Overview of AMR action plans in the region
Alerted to this crisis of antimicrobial resistance, the May 2015 World Health Assembly adopted a global action plan on antimicrobial resistance, which outlines five objectives:
- To improve awareness and understanding of antimicrobial resistance through effective communication, education and training
- To strengthen the knowledge and evidence base through surveillance and research
- To reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures
- To optimise the use of antimicrobial medicines in human and animal health
- To develop the economic case for sustainable investment that takes account of the needs of all countries and to increase investment in new medicines, diagnostic tools, vaccines and other interventions
In 2018 a more recent review article looking at hospital Adoption of Antimicrobial Stewardship Programs in Gulf Cooperation Council Countries was published. It concluded that, despite the established benefits of antimicrobial stewardship programs in reducing inappropriate antimicrobial use and resistance, their adoption in Gulf Cooperation Council hospitals remains low. The article also recommended that the adoption of antimicrobial stewardship programs in hospitals in the region can be facilitated or hindered by a range of institutional and individual factors.
Six outcome measures to evaluate ASPs in GCC countries hospitals have been reported. These include: reduction of inappropriate prescribing, reduction of healthcare-associated infections, reduction of direct antimicrobial cost, reduction of length of stay/mortality metrics, reduction of antimicrobial resistance and reduction of broad-spectrum antibiotic use.
Another article by Nasr et al 2017 looked into the impact of antimicrobial stewardship strategies on antibiotic appropriateness and prescribing behaviours in selected countries in the Middle East. It showed that antimicrobial stewardship programs are in their infancy in the region but that work is currently being done to further develop these programs. It also showed that antimicrobial utilisation is sub-optimal in the region.
Most of the countries in the region have moved forward and currently as per the WHO web site for the national action plan, 12 of 21 countries have submitted their plans. More efforts have to be done to facilitate the plan implementation phase.