National Strategic Action Plan on Antimicrobial Resistance.

Singapore’s National Strategic Action Plan on Antimicrobial Resistance (AMR) is a cross-sectoral policy document. It is aligned with the World Health Organization’s Global Action Plan on Antimicrobial Resistance, and with standards and guidelines established by intergovernmental bodies such as the Food and Agriculture Organization of the United Nations and the World Organisation for Animal Health. The Strategic Action Plan aims to reduce the emergence and prevent the spread of drug-resistant organisms through 5 core strategies: 1. Education; 2. Surveillance and Risk Assessment; 3. Research; 4. Prevention and Control of Infection; and 5. Optimisation of Antimicrobial Use.
The Strategic Action Plan maps out key areas for understanding and controlling AMR, and for mitigating its impact on Singapore, within and between human, animal, food and environment sectors. Under the Core Strategy 1, priority areas for further action include: 1.1 Coordinate a national strategy for improving awareness and understanding of AMR; 1.2 Reinforce food safety and hygiene practices; 1.3 Increase public awareness and understanding of AMR and the importance of using antibiotics appropriately; 1.4 Strengthen awareness of proper disposal of waste with antimicrobials; 1.5 Increase awareness on AMR and prudent antimicrobial use among stakeholders in the veterinary sector; etc. Awareness campaigns will be expanded beyond veterinarians and farmers to include all relevant stakeholders, such as pet owners, feed manufacturers, distributors of veterinary drugs, veterinary technicians and para-professionals. The objective of the Core Strategy 2 is: Detection of AMR through surveillance, coupled with risk assessment, enables a timely and appropriate response to be mounted. The key strategic areas requiring attention include: Integrate surveillance for antimicrobial resistance and antimicrobial utilisation across sectors for human, animals, food and environment; Establish a national coordinating body; Expand the AMR surveillance programme to include all animal production sectors; Harmonise surveillance for antimicrobial resistance with antimicrobial utilisation on farms; Enhance laboratory capacity for testing of AMR and antibiotic residues in food products; Strengthen national surveillance of drug-resistant organisms in food products to include retail food and meat, and to assess risk to consumers; Develop a systematic environmental surveillance system;Conduct risk assessment; etc. Under the Core Strategy 3, Priority research areas for cross-sectoral collaboration have been identified: Determine transmission pathways between sectors (human, animal, food, and the environment), and determine the implications of cross-sectoral transmission on efforts to control AMR; Advanced methods of surveillance of AMR (including genomic analysis) and antimicrobial use; Socio-behavioural research to understand baseline attitudes, practices and knowledge of AMR, and determine how best to change behaviour to facilitate control of AMR; Socioeconomic impact of AMR. The Core Strategy 4 also sets up the Priority Areas for Further Action, including: Improve animal health management practices in local food animal establishments; Promote and facilitate the use of vaccines and alternatives to antimicrobials in livestock, pets and fish; Enhance surveillance and programmes for food safety. The key strategic areas requiring attention under the Core Strategy 5 include: Establish a robust regulatory framework for supply chain control of all antimicrobials; Strengthen the system to ensure prudent use of antimicrobials in veterinary medicine and reduce inappropriate use of antimicrobials in food-producing animals.