National Action Plan on Antimicrobial Resistance: Timor-Leste 2017 - 2020.

The goal of the GAP AMR is: to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them. To achieve this, the GAP-AMR has laid down five strategic objectives which form the basis for developing public health response to AMR globally. These strategic objectives are: Objective 1: Improve awareness and understanding of antimicrobial resistance through effective communication, education and training Objective 2: Strengthen the knowledge and evidence base through surveillance and research Objective 3: Reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures Objective 4: Optimize the use of antimicrobial medicines in human and animal health Objective 5: Develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions Additionally, the NAP AMR is expected to reflect the five principles based on which the GAP AMR strategies have been enunciated. These include: Whole-of-society engagement including a One Health approach, Prevention first, Access, Sustainability, and Incremental targets for implementation.
The development of NAP followed the guidelines enshrined in WHO’s Antimicrobial resistance: A manual for developing national action plans. The approach was structured around the five strategic objectives and five principles which are embodied by the GAP AMR. Within the five strategic objectives of the GAP AMR, 12 key strategic interventions were included. Each of these interventions were described in terms of specific objective, with a defined set of activities to be carried out successfully to execute the strategic intervention and eventually to fulfill the strategic objective. The National Action Plan on AMR for the period 2016 – 2020 takes these efforts further, reinforcing the government’s commitment to make universal healthcare and animal welfare, food security a reality. Based on implementation of the five strategic objectives, each of which has its specific sub-objectives, strategic interventions and key activities, the NAP AMR charts a new phase in Timor Leste’s journey towards achieving goals related to AMR compliance.
The National Multisectoral Committee (NMC) will be the implementation agency for NAP AMR and will draw its powers and mandate from Government resolutions. Being a high level committee, NMC will also provide strategic vision to AMR control efforts in Timor-Leste. The NMC will provide the platform for programme planning and implementation through a supporting structure comprising of technical working group. The NMC is envisioned as a multi-sectoral group of political member and senior policy makers and programme managers from different ministries. To implement strategic objective 2 related to surveillance of AMR, steps would be taken to understand how resistance develops and spreads. This will be done by having a nationwide AMR surveillance system in place along with a national early warning system to identify early the emergence of resistance in priority pathogens and to critical antimicrobials by 2019.
A national multi-sectoral governance mechanism is the pivot around which AMR-related activities can be effectively coordinated in all the relevant sectors. This will ensure a systematic and comprehensive approach However, the scope should be broad enough to address all five strategic objectives of the global action plan, prioritising activities in a step-wise approach. The governance mechanism for Timor-Leste will comprise of a High Level National Multi-sectoral Committee (NMC), for Antimicrobial Resistance. NMC will be supported by a multi-sectoral Technical Working Group who will address the strategic objectives of GAP through specialised Task Forces on related to the five strategic objectives of GAP. Each of these will be formed and will function as per the following criteria.