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Toolbox  –  Policy

Implement the national action 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 Develop a national action plan.

Tool for costing activities in national action plans

On October 13, 2021 the World Health Organization launched a Costing and Budgeting tool for guiding the development and implementation of National Action Plans on Antimicrobial Resistance (NAP-AMR). The tool aims at helping (i) quantify and prioritise AMR-related activities, (ii) identify the available resources and the financial gaps, (iii) advocate for additional funding, and (iv) develop multi-stakeholder partnerships.

Implementation should be built on existing structures, policies, and programs where available.

Want to connect with others working on national action plans?

The WHO AMR community exchange platform is a free and open online resource run by the WHO AMR Secretariat with the goal of sharing knowledge and fostering collaboration among those developing and implementing national action plans on antibiotic resistance. Join here.

See also:
Inspirational examples: 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
The implementation handbook for national action plans on AMR: Guidance for the human health sector Handbook from WHO that provides a practical, stepwise approach to NAP implementation within the human health sector. It also provides a process and supporting WHO tools to prioritize, cost, implement, monitor and evaluate NAP activities.
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).
WHO AMR Community Exchange Platform 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.
Global Database for the Tripartite Antimicrobial Resistance (AMR) Country Self-assessment Survey (TrACSS) Database. A global open-access database with information on country status regarding development and implementation of national action plans, based on country self-assessments. Developed by WHO, FAO and WOAH. See also Monitoring progress on antimicrobial resistance for M&E publications and assessment tools.
EAST: Four Simple Ways to Apply Behavioural Insights Guide that describes four principles for encouraging certain behaviors: Make it easy, attractive, social and timely. Gives practical examples and contains information for more effective and efficient policy.
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WHO AMR Community Exchange. WHO AMR Community Exchange https://amrcommunityexchange.org/.
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FAO, WOAH & WHO. Global Database for the Tripartite Antimicrobial Resistance (AMR) Country Self-assessment Survey (TrACSS). http://amrcountryprogress.org/.
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WHO, FAO & WOAH. Antimicrobial resistance: a manual for developing national action plans. Preprint at https://www.who.int/publications/i/item/9789241549530 (2016).
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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. Preprint at https://www.knowledgehub.org.za/elibrary/guidelines-implementation-antimicrobial-strategy-south-africa-one-health-approach (2017).
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World Health Organization (WHO). WHO implementation handbook for national action plans on antimicrobial resistance: guidance for the human health sector. https://www.who.int/publications-detail-redirect/9789240041981.
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World Health Organization - WHO. Turning plans into action for antimicrobial resistance (AMR). Working Paper 2.0: Implementation and coordination. WHO https://www.who.int/publications/i/item/turning-plans-into-action-for-antimicrobial-resistance-(-amr)-working-paper-2.0-implementation-and-coordination (2019).
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EAST: Four Simple Ways to Apply Behavioural Insights. https://www.bi.team/publications/east-four-simple-ways-to-apply-behavioural-insights/ (2014).
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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. http://siapsprogram.org/publication/building-coalitions-for-containing-antimicrobial-resistance-a-guide/ (2017).
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Gelband, H. & Delahoy, M. Policies to Address Antibiotic Resistance in Low- and Middle-Income Countries. http://cddep.org/publications/policies_address_antibiotic_resistance_low_and_middle_income_countries (2014).