By Shobha Shukla
Asia Pacific Regional Conference on Antimicrobial Resistance (AMR) 2025 opened in Jakarta, Indonesia on the theme: “From Declaration to Action: Operationalizing One-Health AMR Action in the Asia-Pacific Region.”
“Antimicrobial resistance (AMR) is among the top 10 global health threats,” said Shobha Shukla, Chairperson of Global AMR Media Alliance (GAMA – recipient of AMR and One Health Emergent Leaders and Outstanding Talents Award 2024).
Asia Pacific AMR Conference is organised by Ministry of Health (Kementerian Kesehata), Government of Indonesia and ReAct Asia Pacific. This is the second time when Asia Pacific regional AMR conference is being organised in Indonesia.
“It is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths worldwide. Asia Pacific region is home to half of world’s population as well as half of global AMR burden. The misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in the development of drug-resistant pathogens,” said Dr SS Lal, Director of ReAct Asia Pacific.
AMR affects countries in all regions and at all income levels. Its drivers and consequences are exacerbated by poverty and inequality, and low- and middle-income countries are most affected.
“If we ensure that right diagnosis – early and accurate diagnosis for all diseases is made possible in rights-based manner for everyone – where no one is left behind – then right diagnosis would become the entry pathway towards right treatment – and stopping misuse and overuse of medicines. Infection prevention and control at all levels is so important – and so is multisectoral response,” said Shobha Shukla who leads GAMA and CNS, official media partners of regional AMR conference.
Indonesian government’s leadership on AMR
“Government of Indonesia recognises the critical importance of growing health threats like AMR by supporting this conference and global efforts to combat AMR. We aim to reduce the spread of drug-resistant infections, promote responsible antimicrobial use and ensure healthier future for our nation,” said Dr Yuli Astuti Saripawan, Director of Referral Healthcare Quality, Ministry of Health, Indonesia.
“Indonesia developed its National Strategy for AMR 2025-2029 last year, specifically for preventing AMR in human health. Besides this strategy, Indonesia has also developed National Action Plan for addressing AMR with One Health approach,” said Dr Amy Rahmadanti, Team Lead, Antimicrobial Resistance-Infection Prevention and Control, Ministry of Health, Government of Indonesia.
“There are a number of government regulations to implement AMR policies in Indonesia. For example, Ministry of Health of Indonesia has issued government regulations and guidelines for use of antibiotics and other antimicrobials, as well as guidelines for development of antibiogram for antimicrobial stewardship,” said Dr Amy Rahmadanti.
An antibiogram is a summary report of a local hospital or healthcare system’s antimicrobial susceptibility testing results, showing the percentage of bacteria, fungi, virus or parasites which are susceptible to various antimicrobial drugs. It helps guide clinicians in choosing the best antimicrobial for an individual patient and provides insights into local patterns of drug resistance.
“We regularly assess hospitals where most of the antimicrobial use occurs, including those where reserve group of antibiotics is used. For example, this year we are focussing on capacity building of hospitals of Ministry of Health of Indonesia. We are evaluating their diagnostic capacities, personnels, other facilities, and accordingly providing capacity building and education. For some sentinel hospitals, we are procuring medical diagnostic machines,” said Dr Amy Rahmadanti. “We are developing referral diagnostic network between public hospitals and referral laboratories.”
“We hope that Asia Pacific AMR Conference 2025 will help strengthen regional partnerships and collaborations, consolidate regional actionable roadmap, regional alignment on priorities and long-term actions, accelerated implementation of national action plans, optimise engagement of civil society, youth and community, and strengthen sustainable access and stewardship mechanisms,” said Dr SS Lal.
Local action for global goals
Asia Pacific region not only bears over half of global AMR burden but also has its unique set of challenges, problems and issues that warrant localised and contextualised tailored solutions. “While we respect the global action plan on AMR, we need a tailored action plan and reports for this region. Also, we need regional alignment on priorities and long-term actions for AMR. Asia Pacific health systems are different from those in other regions. For example, in several countries of the region, private healthcare sector serves the need of majority of population (70% to 80%). In some countries, it is unregulated too. Almost 90% of countries in the region have national action plans on AMR, but some countries are yet to revise their action plans. Some countries have action plans on AMR but only on paper – without optimal implementation. When actions plans on AMR are implemented at national as well as sub-national level, we see many gaps in many settings and countries,” said Dr SS Lal.
“Working at national level is important but we have to implement activities at sub-national level to prevent AMR too. Working at only national level may not achieve the results,” said Dr Lal. He stressed on the importance of engaging civil society, youth and communities at all levels of AMR response.
Right diagnosis must follow right treatment
Early and accurate multi-disease diagnostics must be made accessible to all -where no one is left behind. Early and accurate diagnostics is not only an entry gate to treatment and care pathway but also helps stops the spread of infections.
“There must be antimicrobial stewardship mechanisms in all healthcare facilities in all countries. Major healthcare facilities where most of antimicrobials are prescribed on a daily basis, should have standard stewardship mechanisms. We also must ensure that all people have access to correct antimicrobials,” said Dr SS Lal.
In 2024 United Nations General Assembly High Level Meeting on AMR, world leaders adopted a Political Declaration. “It is almost one year now since Political Declaration was adopted by world leaders at the UN global meet, where very important and ambitious commitments were made by them. We are now in crucial time to translate these commitments into actions. UN High Level Meeting on AMR 2024 reminded us of immediate action to be taken to safeguard ability to treat humans, animals as well as enhance food security, and foster and safeguard ability for economic development to advance the agenda for sustainable development. So, this is a major win for us but it needs to be translated into actions,” said Anna Sjöblom, Director, ReAct Europe.
“Different countries in European and Asia Pacific regions are at different places in their journeys to prevent AMR – and it is very fruitful to learn from each other. In European context, investments have been done in regulating use of antibiotics. There are agencies to do country audits to assess what has been done at national levels and compare data,” said Anna Sjöblom. “European AMR response can learn a lot on engaging civil society from Asia Pacific region.”
Healthy populations have fewer infections and lesser need for antimicrobials
“Healthy populations will have fewer infections and need for antimicrobials is lesser,” said Anna Sjöblom. That is why we need standard multi-disease diagnostics to make early and accurate (right diagnosis) a reality for everyone – without exception, link to right treatment without any delay, care and support, and optimal infection prevention and control in healthcare facilities, societies, communities and homes. Child and adult vaccination for vaccine-preventable illnesses is also important and so is water, sanitation and hygiene.
(The writer is a feminist, health and development justice advocate, and an award-winning founding Managing Editor and Executive Director of Citizen News Service)
