On 29 February 2024 the World Health Organization (WHO), Indonesian Ministry of Health and key partners such as the Asia-Europe Foundation concluded a series of workshops aimed at developing the world’s first human health sector-specific national action plan to address antimicrobial resistance (AMR) based on the WHO people-centred approach.
AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. In 2019 there were an estimated 4.95 million deaths globally associated with bacterial AMR, including 1.27 million deaths that were directly attributable to bacterial AMR.
Indonesia is especially at risk and is among five countries globally with the highest projected percentage increase in antimicrobial consumption by 2030. The World Bank estimates that AMR could result in US$ 1 trillion additional healthcare costs globally by 2050, with disproportionate impact in low- and middle-income countries, including Indonesia.
“Addressing AMR requires shifting the focus onto people and their health needs. For us to be effective in our efforts, we need greater understanding of the broader health system challenges at all levels of care,” said Dr Yanti Herman, Director of Health Quality Service, Ministry of Health, Government of Indonesia. “A sector-specific, action-oriented framework that recognizes the value of working together is important to prioritize, implement and monitor AMR interventions in the human health sector.”
The WHO and partner-supported workshops, held on 29–30 January and 26–29 February, aimed to translate WHO’s new people-centred core package of 13 interventions for addressing AMR in human health into an Indonesia-specific national health sector action plan.
The workshops included participants from the Ministry of Health and other key ministries and institutions, the National AMR Committee, the Indonesian Food and Drug Authority, professional societies, academia, civil society organizations, patient survivors and national and international partners.
At the January workshop, participants engaged in a series of thematic discussions, with a focus on identifying context-specific priorities and goals based on the WHO core package of 13 interventions. At the February workshop, participants considered how best to monitor and evaluate progress, and developed a detailed, fully costed plan for implementation.
“Since 2017 Indonesia has been implementing a national multisectoral action plan to address AMR, achieving significant progress, particularly in strengthening multisectoral coordination, policies and regulations, increasing advocacy and awareness, and generating high-quality, Indonesia-specific data and evidence,” said WHO Representative to Indonesia, Dr N Paranietharan.
“However, globally, there is an urgent need for more targeted action within the health sector, putting patients at the centre, prioritizing people’s needs and values, and ensuring equitable access in the design and delivery of health care services. Indonesia has pro-actively responded to this need and is now in the final stages of developing the world’s first fully costed, people-centred human health sector plan to address AMR based on our new WHO guidance – a tremendous achievement.”
The WHO core package of 13 interventions was launched in October 2023 and takes a people-centred approach to addressing AMR in human health, highlighting the critical importance of equitable and affordable access to quality health services for the prevention, diagnosis and treatment of drug-resistant infections, referred to as the “AMR people journey”. The package builds on the 2015 Global Action Plan on AMR and directly responds to country-level challenges, including implementation in hard-to-reach health care facilities, which is especially important in Indonesia.
Once launched, Indonesia’s human health sector plan to address AMR will be integrated into the country’s national health transformation agenda, including efforts to strengthen primary health care and build health system resilience and emergency preparedness and response capacities. It will complement ongoing One Health action to address AMR at the human-animal-environment interface and will also feed into the review and update of Indonesia’s multisectoral national action plan on AMR, set to occur this year.
Financial support was provided by the Asia-Europe Foundation, the Kingdom of Saudi Arabia and the UK Department of Health and Social Care’s Fleming Fund using UK Aid.