Parallel Session 3.2

AMR Gap Implementation in Country

2 February 2018

13:00 - 15:00 hrs




Antimicrobial resistance (AMR) is a major threat to global health and the world economy, and poses a unique challenge to humanity. All countries – regardless of their economic situation, the strength of their health systems or the level of antibiotic consumption – will face disastrous consequences if the spread of AMR is not contained.  Global and community solutions are needed to prevent overuse of antibiotics; ensure that all people, regardless of where they live, have access to the antimicrobials they need; and to find new vaccines, diagnostic tests and, above all, antibiotics that are affordable and effective against drug-resistant diseases.  

AMR occurs when disease-causing pathogens (including bacteria, fungi, parasites, or viruses) develop defense mechanisms to the drugs designed to treat them making these resistant pathogens difficult or even impossible to treat. This resistance is the inevitable result of antimicrobial use and an example of natural selection in practice. The more antimicrobials are used, the less effective they become.  Rising levels of AMR are a sign that natural selection is taking place more rapidly than innovation in developing new antimicrobials.  If this is to be reversed, the world must innovate more, but also slow natural selection – by eliminating excess use of all antimicrobials; only using second- and third-level treatments when absolutely necessary; and ensuring appropriate access to treatments.  

The importance for countries to develop and implement national action plans
Developing national action plans (NAPs) is an essential first step for countries to establish an effective response to combat AMR.  At the Sixty-eighth WHA in 2015, Member States committed to have NAPs in place by May 2017.  In February 2016, WHO, in collaboration with FAO and OIE, developed a manual for developing NAPs on AMR and a set of accompanying tools. The three organizations have been working closely with stakeholders to provide technical support to countries for the effective development of their NAPs.  

Moving from planning to implementation
Ensuring political commitment, engagement and support has been a challenge as understanding of AMR and the importance of developing and implementing NAPs is still somewhat limited.  The identification of best practices continues to play an important role as the world is still learning what works best in particular contexts and WHO is sharing expertise and developing communities of practice to support countries with ongoing efforts.  Inter-sectoral action, and the complexity of coordination within and across sectors, continues to be a challenge, particularly as countries shift towards NAP implementation.    

Global Action Plan for Antimicrobial Resistance 
At the Sixty-Eighth World Health Assembly in May 2015, WHO Member States endorsed a global action plan through resolution WHA68.7 to tackle antimicrobial resistance, including antibiotic resistance, the most urgent drug resistance trend. 
The AMR global action plan contains five major strategic objectives:

  1. to improve awareness and understanding of antimicrobial resistance;
  2. to strengthen knowledge through surveillance and research;
  3. to reduce the incidence of infection;
  4. to optimize the use of antimicrobial agents; and
  5. to develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.

The global action plan, which takes into account the commitment, perspectives and roles of all relevant stakeholders is a plan in which everyone has clear and shared ownership and responsibilities. The endorsement of the plan reflects a global consensus that AMR poses a profound threat to human health.

One Health Approach 
Addressing the rising threat of AMR requires a holistic and multisectoral (One Health) approach because antimicrobials used to treat various infectious diseases in animals may be the same as or similar to those used in humans. Resistant bacteria arising in humans, animals or the environment may spread from one to the other, and from one country to another. One Health recognizes that the health of humans, animals and ecosystems are interconnected. It involves applying a coordinated, collaborative, multidisciplinary and cross-sectoral approach. 

The WHO, FAO and OIE speak with one voice and take collective action to minimize the emergence and spread of AMR. The aim is to:

  • Ensure that antimicrobial agents continue to be effective and useful to cure diseases in humans and animals;
  • Promote prudent and responsible use of antimicrobial agents;
  • Ensure global access to medicines of good quality.


  • Arrive at a better understanding of how the world can move from the planning phase to the operationalization phase in addressing AMR and ensuring behavior change – meaningful action in countries
  • What are the context specific needs of countries in implementing their national action plans for AMR and how can specific gaps in capacity be identified?
  • How can the specific needs of marginalized and vulnerable groups be effectively considered?
  • What can the international community and development partners do to assist countries in addressing specific gaps in capacity and moving toward implementation of their national action plans for AMR? 
  • What innovative all of society approaches can be considered and applied?
  • How can AMR national action plan implementation best be linked to SDG implementation?
  • What is the economic impact analysis or business case promoting GAP implementation in country?


Martha Gyansa-Lutterodt

Chief Pharmacist




Michel Roy

Secretary General

CARITAS International


Hajime Inoue

Senior Advisor to the Director General, Special Representative of the Director General on AMR

World Health Organization


Juan Lubroth

Chief Veterinary Officer

Food and Agriculture Organization of the United Nations


Matthew Stone

Deputy Director General

World Organisation for Animal Health


Judith Shamian

Former President

International Council of Nurses


Marco Marzano de Marnis

Secretary General

World Farmers Assocation