Joshi Mohan P, Alombah Fozo, Konduri Niranjan, Ndiaye Antoine, Kusu Ndinda, Kiggundu Reuben, Lusaya Edgar Peter, Tuala Tuala Robert, Embrey Martha, Hafner Tamara, Traore Ousmane, Mbaye Mame, Akinola Babatunde, Namburete Denylson, Acho Alphonse, Hema Yacouba, Getahun Workineh, Sayem Md Abu, Nfor Emmanuel
USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, VA, USA.
USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Abidjan, Côte d'Ivoire.
One Health Outlook. 2023 Apr 14;5(1):7. doi: 10.1186/s42522-023-00081-6.
Antimicrobial resistance (AMR) poses a global threat to human, animal, and environmental health. AMR is a technical area in the Global Health Security Agenda initiative which uses the Joint External Evaluation tool to evaluate national AMR containment capacity. This paper describes four promising practices for strengthening national antimicrobial resistance containment capacity based on the experiences of the US Agency for International Development's Medicines, Technologies, and Pharmaceutical Services Program work with 13 countries to implement their national action plans on AMR in the areas of multisectoral coordination, infection prevention and control, and antimicrobial stewardship.
We use the World Health Organization (WHO) Benchmarks on International Health Regulations Capacities (2019) to guide national, subnational, and facility actions that advance Joint External Evaluation capacity levels from 1 (no capacity) to 5 (sustainable capacity). Our technical approach is based on scoping visits, baseline Joint External Evaluation scores, benchmarks tool guidance, and country resources and priorities.
We gleaned four promising practices to achieve AMR containment objectives: (1) implement appropriate actions using the WHO benchmarks tool, which prioritizes actions, making it easier for countries to incrementally increase their Joint External Evaluation capacity from level 1 to 5; (2) integrate AMR into national and global agendas. Ongoing agendas and programs at international, regional, and national levels provide opportunities to mainstream and interlink AMR containment efforts; (3) improve governance through multisectoral coordination on AMR. Strengthening multisectoral bodies' and their technical working groups' governance improved functioning, which led to better engagement with animal/agricultural sectors and a more coordinated COVID-19 pandemic response; and (4) mobilize and diversify funding for AMR containment. Long-term funding from diversified funding streams is vital for advancing and sustaining countries' Joint External Evaluation capacities.
The Global Health Security Agenda work has provided practical support to countries to frame and conduct AMR containment actions in terms of pandemic preparedness and health security. The WHO benchmarks tool that Global Health Security Agenda uses serves as a standardized organizing framework to prioritize capacity-appropriate AMR containment actions and transfer skills to help operationalize national action plans on AMR.
抗菌药物耐药性（AMR）对人类、动物和环境卫生构成全球威胁。AMR是全球卫生安全议程倡议中的一个技术领域，该倡议使用联合外部评估工具来评估各国的AMR控制能力。本文基于美国国际开发署药品、技术和制药服务项目与13个国家合作实施其国家AMR行动计划在多部门协调、感染预防与控制以及抗菌药物管理等领域的经验，描述了加强国家抗菌药物耐药性控制能力的四种有前景的做法。
我们使用世界卫生组织（WHO）《国际卫生条例能力基准（2019年）》来指导国家、次国家和机构层面的行动，这些行动将联合外部评估能力水平从1级（无能力）提高到5级（可持续能力）。我们的技术方法基于实地考察、联合外部评估基线分数、基准工具指导以及国家资源和优先事项。
我们总结出实现AMR控制目标的四种有前景的做法：（1）使用WHO基准工具实施适当行动，该工具对行动进行优先排序，使各国更容易逐步将其联合外部评估能力从1级提高到5级；（2）将AMR纳入国家和全球议程。国际、区域和国家层面正在进行的议程和项目为将AMR控制努力纳入主流并相互联系提供了机会；（3）通过AMR多部门协调改善治理。加强多部门机构及其技术工作组的治理可改善运作，从而更好地与动物/农业部门互动并更协调地应对COVID-19大流行；（4）为AMR控制筹集资金并使其多样化。来自多样化资金流的长期资金对于提升和维持各国的联合外部评估能力至关重要。
全球卫生安全议程工作为各国在大流行防范和卫生安全方面制定和开展AMR控制行动提供了实际支持。全球卫生安全议程使用的WHO基准工具作为一个标准化的组织框架，用于优先开展与能力相适应的AMR控制行动并传授技能，以帮助实施国家AMR行动计划。
