Survey charts progress in 154 countries on developing and implementing plans to address antimicrobial resistance in human medicine, ag and environment.

July 18, 2018

4 Min Read
Report: Countries step up to tackle AMR
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Countries are making significant steps in tackling antimicrobial resistance (AMR), but serious gaps remain and require urgent action, according to a report released July 18 by the U.N. Food & Agriculture Organization (FAO), the World Organization for Animal Health (OIE) and the World Health Organization (WHO).

The report charts progress in 154 countries and reveals wide discrepancies. Some, including many European countries, have been working on AMR policies in human and animal sectors for more than four decades, the report says, while others only recently have started to take action on AMR.

According to the international agencies, progress in developing and implementing plans is greater in high-income than low-income countries, but all countries have room for improvement. No country reports sustained capacity at scale in all areas.

The report looks at surveillance, education, monitoring and regulating consumption and use of antimicrobials in human health, animal health and production, as well as in plants and the environment — as recommended in the Global Action Plan published in 2015, FAO, OIE and WHO said.

Promising findings include 105 countries with a surveillance system in place for reporting drug-resistant infections in human health and 68 countries with a system for tracking consumption of antimicrobials. In addition, 123 countries reported that they have policies to regulate the sale of antimicrobials, including requiring a prescription for human use — a key measure to tackle overuse and misuse of antimicrobials, the report says.

However, implementation of these policies varies, and unregulated medicines are still available in places such as street markets, with no limits on how they are used, the announcement pointed out. Medicines are very often sold over the counter with no prescription requested. This puts human and animal health at risk, potentially contributing to AMR development.

The report highlights areas where there is an urgent need for more investment and action, particularly in the animal and food sectors, the agencies said. For example, only 64 countries reported that they follow FAO/OIE/WHO recommendations to limit the use of critically important antimicrobials for growth promotion in animal production. Of these, 39 are high-income countries, with the majority in WHO's European region, the report says. By contrast, only three countries from WHO's African region and seven countries from the region of the Americas have taken this step to reduce the emergence of AMR.

A total of 67 countries reported at least having legislation in place to control all aspects of production, licensing and distribution of antimicrobials for use in animals, the announcement said. However, 56 reported that they either had no national policy or legislation regarding the quality, safety and efficacy of antimicrobial products used in animal and plant health and their distribution, sale or use or that they were unable to report whether they have these policies in place.

There is also a substantial lack of action and data in the environment and plant sectors. Although 78 countries have regulations in place to prevent environmental contamination generally, only 10 of them report having comprehensive systems to ensure regulatory compliance for all waste management, including regulations that limit the discharge of antimicrobial residues into the environment, the agencies reported, saying this is insufficient to protect the environment from the hazards of antimicrobial production.

"This report shows growing global momentum to combat antimicrobial resistance," said Dr. Ranieri Guerra, WHO assistant director-general for antimicrobial resistance. "We call on governments to make sustained commitments across all sectors: human and animal health, plant health and the environment; otherwise, we risk losing the use of these precious medicines."

OIE deputy director general Dr. Matthew Stone added, "Supporting low- and middle-income countries to follow guidance of responsible and prudent use of antimicrobials in animals is an urgent priority. Implementation of dedicated OIE international standards, appropriate national legislation and strengthening of veterinary services are essential steps to help all animal health stakeholders contribute to controlling the threat posed by antimicrobial resistance."

From this survey and other sources, FAO, OIE and WHO said they are aware that 100 countries now have national action plans for AMR in place and a further 51 countries have plans under development, but more needs to be done to ensure that these plans are implemented. Only 53 countries reported having a multi-sectoral working group that is fully functional, although a further 77 have established such a group. Only 10 countries have identified the funding for all actions in the plan, and many middle- and low-income countries may need long-term development assistance to implement their plans effectively and sustainably.

According to the agencies, among the top 10 chicken-, pork- and cattle-producing countries that responded to the AMR survey, nine out of 10 have, at a minimum, developed a national action plan; the majority of these have plans in operation with a monitoring arrangement.

About the survey

The global Tripartite survey of country progress in addressing AMR is part of monitoring implementation of the Global Action Plan on AMR, which was endorsed by WHO and FAO member states and OIE member countries in 2015.

The survey is developed and issued jointly by the three organizations, and the report analyzes the data from the second year of the survey.

The 2018 survey received responses from 154 countries, out of the 194 of WHO member states contacted. All countries' responses from both years are published in an open-access database, offering the opportunity for in-country review with civil society and other stakeholders.

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