National Action Plan to Combat Antimicrobial Resistance in Hashemite Kingdom of Jordan 2018-2022.

This National Action Plan is a five-years document in alignment with WHO Global Action Plan to combat Antimicrobial Resistance. Jordan is committed to implement this National Action Plan through its health system and using holistic and multi-sectoral approach – referred to as One Health approach, in view of the fact that AMR is not just a health issue but it has grave potential to impede economy, food security and health of the people. The Vision at the basis of the NAP is to reduce mortality, morbidity and economic impact of AMR. The consequent Mission aims at establishing policies and national multi-sectoral mechanisms which support an effective and sustained AMR management system.
Main goals to be met by 2022 are (1) 10% reduction in AMR morbidity; (2) 20% reduction in antimicrobial consumption in humans; (3) 30% reduction in antimicrobial consumption in animals; (4) 30% reduction in diseases due to multi drug resistant organisms; and (5) 40% increase of public knowledge on AMR and awareness of appropriate use of antimicrobials. The strategic objectives of NAP for developing Jordanian public health response to AMR are aligned with the five broad objectives as enunciated in WHO Global Plan, covering different sectors especially human health, animal health and environment contributing towards minimizing the emergence and impact of AMR in Jordan. They are (i) improving awareness and understanding of AMR through effective communication, education and training (it has the three following components hygiene and appropriate use of antibiotics, political commitment for AMR and knowledge of AMR and related topics); (ii) strengthening knowledge and evidence through surveillance and research, including identification of the critical gaps and establishment of a national early warning system to identify the emergencies; (iii) reducing the incidence of infection, through effective infection prevention and control, especially in the context of hospitals, vaccination in humans and animals and bio-security in food production systems; (iv) optimizing the use of antimicrobial agents in health, animals and food through the establishment of a robust system for regulation and surveillance of use of antimicrobial agents; and (v) promoting investments for AMR activities, research and innovations based on country needs and increasing of investment in new vaccines, diagnostics and other interventions. The guiding principles for implementation of the NAP's strategic objectives are (i) whole-of-society engagement including a One Health approach; (ii) prevention first; (iii) access; (iv) sustainability; and (v) incremental targets for implementation.
To make agriculture more productive and sustainable, proposed interventions of the NAP are (i) conduct field orientation visits for farmers regarding the vaccination, bio-security, feed additives, water purification, antibiotic use, etc.; (ii) strengthen hygiene best practices in animal health, raising awareness for vets and farmers; (iii) promote disease prevention in animals, increasing vaccination awareness; and (iv) enforce the existing laws and regulations for veterinarians related to veterinaries clinics, animal farms and slaughter houses.
To enable more inclusive and effective agricultural and food systems, the NAP proposes to (i) collaborating and communicating with the associations e.g. agriculture, medical; (ii) establishing a high-level committee on One Health with representatives from all relevant sectors, including human, animals, food, agriculture and environmental; and (iii) implementing bio-security in food production systems to reduce risk of emergence of AMR.
As for the Governance, the Government will (i) increase the interventions of the national committee and the various sub-committees to bring down the prevalence of AMR and reduce substantially its emergence in the country; (ii) strengthen laboratory capacity establishing leadership and governance of laboratories for each sector together with the development of laboratory quality management system, appropriate training/competence development program, nationwide integrated health laboratory network (informatics), and sustainable laboratory services through adequate funding.