Combating antimicrobial resistance: collaboration in the Western Pacific

Antimicrobial resistance (AMR) is when bacteria, viruses, fungi and parasites evade the effects of medicines that once effectively treated them. Overuse and misuse of antimicrobials are driving the rise of AMR, which has been identified by the World Health Organization (WHO) as one of the top 10 global health threats.

In the WHO Western Pacific Region alone, drug-resistant infections are projected to cause up to 5.2 million deaths at a cost of as much as US$ 148 billion between 2020 and 2030. "AMR is among the greatest challenges we are facing," said Dr Saia Ma'u Piukala, WHO Regional Director for the Western Pacific. "It threatens not only human health and health security but also global and national economies."

Sustained commitment and collaboration are essential in the fight against AMR. Working closely with countries, and supported by the Fleming Fund and other partners, WHO is leading efforts to implement strategic frameworks and empower Member States to build resilient and sustainable systems for detecting, tracking and responding to AMR.

The work of the WHO Regional Office for the Western Pacific to tackle AMR is guided by the Framework for Accelerating Action to Fight Antimicrobial Resistance in the Western Pacific Region, which was endorsed by Member States in 2019. Operational guidance has been developed to put the framework into practice and the AMR team conducts on-the-ground missions tailored to local contexts to strengthen key components of the AMR response.

Strengthening AMR surveillance systems

Monitoring and tracking drug-resistant pathogens through robust surveillance systems is essential in the fight against AMR. Recognizing this need, WHO, in collaboration with the WHO Collaborating Centre for AMR at the University of Melbourne, released the Guidance on establishing national and local AMR surveillance systems in the Western Pacific Region in February 2024. This resource presents countries with a step-by-step approach to establishing national AMR surveillance systems and provides guidance on strengthening surveillance in hospitals.

In response to requests from ministries of health, WHO deploys expert teams to Member States to develop and strengthen sustainable AMR surveillance systems based on this guidance, while Fleming Fund beneficiary countries receive on-the-ground support, for example, to strengthen microbiological testing and AMR surveillance data management.

Many countries have benefited from WHO missions, including Brunei Darussalam, Cambodia, Fiji, the Lao People's Democratic Republic, Malaysia, Mongolia, Papua New Guinea, the Philippines and Samoa. Follow-up actions and visits are designed to respond to specific country needs. For example, following WHO missions to Cambodia in 2023, the Ministry of Health published its second annual AMR surveillance bulletin and updated its national AMR surveillance guidance.

Building capacity to prevent, prepare and respond to AMR outbreaks in hospitals

Swift detection and response to AMR outbreaks in hospitals are critical for controlling the spread of drug-resistant pathogens. In 2022, WHO, in collaboration with the University of Melbourne, developed the guidance document Responding to outbreaks of antimicrobial-resistant pathogens in health-care facilities: guidance for the Western Pacific.

In collaboration with ministries of health, WHO has supported train-the-trainer capacity-building workshops in Brunei Darussalam, Cambodia, Fiji, Malaysia, Mongolia, the Philippines and Samoa, training multidisciplinary teams on prevention, preparedness and management of outbreaks of AMR pathogens in hospital settings. At the end of each workshop, each health-care facility developed its own tailored action plan, detailing steps to cascade training and strengthen capacity to respond to outbreaks of AMR pathogens in their hospital.

In Malaysia, following a national outbreak response training workshop, experts led subnational training in all six regions of the country, strengthening preparedness for AMR outbreaks in health-care facilities across Malaysia. This cascading of knowledge demonstrates the importance of WHO's partnership with Member States, by ensuring that skills are institutionalized for lasting impact.

Looking ahead: local solutions to a global crisis

By advancing AMR interventions in the Western Pacific Region, strengthening national surveillance and laboratory systems, and contributing to the global effort to preserve the efficacy of antimicrobial drugs for future generations, WHO, supported by the Fleming Fund and other partners, is demonstrating that a coordinated, multisectoral approach and practical, context-specific solutions can enhance countries' capacities to address AMR and protect their communities from the devastating impacts of AMR now and in the future.

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