Monitoring And Evaluation Of The Global Action Plan On Antimicrobial Resistance

This paper summarises the approach proposed for monitoring and evaluation (M&E) of both the implementation of the GAP and the resulting effects on AMR and on health. M&E is required at both national and global levels; for management, to identify and respond to barriers to progress, and to inform course correction, in order to increase impact and value for money. M&E is also needed for accountability, within countries and at regional and global levels. This includes reporting back to the global health community, including the governing bodies of WHO, FAO and OIE, and the Interagency Coordination Group on AMR that was established by the UN General Assembly.

The response to the antimicrobial resistance (AMR) crisis has been spearheaded through the Global Action Plan on Antimicrobial Resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015 in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations' governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite, adding the United Nations Environment Programme (UNEP) to the Alliance "to accelerate the coordination strategy for human, animal and ecosystem health."By adopting the GAP-AMR, countries agreed to develop National Action Plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally.This country M&E guidance document was developed as a reference for countries to support the development and delivery of AMR NAPs. It assists in establishing an M&E plan for their AMR NAP, building on existing national reporting systems and recommended indicators from the GAP-AMR M&E framework.

In 2015 the World Health Assembly endorsed the Global action plan on antimicrobial resistance calling on countries to develop and implement national action plans on antimicrobial resistance (AMR). For most countries, the greatest challenge is not developing a national action plan; rather, it is the implementation of the plan based on evidence-based prioritization of activities, systematic monitoring of progress, and ensuring sustainability of efforts. The purpose of this publication is to to provide a practical, stepwise approach to the implementation of the national action plan on AMR within the human health sector; and to provide a process and collation of existing WHO tools to prioritize, cost, implement, monitor and evaluate national action plan activities. The target audience of the publication are national/subnational stakeholders working on AMR within the human health sector. This includes national health authorities, national multisectoral coordination groups, senior technical experts and policymakers involved in implementing AMR activities at all levels of the health system, and implementation partners to accelerate sustainable implementation and monitoring and evaluation of national action plans on AMR.

The global analysis report of the annual Tripartite AMR country self-assessment survey (TrACSS) is a component of a broader approach for monitoring and evaluating the global action plan on antimicrobial resistance (GAP-AMR). This report summarizes global responses from the fourth round of the TrACSS, held from November 2019 to July 2020. Due to the COVID-19 pandemic, the response rates for the 2019–2020 TrACSS around were 11.8% lower than the previous year. A total of 136 (70.1%) countries out of 194 WHO Member States responded to the 2019–2020 TrACSS, compared to 159 out of 194 (81.9%) in 2018–2019.

Building on the momentum of increased collaboration, WHO, FAO, OIE and UNEP have developed a Strategic Framework for collaboration on antimicrobial resistance (AMR). This Framework reflects the joint work of the four organizations to advance a One Health response to AMR at global, regional and country levels. It broadly supports the implementation of the five pillars of the Global Action Plan on AMR, as well as strengthening global AMR governance.

Antimicrobial resistance (AMR) is the ability of microorganisms to fight antimicrobial compounds, reducing the efficacy of treating diseases in humans, animals, and plants. AMR risk is outpacing human population growth, owing to misuse of antimicrobials in large quantities in food systems, and is a serious threat to food security and sustainable development. FAO, with the World Health Organization (WHO), the World Organization for Animal Health (OIE), and the United Nations Environment Programme (UNEP), is supporting countries in developing and implementing their One Health National Action Plans on AMR. The eventual aim is to ensure sustainable use of antimicrobials to minimize AMR risks, in alignment with the Global Action Plan on AMR. The scope of the evaluation covers FAO’s entire work on AMR up to early 2020 and its role in the global AMR architecture. It examines FAO’s organizational and institutional set-up for AMR work. FAO has a strong mandate to work on AMR, implementing activities in 45 countries and providing far-reaching support on AMR National Action Plans (NAPs). FAO’s technical expertise is a key comparative advantage in its work on AMR. It is underpinned by the strong scientific grounding of FAO’s work, engendered in its AMR working groups and supported by its collaboration with research centers, universities, and the Tripartite organizations. Nevertheless, the work is relatively recent and, given the long impact pathways, it has had limited results. A comprehensive strategic and programmatic approach would increase the likelihood of achieving results in combating AMR. FAO should prioritize its work in a long-term strategy on AMR that recognizes the seriousness of the threat and is fully integrated into the Organization’s Strategic Framework. The strategy should set out FAO’s long-term role in combating AMR and that of its divisions and offices, as well as its approach at the country and regional level. FAO should consolidate its work on AMR through a strong programmatic approach with a central coordination and management structure that links with the Regional Offices and is supported by dedicated core funding.

An accessible overview of the challenges in tackling AMR, and the economic and policy responses of the 'One Health' approach. It will appeal to policy-makers seeking to strengthen national and local polices tackling AMR, as well as students and academics who want an overview of the latest scientific evidence regarding effective AMR policies.