Syria National Action Plan on Combating Antimicrobial Resistance.

This nationwide, multisectoral Action Plan to Combat Antimicrobial Resistance is designed to address and combat AMR in post-conflict Syria. Aligned with a One Health approach involving both human and non-human sectors, the plan adheres to the WHO Global Action Plan (GAP) structure. It incorporates a Strategic Plan, an Operational Plan, and a Monitoring Plan within each of the four axes (awareness, surveillance, infection prevention and control, and antibiotic use), following the WHO template. The Operational Plan breaks down each activity or sub-activity, providing details such as the responsible entity or person, the timeframe, the cost, and the source of funding. Implementation of the plan necessitates a priority focus on legislation, an aspect that has been neglected or forgotten during the years of conflict.
The primary goals of the Plan are as follows (i) enhance awareness of AMR among authorities, the public, and relevant professionals, including farmers and veterinarians; (ii) establish an AMR surveillance system that can report to the Global Antimicrobial Resistance Surveillance System (GLASS) and produce local surveillance reports. This involves (a) reintroducing antibiogram culture in clinical specimens for human, veterinary, and food samples; (b) incorporating the cost of antibiograms into the health system budget; (c) providing necessary materials despite the current economic and trade embargo on Syria; (d) offering human capacity building through workshops and educational opportunities for microbiologists and laboratory technicians; (d) strengthening the central laboratory to become a reference laboratory for AMR; (iii) enhance Infection Prevention and Control (IPC) in healthcare systems by implementing mandatory IPC programs and requiring education for professionals; (iv) improve antimicrobial use in humans, animals, and agriculture by implementing activities such as (a) monitoring the quality of available antimicrobial molecules in the Syrian market; (b) providing treatment guidelines to professionals for common infectious diseases (ID) and disseminating these guidelines in healthcare facilities, along with educational lectures; (c) introducing the concept of antimicrobial stewardship by limiting specific high-priority antimicrobials to professionals who have received education/training on their use; (d) regulating antimicrobial use in the community by restricting dispensing in pharmacies to prescription-based dispensing and educating primary care physicians about treatment guidelines; (e) reinforcing OIE biosafety laws in the veterinary world. These initiatives across different axes are expected to be implemented over the next 5 years.