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Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map

Van Katwyk, S. R.; Grimshaw, J. M.; et al (2019) C2

BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans. METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review. CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published. more

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Young doctors’ perspectives on antibiotic use and resistance: a multinational and inter-specialty cross-sectional European Society of Clinical Microbiology and Infectious Diseases (ESCMID) survey

Beovic B., M. Dousak, C. Pulcini et al. Oxford University Press (2019) C2

Antibiotic resistance has been recognized as a major global health threat and optimizing prescribing is one of the most effective measures to preserve the effectiveness of antibiotics. The quality of prescribing depends mostly on those prescribers belonging to clinical medical specialties... more

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Antimicrobial resistance and causes of non-prudent use of antibiotics in human medicine in the EU

European Commission (2017) C1

Antimicrobial resistance (AMR) is an increasing worldwide public health problem with important implications for the European Union (EU). When antibiotics become ineffective, bacterial infections lead to increased morbidity, use of healthcare, mortality and cost. Globally, estimates suggest that ... more

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Belgian Antibiotic Policy Coordination Committee Policy paper for the 2014-2019 term

Erica Balligand, Michiel Costers and Evelyne Van Gastel Belgian Antibiotic Policy Coordination Committee (2014) C2

Antimicrobial resistance represents a big threat to public health. The Centers for Disease Control and Prevention (CDC) estimate that every year two million Americans are infected with a (multi-)drug resistant bacterium, resulting in 23,000 deaths. The WHO has repeatedly drawn attention to this majo... more

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Situational Brief: Impact of Covid-19 on forcibly displaced persons inside Syria

Marzouk M., Rayes D., Y. Douedari et al. Lancet Migration (2020) CC

Over nine years of protracted and violent conflict in Syria has decimated its health system,killed an estimated 586,000 people and forcibly displaced more than half the 22 million pre-war population from their homes. As of June 2020, a total of 6.2 million Syrians (of whom 40% are children) are inte... more

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Nigeria: Yellow Fever DREF Operation n° MDRNG031 Final Report

The International Federation of Red Cross and Red Crescent Societies IFRC (2021) CC

The Nigeria Centre for Disease Control (NCDC) declared a Yellow Fever (YF) outbreak and activated a multi-sectoral Emergency Operations Centre for coordination of Yellow Fever response on 12 November 2020. The outbreak, which mainly affected three states of Delta, Enugu and Bauchi, already recorded ... more

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Powering Healthcare Solutions Catalogue

Sustainable Energy for All; The World Bank; ESMAP (2020) CC

This catalogue serves the purpose of connecting stakeholders from the energy and health sectors with solutions providers, to help meet the energy needs of healthcare facilities in response to COVID-19 and beyond. The solutions provided herein represent a sample of a larger group of solution prov... more

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Guidelines for the use of antimicrobials in the South African pig industry

Pig Veterinary Society of the South African Veterinary Association (2016) C2

Antimicrobial resistance(AMR) poses a serious threat to human, animal and environmental health. Implementing ethical practice guidelines on how to use antimicrobials effectively and responsibly within the pig industry will contribute in reducing and preventing antimicro... more

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Checklist to ensure the meaningful engagement of young persons with disabilities in humanitarian action

UN Youth Office; United Nations Population Fund (2023) CC

After the earthquake in Türkiye-Syria in February 2023 an emergency response was provided to the affected population. Young persons with disabilities were one of the social groups most affected by the crisis. These were either young persons who acquired a disability due to the earthquake, or young ... more

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Responses of the Catholic Church to HIV and AIDS in Africa: Lessons learned. Summary

Fleischer, K. et al. German Bishops' Conference Research Group on International Church Affairs (2015) CC

An international field study by African and German Theologicans and health workers

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Protocolo de manjeno clinico do Coronavirus (COVID-19) na atencao primaria a saude (Versao 7)

Secretaria de Atencao Primaria Saude (SAPS) Ministerio da Saude Brasilia (2020) CC

Coronavirus Clinical Management Protocol (COVID-19) in Primary Health Care (Version 7)

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Where women have no doctor: Chapter 29: Refugees and Displaced Women

Hesperian (2014) C1

Chapter 29: Refugees and Displaced Women: Flight and Arrival, Basic Needs, Reproductive Health, Mental Health, Women as Leaders

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Safe Reopening of Borders to Save Lives, Economies and Livelihoods in Africa

African Union; Africa CDC Centres for Disease Control and Prevention; et al. (2021) C1

17 February 2021 During the second joint meeting of African ministers responsible for health, ICT and transport on the rollout of the Africa Against COVID-19: Saving Lives, Economies and Livelihoods campaign, a call was made to African countries to work together towards harmonizing travel entry and... more

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Youth-Friendly Services - A Manual for Service Providers

EngenderHealth (2002)

All young people, including those with special needs and from the most vulnerable groups, have the right to quality health care services. Unfortunately, this right is not a reality, particularly in the case of sexual and reproductive health services. Many youth in need of sexual and reproductive hea... more

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2021 Malawi Sustainability Index and Dashboard Summary

2021 Malawi Sustainability Index and Dashboard Summary (2021) CC2

The HIV/AIDS Sustainability Index Dashboard is a tool completed every two years by President’s Emergency Plan for AIDS Relief (PEPFAR) teams, host government and partner stakeholders to sharpen the understanding of each country’s sustainability landscape and to assist PEPFAR and other donors in ... more

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COVID-19 Resource and Information Guide

National Alliance on Mental Illness (2020) C1

NAMI HelpLine Contents I’m having a lot of anxiety because of the coronavirus. Please help. I’m quarantined or working from home – lonely and isolated even further – what can I do? I don’t have health insurance or a regular doctor – how can I get care? What if I’m quarantin... more

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HIV in humanitarian emergencies

UNAIDS (2015) C2

Information Note 1 of every 22 people living with HIV was affected by a humanitarian emergency in 2013

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Mixed Migration Review 2021: Reframing human mobility in a changing world. Message Summary

Mixed Migration Centre (2021) CC

The global migration context is rapidly changing with new conflicts and coups, new public health threats, new levels of environmental stress and changing perceptions around human mobility. Against that backdrop, migration policies, actions and attitudes are becoming more and more extreme, according ... more

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USA National Action Plan for Combating Antibiotic Resistant Bacteria 2020-2025

U.S. Government (2020) C2

The National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), 2020-2025, presents coordinated, strategic actions that the United States Government will take in the next five years to improve the health and wellbeing of all Americans by changing the course of antibiotic resistance. T... more

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Bhutan: National Action Plan on Antimicrobial Resistance 2018 - 2022

Royal Government of Bhutan (2017) C2

Antimicrobial resistance has become one of the most eminent threats to global health and a rising concern for healthcare specialists. All around the world, many common infections are becoming resistant to the antimicrobial medicines used to treat them, resulting in high morbidity and mortality with ... more