National Multisectoral Action Plan on antimicrobial resistance for Micronesia 2019-2023.

The National Multisectoral Action Plan on antimicrobial resistance is a national policy with a multi-sectoral approach. The timeframe of the policy is 5 years between 2019 and 2023. The purpose of this policy is to maintain a healthy population by ensuring the availability and accessibility of effective antimicrobials.
This policy lays down strategies to tackle the issues of overuse and misuse of antimicrobials in human and animal health and to prevent antimicrobial residues in the environment with the one-health approach, and to deliver an effective and sustainable response to antimicrobial resistance in Micronesia. The negative impact of antimicrobial resistance on health systems will be reduced, focusing on four main principles of the global action plan: whole-of-society engagement, prevention first, access to effective treatment, and sustainability. The participation of stakeholders from the four states, including private sectors and civil societies, will be promoted to address the growing threat of the development of AMR by an ever-increasing range of bacteria, parasites, virus and fungi. Antimicrobial Resistance Committee will be established at the national and state levels. In order to combat antimicrobial resistance, appropriate legislation will be enforced in all sectors and sustainable investment will be ensured. Furthermore, awareness and understanding of antimicrobial resistance will be improved across all institutions and sectors. More specifically, awareness of health-care workers and veterinarians on AMR will be raised and their skills will be improved. AMR, basic sanitation and hand hygiene will be integrated into education curriculum. Information on the incidence of AMR and use of antimicrobials will be shared between the institutions and sectors. A database will be developed for AMR reporting and analysis, and the electronic laboratory information system will be improved for reporting and surveillance and standard operating procedures will be improved for antibiotic testing and quality management system in all laboratories. A national AMR surveillance system will be developed with a reference laboratory and diagnostic capacity and research on antimicrobial resistance will be strengthened. Effective infection prevention and control measures will be implemented to reduce the incidence of antimicrobial resistance. The Water, Sanitation and Hygiene program will be carried out to promote safe water and hygiene practices at the community and national level. Food safety will be ensured by promoting good infection control and biosecurity practices in animal husbandry, and by strengthening Good Hygienic Practices and Hazard Analysis and Critical Control Point in food handling and processing. A mechanism will be established for testing AMR pathogens and antibiotic residues on meat and other food products. Moreover, both human and animal health will be protected through effective vaccination program and efficient use of antimicrobial medicines. Legal framework will be strengthened to promote the responsible use of antimicrobials. In addition to that, the use of antimicrobials will be controlled through national guidelines and programs. Border control will be strengthened for detection of imported antimicrobials, taking into account the ban on the use of antibiotics on animal feed as growth promoters.
The National Antimicrobial Resistance Committee shall be responsible for monitoring and evaluation of the implementation of this policy.