Boston University, Institute for Health System Innovation & Policy, 180 Riverway, Boston, MA 02215, USA; Boston University, Department of Biomedical Engineering, 44 Cummington Mall, Boston, MA 02215, USA.
Boston University, Department of Biomedical Engineering, 44 Cummington Mall, Boston, MA 02215, USA.
J Glob Antimicrob Resist. 2020 Jun;21:105-115. doi: 10.1016/j.jgar.2019.09.020. Epub 2019 Oct 7.
In 2015, the World Health Organization (WHO) released its global action plan (GAP) on antimicrobial resistance (AMR) as a blueprint for the design of national action plans for AMR containment. Bangladesh, with 80% rural household ownership of at least one livestock, introduced its national action plan in May 2017. The objective of this study was two-fold: (i) to perform a policy content evaluation of the Bangladesh National Action Plan (BNAP) against the GAP with a focus on veterinary AMR containment strategies; and (ii) to assess the evidence on the implementation of veterinary AMR containment strategies of the BNAP.
The BNAP was evaluated against the GAP to identify commonalities and policy gaps. A scoping review of peer-reviewed and grey literature was performed to identity evidence of policy implementation and practice gaps.
The BNAP is strongly aligned with the GAP. However, the study identified policy gaps, including an explicit financing modality, specifications for antimicrobial stewardship (AMS) in the veterinary sector, and rigorous operational and monitoring & evaluation frameworks. More evidence on implementation is needed in terms of incorporation of AMR in the curriculum of veterinarians, AMS plans throughout the veterinary sector, and infection prevention and control protocols and implementation.
Closing the identified gaps is essential for successful veterinary AMR containment in Bangladesh but will require sustained and significant investment in institutional and human resource development in the coming years.
2015 年，世界卫生组织（WHO）发布了全球抗微生物药物耐药性行动计划（GAP），为制定抗微生物药物耐药性遏制国家行动计划提供了蓝图。孟加拉国 80%的农村家庭至少拥有一种牲畜，于 2017 年 5 月推出了国家行动计划。本研究的目的有两个：（i）根据 GAP 对孟加拉国国家行动计划（BNAP）进行政策内容评估，重点关注兽医抗微生物药物耐药性遏制策略；（ii）评估 BNAP 中兽医抗微生物药物耐药性遏制策略的实施证据。
根据 GAP 评估 BNAP，以确定共同之处和政策差距。对同行评议和灰色文献进行范围综述，以确定政策实施和实践差距的证据。
BNAP 与 GAP 高度一致。然而，研究发现了一些政策差距，包括明确的融资模式、兽医部门中抗菌药物管理（AMS）的规范以及严格的运营和监测与评估框架。在兽医课程中纳入抗微生物药物耐药性、兽医部门的 AMS 计划以及感染预防和控制方案的制定和实施方面，需要更多关于实施情况的证据。
为了在孟加拉国成功遏制兽医抗微生物药物耐药性，必须弥合已确定的差距，但这将需要在未来几年对机构和人力资源发展进行持续和大量的投资。
