization; 2015 [cited 2015 Apr 20]. Available from: http://www.wpro.who.int/entity/drug_resistance/resources/en/
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Marieke Gerards. International Policy Overview: Antibiotic Resistance [Internet]. WHO; 2011 [cited 2015 Apr 23]. Available from: http://apps.who.int/medicinedocs/documents/s19478en/s19478en.pdf
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Gelband H, Delahoy M. Policies to Address Antibiotic Resistance in Low- and Middle-Income Countries [Internet]. The Centre for Disease Dynamic, Economics & Policy; 2014 Sep. Available from: http://cddep.org/publications/policies_address_antibiotic_resistance_low_and_middle_income_countries