Technical Brief On Water Sanitation Hygiene And Wastewater Management To Prevent Infections And Reduce The Spread Of Antimicrobial Resistance

This technical brief provides information to inform Water Sanitation and Hygiene (WASH) and wastewater elements within multi-sectoral antimicrobial resistance (AMR) national action plans (NAPs). It includes a summary of evidence and the co-benefits rationale for action in each sector and presents a menu of actions for consideration and refinement in each country context. The technical brief also identifies sector specific policy options and to additional information, including knowledge gaps and research needs, as well as additional technical resources to support planning and implementation.

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.

This report summarizes the World Health Organization’s (WHO) global work on water, sanitation and hygiene (WASH) during 2021, including on global monitoring, on development and implementation of WASH norms, and on advocacy on partnerships, including on hand hygiene.

Antimicrobial resistance (AMR) has been recognized as one of the greatest global threats to humans, animals, plants and ecosystems health threatening the achievement of the Sustainable Development Goals. In our globally connected world, resistance to antimicrobials may spread and circulate among humans, animals, plants and the environment, necessitating a “One Health” approach. While the One Health approach is relevant to all efforts to prevent and control AMR, this priority research agenda focuses on research areas at the interface between sectors. This research agenda is a joint product of the Quadripartite organizations –FAO, UNEP, WHO and WOAH - and a result of extensive stakeholder and expert engagement. A structured mixed-methods approach was used including reviews of academic and grey literature, online open global survey, and consensus exercise by modified Delphi method in which global experts prioritized research areas for the five pillars: transmission, integrated surveillance, interventions, behavioral insights and change, and economics and policy. We hope this research agenda will serve as a guiding tool for countries, research institutes and funding bodies to support for One Health AMR research, helping policymakers, researchers and the multidisciplinary scientific community to work together across sectors on solutions that will prevent and mitigate AMR on a national, regional and global scale as further evidence on research strategies, interventions and policies is required to understand what works, in which contexts and for whom.

The WHO Policy Guidance on Integrated Antimicrobial Stewardship Activities was developed after global consultations and is anchored in public health guiding principles in the human health sector.