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Policy  –  Develop a plan

Implement the plan

Turning the national action plans on antimicrobial resistance into action requires a dedicated budget and committed stakeholders. The coordinating group has an important function to engage the relevant actors and make sure resistance is addressed in appropriate strands of work. Important components of the plan are likely already carried out in some form but may have to be scaled up or be adapted to more specifically address resistance. Other components will be new.

Implementation is probably the most challenging part of the policy process. In many cases, lack of policy implementation is a result of disproportion between the ambition of the policy and the resources and capacity available to actually implement it. Therefore, a proper resource analysis and planned budget allocation is key, as described in the previous section. Implementation should be built on existing structures, policies, and programs where available.

Want to connect with others working to implement national action plans?

The AMR-NAP discussion forum is a free and open online resource run by the WHO AMR Secretariat for those developing and implementing national action plans on antibiotic resistance. Join here.

See also:

  • Elements of a national action plan, which covers some possible policy areas (such as surveillance, and infection prevention) to include in the plan and support tools for their implementation on a policy level.
  • Examples from the field: More about how different countries and regions have worked to develop and implement plans.
  • The other focus areas of the Toolbox, in particular RATIONAL USE, PREVENT INFECTION, RAISE AWARENESS and MEASURE are aimed at supporting interventions taking place in the community, in hospitals and in the farming of animals.

Selected Resources

Resource Description
Turning plans into action for antimicrobial resistance (AMR), Working Paper 2.0: Implementation and coordination Paper developed by WHO with practical guidance on implementation of national action plans on antimicrobial resistance, with a specific focus on LMICs. For coordination committees and others working at country level. Points out importance of building on existing plans and initiatives in relevant areas (such as IPC, immunization, and laboratory strengthening programmes).
The antimicrobial resistance national action plan (AMR-NAP) forum Community of practice run by the WHO AMR Secretariat. The primary aim is to enable those developing and implementing national action plans to have access to advice, support and peer-to-peer discussions.
Building Coalitions for Containing Antimicrobial Resistance: A Guide Guide by SIAPS that offers guidance on how to formulate and implement a plan and evaluate outcomes. Also provides a number of templates and sample interview forms that can be adapted for different local contexts. The chapter “Implement the Action Plan” describes some tools and strategies for managing technical and logistical issues to effectively implement a plan. An older version is available in Spanish and French.
Guidelines on Implementation of the Antimicrobial Strategy in South Africa: One Health Approach & Governance Example of an implementation plan. ‘How to’, step-by-step guide for South African healthcare and veterinary workforce to enact the national strategy, addressing the governance framework at different levels of the health system.
Country progress in the implementation of the global action plan on antimicrobial resistance: WHO, FAO and OIE global tripartite database Database. A global open-access tripartite antimicrobial resistance database developed by WHO, FAO and OIE. Baseline information of country status regarding implementation of national action plans based on country self-assessments.
Tackling antimicrobial resistance (AMR) together. Working Paper 5.0: Enhancing the focus on gender and equity Working paper from WHO to assist countries towards better considering gender and equity in work on antibiotic resistance; informing the implementation of strategies in national action plans.
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SIAPS. Building Coalitions for Containing Antimicrobial Resistance: A Guide. Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services Program. Arlington, VA: Management Sciences for Health. [Internet]. 2017 [cited 2018 Mar 14]. Available from: http://siapsprogram.org/publication/building-coalitions-for-containing-antimicrobial-resistance-a-guide/
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World Health Organization - WHO. Tackling antimicrobial resistance (AMR) together. Working Paper 5.0: Enhancing the focus on gender and equity [Internet]. WHO. 2018 [cited 2019 May 28]. Available from: http://www.who.int/antimicrobial-resistance/national-action-plans/workingpaper5enhancingthefocusongenderandequity/en/
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World Health Organization - WHO. Turning plans into action for antimicrobial resistance (AMR). Working Paper 2.0: Implementation and coordination [Internet]. WHO. 2019 [cited 2019 Mar 26]. Available from: http://www.who.int/antimicrobial-resistance/publications/Turningplansintoactionforantimicrobialresistance/en/
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Ministerial Advisory Committee on Antimicrobial Resistance, National Department of Health and Affordable Medicines Directorate. Guidelines on Implementation of the Antimicrobial Strategy in South Africa: One Health Approach and Governance [Internet]. 2017 [cited 2017 Nov 22]. Available from: http://nahf.co.za/guidelines-on-the-implementation-of-the-antimicrobial-strategy-in-south-africa-2017-07-14/
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The antimicrobial resistance national action plan (AMR-NAP) forum [Internet]. WHO. [cited 2017 Jun 14]. Available from: http://www.who.int/antimicrobial-resistance/national-action-plans/discussion-forum/en/
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World Health Organization - WHO. Country progress in the implementation of the global action plan on antimicrobial resistance: WHO, FAO and OIE global tripartite database [Internet]. WHO. [cited 2017 May 22]. Available from: http://www.who.int/antimicrobial-resistance/global-action-plan/database/en/
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World Health Organization - WHO, Food and Agriculture Organization of the United Nations - FAO, World Organization for Animal Health - OIE. Antimicrobial resistance: A manual for developing national action plans [Internet]. Geneva, Switzerland: World Health Organization; 2016 [cited 2016 Mar 1]. Available from: http://www.who.int/drugresistance/action-plans/manual/en/
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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