Progress on the national action plan of Pakistan on antimicrobial resistance (AMR): a narrative review and the implications

ABSTRACT

Introduction

The emergence of antimicrobial resistance (AMR) is a threat to public health. In 2015, the World Health Organization (WHO) introduced a global action plan to tackle AMR in the World Health Assembly. Pakistan’s national action plan (NAP) for AMR was released in May 2017 by the Ministry of National Health Services. Based on the NAP, strategies have been initiated on a national and provincial scale in Pakistan.

Areas covered

This narrative review of the five components of the Pakistan NAP has been undertaken to discuss some of the challenges in implementation of the NAP for AMR in Pakistan including different opinions and views of key stakeholders, combined with suggestions on potential ways to reduce the burden of the AMR.

Expert opinion

Going forward, healthcare authorities should focus on screening and monitoring of all the objectives of the NAP by establishing proper policies as well as promoting antimicrobial stewardship interventions and Infection prevention and control (IPC) practices. Overall, the comprehensive strengthening of the healthcare system is required to adequately implement the NAP, tackle continued inappropriate antimicrobial use and high AMR rates in Pakistan.

KEYWORDS:

• Antimicrobial resistance
• antimicrobial utilization
• antimicrobial surveillance. antimicrobial stewardship
• national action plan
• pakistan

Article highlights

• There are many challenges to the implementation of the National Action Plan (NAP) for antimicrobial resistance (AMR). Concerns include the lack of the diagnostic facilities and financial resources combined with continued excessive use of antimicrobials as prophylaxis in hospitalized patients and their sale without prescription at the community level.

• Healthcare authorities should focus on screening and monitoring of all the objectives of the NAP through establishing proper policies as well as promoting antimicrobial stewardship interventions and IPC practices.

• The comprehensive strengthening of the healthcare system is required to adequately implement the NAP.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author’s Contributions

All authors have substantially contributed to the conception and design of the review article and interpreting the relevant literature and been involved in writing the review article or revised it for intellectual content.

Additional information

Funding

This paper was not funded.