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Review
. 2020 Apr;5(4):e002418.
doi: 10.1136/bmjgh-2020-002418.

Antimicrobial resistance in the Pacific Island countries and territories

Michael Loftus  1 , Andrew Stewardson  2 , Ravi Naidu  3 , Ben Coghlan  4 , Adam Jenney  2   5 , Jonila Kepas  6 , Evelyn Lavu  7 , Alex Munamua  8 , Trisha Peel  2 , Vinita Sahai  3 , Rosemary Tekoaua  9 , Litia Tudravu  3 , Julie Zinihite  10 , Allen Cheng  2   11 , Eric Rafai  12 , Anton Peleg  1   13
Affiliations
Review

Antimicrobial resistance in the Pacific Island countries and territories

Michael Loftus et al. BMJ Glob Health. 2020 Apr.

Abstract

Antimicrobial resistance (AMR) is a critical global health threat with a disproportionate impact on low-income and middle-income countries (LMICs) due to their higher burden of infections, reduced laboratory surveillance infrastructure and fewer regulations governing antimicrobial use among humans or animals. While there have been increasing descriptions of AMR within many LMICs in WHO's Western Pacific and South East Asian regions, there remains a paucity of data from Pacific Island countries and territories (PICTs). The PICTs represent 22 predominantly middle-income countries and territories with a combined population of 12 million people and 20 official languages, spread over hundreds of separate islands spanning an area corresponding to more than 15% of the earth's surface. Our paper outlines the present state of the evidence regarding AMR in PICTs-discussing the present estimates of AMR and their accompanying limitations, important drivers of AMR, as well as outlining key priorities and potential solutions for tackling AMR in this region. Significant areas for action include developing National Action Plans, strengthening laboratory surveillance systems and educational activities targeted at both healthcare workers and the wider community. Ensuring adequate funding for AMR activities in PICTs is challenging given competing health and environmental priorities, in this context global or regional funding initiatives such as the Fleming Fund can play a key role.

Keywords: antimicrobial resistance; antimicrobial stewardship; antimicrobial use; pacific island countries and territories; surveillance.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Map of Pacific Island countries and territories, Australia and New Zealand. Australia and New Zealand are not PICTs. Source: Shutterstock/frees. Reproduced with permission of Shutterstock. PICTs, Pacific Island countries and territories; W&F, Wallis and Futuna.
Figure 2
Figure 2
Drivers of and potential solutions for antimicrobial resistance (AMR) in Pacific Island countries and territories (PICTs).
See this image and copyright information in PMC

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