Chua Alvin Qijia, Verma Monica, Villanueva Sharon Yvette Angelina, Roxas Evalyn, Hsu Li Yang, Legido-Quigley Helena
Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore.
College of Public Health, University of the Philippines Manila, 625 Pedro Gil St, Manila 1000, Philippines.
Antibiotics (Basel). 2023 Jul 31;12(8):1258. doi: 10.3390/antibiotics12081258.
Antimicrobial resistance (AMR) is a global public health threat that affects humans, animals, and the environment across the One Health spectrum. Singapore launched its own National Strategic Action Plan (NSAP) on AMR in 2017 with the aim of tackling the growing threat of AMR in Singapore through coordinated approaches. However, little is known about the implementation of the NSAP. In this study, we analysed the implementation of the NSAP with guidance from an AMR governance framework. We conducted in-depth interviews with 20 participants across the One Health spectrum. The interviews were transcribed verbatim and analysed thematically. Overall, the implementation of activities against AMR was more advanced with respect to human health compared to other sectors such as (1) AMR and antimicrobial use (AMU) surveillance systems in hospitals; (2) the hospital antimicrobial stewardship (AMS) service and legislation to optimise AMU; (3) the national children and adults vaccination programme for IPC; (4) multiple avenues for education and awareness for both professionals and public; and (5) extensive research and collaboration networks with many sources of funding. Areas that were lacking presented problems including (1) an incomplete surveillance system for AMR and AMU across all sectors; (2) the need for better AMS and legislation in some sectors; (3) insufficient innovation in education for sustained behavioural modification; and (4) the need for more open research collaborations and the translation of research into policy outcomes. Improvements in these areas will enhance the overall implementation of the NSAP through a more holistic One Health approach.
抗菌药物耐药性（AMR）是一种全球公共卫生威胁，影响着“同一健康”范围内的人类、动物和环境。新加坡于2017年推出了自己的抗菌药物耐药性国家战略行动计划（NSAP），旨在通过协调一致的方法应对新加坡日益增长的抗菌药物耐药性威胁。然而，对于NSAP的实施情况却知之甚少。在本研究中，我们在抗菌药物耐药性治理框架的指导下分析了NSAP的实施情况。我们对“同一健康”范围内的20名参与者进行了深入访谈。访谈内容逐字记录，并进行了主题分析。总体而言，与其他部门相比，在人类健康方面针对抗菌药物耐药性开展的活动实施更为先进，例如：（1）医院的抗菌药物耐药性和抗菌药物使用（AMU）监测系统；（2）医院抗菌药物管理（AMS）服务以及优化抗菌药物使用的立法；（3）针对感染预防与控制（IPC）的国家儿童和成人疫苗接种计划；（4）针对专业人员和公众的多种教育和宣传途径；（5）拥有众多资金来源的广泛研究与合作网络。存在不足的领域呈现出一些问题，包括：（1）所有部门对抗菌药物耐药性和抗菌药物使用的监测系统不完整；（2）一些部门需要更好的抗菌药物管理和立法；（3）教育方面缺乏足够的创新以实现持续的行为改变；（4）需要更多开放的研究合作以及将研究转化为政策成果。这些领域的改进将通过更全面的“同一健康”方法加强NSAP的整体实施。
