Background
The Asia-Europe Foundation Public Health Network (ASEF PHN) has been supporting the efforts of the World Health Organization (WHO) to address the growing challenge of antimicrobial resistance (AMR) in all Asia-Europe Meeting (ASEM) Partners and beyond by targeting core AMR interventions that strengthen health systems towards a primary health care approach (PHC). Most health systems were built on the assumption that effective and affordable antimicrobials would be readily available. An increasing incidence of AMR means that the effectiveness of antimicrobials is no longer guaranteed, threatening health systems. The elements necessary for effectively tackling AMR – such as effective infection prevention and control, surveillance of AMR and Antimicrobial use (AMU), microbiology labs, timely diagnosis, rational use of medicines, training for the health workforce, community engagement and the capacity to develop and produce new therapeutic agents – are also valuable in the context of enhancing Pandemic Preparedness and Response (PPR) capacities that contribute to global health security.
Primary health care (PHC) plays a crucial role in addressing AMR as it involves the whole continuum of care, works across sectors and empowers individuals and communities. Primary care and the essential public health functions are a core component of the PHC approach; this is key to addressing AMR as most patient interactions occur at the primary care level, and 80% of antibiotics are prescribed at the primary care level. Even though AMR is a natural phenomenon, its emergence and spread are accelerated by the inappropriate use of antimicrobial medicines, weak infection prevention measures, inadequate WASH facilities in health care facilities, low levels of awareness, etc. Strengthening health systems towards a PHC approach to prevent and mitigate AMR is therefore crucial in addressing AMR.
For a sustainable and comprehensive response to AMR, it is essential to link/mainstream core AMR interventions at the country level more firmly with health systems strengthening efforts including to achieve UHC through the PHC approach and building capacity for pandemic preparedness and response efforts. Mainstreaming AMR requires a shift from addressing AMR as purely a biological phenomenon and instead placing the barriers faced by people and health system challenges at the centre of the AMR response.
The WHO core package of AMR interventions based on WHO’s people-centred approach (AMR PCA) provides guidance for countries to consider interventions that strengthen their health systems at all levels, including in primary care. In line with the WHO Operational Framework for PHC these interventions cover multisectoral policy and actions (national/subnational level), primary care and essential public health functions (facility level), and empowering people and communities.
The core AMR interventions for inclusion in primary care include: awareness and education, community engagement, infection prevention and control (IPC), water, sanitation and hygiene (WASH), immunization, AMR diagnostics, appropriate use of antibiotics and adoption of the WHO AWaRe antibiotic book, regulations on over-the-counter sales of antibiotics, and health information systems.
Meeting objectives
The planned meeting, organized in close partnership with WHO, and the Government of Thailand will provide an opportunity for the national focal points for AMR and PHC from countries to work together to strengthen their health systems’ orientation towards a PHC approach, with a focus on services provided at the primary care level while also addressing AMR. The primary goal of this multi-country meeting is to promote actions against AMR at the primary care level by sharing the best practices and lessons learned from a multi-country validation project. This project, led by WHO and supported by ASEF, was implemented over the course of 2023 and 2024 in four selected ASEM Partners: Indonesia, Thailand, Kazakhstan, and Sweden. The project aimed to test the use of WHO’s People-centred approach (AMR PCA) across Asia and Europe. The practical lessons identified from the implementation of AMR PCA in the four pilot countries will provide valuable insights for other ASEM partners to consider when planning strategies to address AMR in their countries.
More specifically the meeting aims to:
- Highlight key AMR interventions and priority actions relevant for primary care level implementation and discuss specific action steps that can be considered at national level, community level and at primary care facility level;
- Share the challenges, opportunities, best practices, lessons learned and step-by-step approaches based on different country contexts;
- Introduce practical guidance and tools for countries to perform a scoping exercise in identifying opportunities in their countries to strengthen the integration of AMR interventions into PHC facilities, plans and strategies;
- Provide entry points for action with regards to addressing inequalities – gender, equity, disability inclusion.
- Foster essential collaborations among stakeholders to effectively integrate AMR interventions into PHC.
Target Audience
National AMR and PHC focal points
Attendance for this meeting is strictly by invitation only.
