In 2015 the World Health Assembly endorsed the Global action plan on antimicrobial resistance calling on countries to develop and implement national action plans on antimicrobial resistance (AMR). For most countries, the greatest challenge is not developing a national action plan; rather, it is the implementation of the plan based on evidence-based prioritization of activities, systematic monitoring of progress, and ensuring sustainability of efforts. The purpose of this publication is to to provide a practical, stepwise approach to the implementation of the national action plan on AMR within the human health sector; and to provide a process and collation of existing WHO tools to prioritize, cost, implement, monitor and evaluate national action plan activities. The target audience of the publication are national/subnational stakeholders working on AMR within the human health sector. This includes national health authorities, national multisectoral coordination groups, senior technical experts and policymakers involved in implementing AMR activities at all levels of the health system, and implementation partners to accelerate sustainable implementation and monitoring and evaluation of national action plans on AMR.

"This manual for developing national action plans to address antimicrobial resistance has been developed at the request of the World Health Assembly to assist countries in the initial phase of developing new, or refining existing national action plans in line with the strategic objectives of the Global Action Plan. It proposes an incremental approach that countries can adapt to the specific needs, circumstances and available resources of each individual country. Details of actions to be taken will vary according to national contexts. A series of supporting tools have also been developed by WHO, in collaboration with FAO and OIE, to accompany this manual. These include sample terms of reference for suggested coordination mechanisms, a generic template for a national action plan, a sample plan for monitoring and evaluation, and a checklist. Other tools will be added as the needs arise. It is expected that countries' experiences in developing national action plans, particularly during the initial phase in 2016, will become a valuable source in helping to refine and adapt this manual. It is therefore anticipated that this manual will be revised in 2017 in order to reflect this experience and better serve the needs of countries."--Page 1.

This document outlines the concept and content of the WHO people-centred approach to addressing antimicrobial resistance (AMR) in the human health sector. The proposed approach recognizes and aims to address the challenges and health system barriers people face when accessing health services to prevent, diagnose and treat (drug-resistant) infections. It puts people and their needs at the centre of the AMR response and guides policy-makers in taking programmatic and comprehensive actions to mitigate AMR in line with a proposed package of core interventions. These interventions are based on a review of four pillars and two foundational steps that are critical to overcome barriers faced by people and health systems in addressing AMR. The four pillars are: (1) prevention of infections; (2) access to essential health services; (3) timely, accurate diagnosis; and (4) appropriate, quality-assured treatment. The pillars are supported by the two foundational steps: effective governance, awareness and education; and strategic information through surveillance and research. Building and adding on to the objectives of the Global action plan on AMR, the 13 core interventions and accompanying priority actions are designed to address AMR in a programmatic manner that puts people, their needs and equitable access to health services at the centre of the AMR response in the community, in primary care, secondary and tertiary care, and at national and/or subnational level. The development of the people-centred core package of AMR interventions was based on a review of the evidence and multidisciplinary expert opinion, complemented with feedback from a global online consultation and WHO’s strategic and technical advisory group on antimicrobial resistance. As countries develop or revise their national action plans (NAPs) on AMR, the people-centred core package of interventions can support the design and prioritization of actions in the human health sector at the different levels of implementation and integrated with broader health system strengthening and pandemic preparedness and response plans.

In 2015 the World Health Assembly endorsed the Global action plan on antimicrobial resistance (GAP-AMR) calling on countries to develop, implement and monitor national action plans on AMR. In 2019, FAO, WHO and WOAH developed a monitoring and evaluation (M&E) framework for the GAP-AMRto track progress towards the plan’s five global objectives, designed with a One Health perspective and reflecting the cross-sectoral nature of AMR with indicators across human and animal health, plant and food production and the environment. Countries are expected to develop an M&E plan for their NAP, tailored to their context and priorities. This includes developing indicators appropriate to the country’s own circumstances, aligned with the proposed core indicators of the GAP-AMR M&E framework, as far as possible. This country M&E guidance document was developed as a reference for countries to support the development and delivery of AMR NAPs. It provides assistance on how to establish an M&E plan for their AMR NAP, building on existing national reporting systems and recommended indicators from the GAP-AMR M&E framework.