Multidisciplinary and multisectoral coalitions as catalysts for action against antimicrobial resistance: Implementation experiences at national and regional levels

Abstract

The multi-faceted complexities of antimicrobial resistance (AMR) require consistent action, a multidisciplinary approach, and long-term political commitment. Building coalitions can amplify stakeholder efforts to carry out effective AMR prevention and control strategies. We have developed and implemented an approach to help local stakeholders kick-start the coalition-building process. The five-step process is to (1) mobilise support, (2) understand the local situation, (3) develop an action plan, (4) implement the plan, and (5) monitor and evaluate. We first piloted the approach in Zambia in 2004, then used the lessons learned to expand it for use in Ethiopia and Namibia and to the regional level through the Ecumenical Pharmaceutical Network [EPN]. Call-to-action declarations and workshops helped promote a shared vision, resulting in the development of national AMR action plans, revision of university curricula to incorporate relevant topics, infection control activities, engagement with journalists from various mass media outlets, and strengthening of drug quality assurance systems. Our experience with the coalition-building approach in Ethiopia, Namibia, Zambia, and with the EPN shows that coalitions can form in a variety of ways with many different stakeholders, including government, academia, and faith-based organisations, to organise actions to preserve the effectiveness of existing antimicrobials and contain AMR.

An analysis of national action plans on antimicrobial resistance in Southeast Asia using a governance framework approach

“…AMR is a contested space where actors with distinct values present their version of the problem, resulting in different possible solutions [22] . Evidence shows that while endorsement from WHO created an initial momentum for development of AMR related call-to-action documents, collaborations were hard to sustain, for they were reliant on voluntary partnerships [23] . Lack of robust evidence regarding the political and economic context for coordinated and effective policy development has further complicated AMR policy formulation and implementation [24] .…”

A model to strengthen utility of quality pharmaceutical health systems data in resource-limited settings

“…14,15 Implementation and surveillance of national PIS in resource-limited countries such as Namibia is largely donor-supported; this is not sustainable in terms of quality. 16,17 Thus, it is not surprising that limited utility of quality PIS data remains an important bottleneck to healthcare delivery in these settings in public healthcare. 18,19 Previously, the authors have described challenges with quality and utility of PIS data and indicators, as well as misalignment of PIS indicators with National Standard Treatment Guidelines (NSTGs) for Namibia implemented in 2011.…”

COVID-19 resilient pharmacy education: A grassroots work-integrated programme to strengthen the pharmaceutical workforce in Namibia

“…is partly due to a shortage of skilled pharmaceutical workforce in these settings, as well as the high disease burden and patient overload in the public sector which limits pharmacists to dispensing roles (Bates et al, 2016;Joshi et al, 2018). Similarly, the COVID-19 pandemic has caused a paradigm shift in pharmacy education in developed countries particularly in experiential learning.…”

“…The continued, chronic need for pharmaceutical personnel in Namibia negatively impacts service delivery (Rennie & Hunter, 2020). During the needs-analysis for the diploma programme, various stakeholders, including Health Professions Council of Namibia, Ministry of Health and Social Services (MoHSS), Pharmaceutical Society of Namibia and pharmacy practice sector expressed the need for a mid-level pharmacy cadre to bridge current gaps (Kibuule et al, 2017;Koehler & Brown, 2017;Joshi et al, 2018;Rennie et al, 2019).…”