Tonga National Multisectoral Plan on Antimicrobial Resistance 2017-2022.

The Tonga National Multisectoral Plan on Antimicrobial Resistance is a national policy with a multisectoral approach. The timeframe of this Plan is 5 years covering the period between 2017 and 2022. The goal of this Plan is to establish and maintain a sustained provision of effective and safe medicines, quality-assured and responsibly administered, to ensure the continuous treatment and prevention of infectious diseases for as long as possible, making them accessible to all in need. The strategic objectives of this Plan are: (I) to establish and ensure governance, sustainable investment and actions to combat antimicrobial resistance (AMR); (II) to improve awareness and understanding of AMR across all institutions and sectors; (III) to strengthen surveillance, diagnostic capacity and research on AMR; (IV) to reduce the incidence of AMR through effective infection prevention and control measures, food safety and hygiene; and (V) to optimize the use of antimicrobial medicines in human and animal health.
The AMR governance structure will be established for finalizing and implementing the national action plan. On the basis of multisectoral approach, an AMR memorandum of understanding will be developed between key sectors. Appropriate legislation regarding AMR and medicines will be enforced in all sectors. Sustainable investment will be ensured in appropriate human resources and infrastructure to ensure sustainable implementation of the national action plan. Information sharing on current update of AMR and use of antimicrobials will be promoted across institutions and sectors. The capacities of health-care workers, veterinarians and livestock officers will be increased. Regular awareness raising activities will be carried out for farmers, importers, exporters, food processors, and animal production officers. The education curriculum will be revised to capture AMR, basic sanitation and hand hygiene. AMR will be included as core component of professional education in health, agricultural and fisheries sector in tertiary institution. A national AMR surveillance system will be developed through training on microbiology and quality antimicrobial susceptibility testing, strengthened laboratory capacity and infrastructure, random and regular testing on meat and other food product imports for AMR pathogens and antibiotic residues, and sharing of AMR surveillance and use data. The information sharing, diagnostic capacity and research on AMR will be strengthened.
A national infection prevention and control programme will be established, and vaccination program will be strengthened in human and animal sectors. The legal frameworks will be strengthened to promote responsible use, procurement and supply of antimicrobials in human and animal health. The use of prescription on antimicrobials will be enforced in the human and animal sector. The availability and accessibility of quality antimicrobials will be ensured. Antibiotic guidelines based on country antibiogram will be developed for human and animal use. Effective system will be developed for the disposal of unused antibiotics, including veterinary medicines; pharmaceuticals; medical waste; and veterinary waste. The Water, Sanitation and Hygiene (WASH) program will be implemented in communities and schools to promote safe water and hygiene practices. Good infection control and biosecurity practices will be promoted in animal husbandry. Food safety capacity will be strengthened to combat AMR. Good Hygienic Practices (GHP) and Hazard Analysis and Critical Control Point (HACCP) will be implemented in food handling and processing.