On 11 April 2023, the research team led by Alvin Chua, Pami Shrestha and Helena Legido-Quigley, together with the Asia Pacific Observatory on Health Systems and Policies (APO) conducted a workshop/policy dialogue to discuss the development and implementation of the national action plan (NAP) on antimicrobial resistance (AMR) in a selection of Asian countries. The event provided an opportunity for participants to share and discuss (1) research findings from the individual country analyses of the NAPs, (2) lessons learnt and best practices in AMR management, (3) AMR research priorities, and (4) how to keep AMR in the political agenda.
The APO is a collaborative partnership of interested governments, international agencies, foundations, and researchers that promotes evidence-informed health system policy regionally and in all countries in the Asia Pacific region.
Members of APO’s NUS consortium, including SSHSPH, BRAC University, Duke Kunshan University, University of Hong Kong, and University of the Philippines, collaborated on this project. Selected participants including academics from each of the consortium partner institutions, and policymakers attended the event. Representation from SSHSPH included Prof Teo Yik Ying, Prof Helena Legido-Quigley, A/Prof Hsu Li Yang, A/Prof Natasha Howard, Pami Shrestha, Alvin Chua, Foo Chuan De, and Afifah Ismat Rahman-Shepherd.
Participants shared why it is important to have these policy dialogues.
Dr Nima explained, “In Asia, we often see a disconnect between researchers who work on health systems and policy makers who need to make decisions around health system. It is as though the two groups use the same the words but speak different languages. The answers that researchers give are not specific enough for policy makers and the questions that they ask often have too short a time frame to allow robust analysis. This is why there is a paramount need to bring together the two groups in formal and informal settings to increase understanding of the challenges that they both have and develop collaborative work that creates the necessary evidence for evidence informed policy making.”
A/Prof Hsu Li Yang highlighted, “AMR is a wicked problem that cannot be solved purely by technological advances. It is important to bring policymakers, stakeholders and researchers to the same table and I hope this will be the first of many such meetings supported by APO and our school.”
The programme started off with a series of presentations on research findings from each of the partner institutions in the morning.
Alvin presented the work done in Singapore and shared some areas that were well executed and areas that were lacking, as shared by the study participants. For the latter, some of these areas included a need for (1) better antimicrobial stewardship and legislation in some sectors such as the private hospitals, primary care, and animal health; (2) innovation on education for sustained behaviour changes toward antimicrobials; and (3) inclusion of certain sectors in the plan, including the media, primary care, and pharmaceutical industries.
Alvin also highlighted the need for a One Health approach when dealing with complex problems such as AMR. “Given that AMR is a One Health issue that affects humans, animals, and the environment, it is important to develop systems that move away from anthropocentrism which prioritises human beings as ‘morally superior to everything else in the natural order’, while focusing on the dynamic interaction where humans are an equal component in a reciprocal and symbiotic relationship with the rest of nature”, he says.
In addition to this, AMR research collaborations is Asia, faces multiple challenges such as the multidimensional nature of AMR, limited or lack of funds, different AMR research priorities in Asian countries, absence of Asia-centric AMR leadership, lack of trust and, unequal power relationships between researchers, and the negative impact of the COVID-19 pandemic in research collaborations; opportunities such as the willingness of researchers to collaborate, the formation of a few multi discipline networks, and the prioritization of the One Health paradigm for framing AMR research by many academics of are also present, as shared by Pami. She emphasises, “It is essential to build networks across disciplines of all stakeholders and countries in the region to develop an equitable collaborative partnership for effective AMR research and management in Asia.”
The morning presentations were followed by a roundtable discussion in the afternoon. Participants had the opportunity to contribute to the discussion and networking sessions during the programme.
Overall, the event was a successful one, with engaging discussions between researchers and policymakers. Participants talked about future action points for AMR policy and research priorities, how to keep AMR on the political agenda, as well as how researchers and policymakers can help each other further their work against AMR.