COVER STORY/ANTIBIOTIC

part of the country, the same drug continues to be effective in other parts. The country has also strengthened the surveillance system through the Zambia National Health Strategic Plan (2017-2021), which has proposed that laboratory services will be set in hospitals and health centres across the country. Additionally, the Ministry of Health also provides point of care testing to the rest of the health centres and some health posts as part of the National Biomedical Laboratory Strategic Plan 20182022. The country has also put in place systems to monitor the environment.

Ghana launched its National Action Plan in 2017, which will ensure collaboration between various ministries. The policy and action plan regulates efforts to improve awareness and knowledge of AMR; provide evidence-based knowledge to reduce the burden of AMR; reduce the occurrence of infections in establishments; optimise the use of antimicrobials in animal and human health; and, create an enabling environment for sustainable investment in AMR reduction. To back the implementation of the AMR policy, President Nana Akufo-Addo has asked the Ministry of Health and the Attorney-General Department to move selected aspects of the policy into legislation. Some of the features in the policy could become legislation and this may include rules regarding prescribing of antibiotics and good laboratory practices and restricting the use of antibiotics in animal husbandry. This action according to Angela Ama Ackon, deputy director, Ministry of Health is a display of high level of commitment by the government to combat the threat of AMR in the country.

THE INTERAGENCY COORDINATION Group (IACG) on Antimicrobial Resistance was set up in 2016 by the UN to formulate a blueprint to fight against antimicrobial resistance. It recommended a “One Health” response in April 2019 to deal with the problem. One Health approach keeps humans, animals, the foodchain, the environment, and the inter-connectedness between

fight against AMR. In September 2019, India joined the partnership that has 16 countries, the European Commission, two philanthropic foundations and four international organisations (as observers). The hub proposes to develop a dynamic dashboard, establish operational activities and procedures and engage experts in ad-hoc expert advisory groups to understand the range of R&D incentives and gaps in the incentive toolbox.

In June 2019, FAO, OIE and WHO launched the AMR Multi-Partner Trust Fund to scale up efforts to support countries to counter the threat of AMR. The AMR Trust Fund has a five-year scope (through 2024) and has received an initial contribution of US $5 million from the Government of the Netherlands. The immediate funding requirement is US $70 million, which will provide technical support to countries designing NAPs and scale up local action.

To achieve this countries could also modify their NAPs based on learnings from within and outside the country. The Centre for Science and Environment, a New Delhibased non-profit, is working with the Zambian government to improve implementation of their NAP. It has helped the country to reprioritise NAP based on current ground level scenario, implementation progress and available resources. It also provides an understanding of how each sector—human health, animal and environment—perceive each activity and what timeline each would prefer to implement them. The two stakeholders have also worked on AMR surveillance.

A five-year roadmap to phase-out antibiotic misuse in food-animal sector, particularly non-therapeutic antibiotic use and use of critically important antibiotics in therapeutic applications has been developed as well.

EVIDENCE OF THE rampant misuse of antibiotics is overwhelming. The question is how to ensure that medical practitioners and people know what is “right” for their health. We should ensure that doctors do