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. 2020 Jul;5(7):e002427.
doi: 10.1136/bmjgh-2020-002427.

National action to combat AMR: a One-Health approach to assess policy priorities in action plans

Anju Ogyu  1 , Olivia Chan  2 , Jasper Littmann  3 , Herbert H Pang  2 , Xia Lining  4 , Ping Liu  2 , Nobuaki Matsunaga  5 , Norio Ohmagari  5 , Keiji Fukuda  2 , Didier Wernli  2   6
Affiliations

National action to combat AMR: a One-Health approach to assess policy priorities in action plans

Anju Ogyu et al. BMJ Glob Health. 2020 Jul.

Abstract

Little is known about the overall trend and prioritisations of past and current antimicrobial resistance (AMR) policies. Here we introduce a quantitative method to analyse AMR policies. The AMR-Policy Analysis Coding Toolkit (AMR-PACT) uses several categorical variables. Thirteen AMR action plans from five countries (China, Japan, Norway, the UK and the USA) were used to develop the tool and identify possible values for each variable. The scope and capability of AMR-PACT is demonstrated through the 2015 WHO's Global Action Plan and 2017 Hong Kong AMR Action Plan (HKAP). Majority of policies were aimed at either human or animal sector with less attention given to the environment, plant or food sector. Both plans shared the same two strategic focus areas, namely the conservation of antibiotics and the improved surveillance of resistance. There were no policies dedicated to improving access to antibiotics in the HKAP. These empirical results provide useful insights into the priorities and gaps of AMR policies. The method proposed here can help understand countries' priorities regarding AMR, support the creation of AMR policy database and foster innovative policymaking.

Keywords: health policy; medical microbiology; other study design.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Steps taken in the analysis of AMR policies within policy documents. AMR, antimicrobial resistance; AMR-PACT, AMR-Policy Analysis Coding Toolkit.
Figure 2
Figure 2
(A) The 22-digit coding string is used to store the coder-selected variables which best describes the content of policy statements. (B) The policy document is cleaned and given a hierarchical numbering system to ensure relationships between statements are retained within the database and during query. The smallest units of each heading are coded.
Figure 3
Figure 3
The six challenges of AMR addressed in each of the objectives (GAP) and KAs (HKAP). KAs were arranged in order of the corresponding GAP objectives. Objective 5 in the GAP and KA 5 and 6 in the HKAP did not correspond. Results of coding of statements under ‘strategic objectives’ and ‘framework for action on antimicrobial resistance’ was combined for each objective. AMR, antimicrobial resistance; GAP, Global Action Plan; HKAP, Hong Kong AMR Action Plan; KAs, key areas.
Figure 4
Figure 4
Use of policy instruments in different sectors and challenge of AMR within the GAP and HKAP. AMR, antimicrobial resistance; GAP, Global Action Plan; HKAP, Hong Kong AMR Action Plan.
See this image and copyright information in PMC

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