National Action Plan on Antimicrobial Resistance (AMR- NAP) 2023–2028.

This document sets out South Sudan’s first One Health National Action Plan on Antimicrobial Resistance (NAP‑AMR) for 2023–2028. It frames antimicrobial resistance (AMR) as a top global and national public health and health security threat, driven by misuse and overuse of antimicrobials in humans, animals, plants and environmental contamination. The plan aligns with the Global Action Plan on AMR (GAP‑AMR) endorsed by WHO, FAO, WOAH and UNEP, and responds to findings of the 2017 Joint External Evaluation. It is grounded in a One Health approach, recognizing interlinkages between human, animal, plant and environmental health, and is intended to complement existing national strategies, including the National Action Plan for Health Security (NAPHS), environmental and wildlife policies, and health sector plans. The NAP‑AMR is structured around five strategic objectives: improving awareness and understanding of AMR; strengthening knowledge and evidence through surveillance and research; reducing the incidence of infection via sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in humans, animals and plants; and developing the economic case for sustainable investment, including in new medicines, diagnostics, vaccines and other interventions. For each objective, the plan specifies strategic interventions and detailed activities, such as baseline knowledge, attitudes and practices surveys; development and dissemination of communication strategies and IEC materials; integration of AMR into pre‑service curricula and in‑service training; establishment and strengthening of laboratory capacity and quality management systems; creation of integrated, multisectoral AMR and antimicrobial use surveillance systems; and promotion of research agendas and platforms for sharing AMR evidence. Implementation arrangements are defined through an approved One Health governance structure chaired by the Minister for Cabinet Affairs, with a National AMR Multisectoral Steering Committee, an AMR Secretariat and six technical working groups covering surveillance and research, awareness and education, infection prevention and WASH, regulation and enforcement, resource mobilization and stewardship. The plan includes a costed operational plan (172 sub‑activities, total estimated budget USD 11.9 million), a monitoring and evaluation framework with logic model and indicators, and timelines for biannual monitoring and mid‑term and end‑term evaluations. It emphasizes coordination across ministries (health, livestock and fisheries, environment and forestry, wildlife, agriculture and others), engagement of civil society, media and private sector, and mobilization of domestic and external resources. The document also presents a SWOT analysis of current AMR capacities, stakeholder mapping, and key implementation priorities such as legislation on antimicrobial prescription and sale, antimicrobial stewardship programmes, vaccination campaigns, improved WASH and waste management, and surveillance of antimicrobial residues in food and the environment.