Gap Analysis and Priority Identification for Antimicrobial Resistance in Countries of the Western Pacific Region

The purpose of this Request for Proposals (RFP) is to enter into a contractual agreement with a successful bidder and select a suitable contractor to carry out the following work: analyzing key gaps and identify proposed priorities in combatting AMR in the regional and selected Member States.

BACKGROUND

The silent pandemic of rising antimicrobial resistance (AMR) threatens our future health and security and endangers overall development. Globally, over 7 million deaths, comprising 13.6% of all global deaths, in 2019 were associated with bacterial infections, making such infections the second leading cause of death globally. In the Western Pacific Region between 2020 to 2030, an estimated 5.2 million people are expected to die as a result of AMR. The regional AMR mortality rate is similar to rates for kidney diseases, diabetes, liver cirrhosis and breast cancer, and it is considerably higher than rates for tuberculosis and HIV/AIDS. The AMR-related economic cost in the Region will reach an estimated US$ 148 billion from 2020 to 2030.  Effective antibiotics are critical for preventing and treating bacterial infections, However, as infections resistant to antibiotics become harder and more expensive to treat, heath systems and economies will be strained.

At the High-Level Meeting of the UNGA on AMR in 2016, the global leaders made commitment to work at national, regional and global levels to develop multisectoral action plans and initiatives, mobilize human and financial resources and investment to support actions, strengthen surveillance and regulatory frameworks, raise and sustain awareness, and support multisectoral engagement. To further advance the progress in the Western Pacific Region, Member States in the Western Pacific Region endorsed Action Agenda for Antimicrobial Resistance in the Western Pacific Region in 2014 and a Framework for Accelerating Action to Fight Antimicrobial Resistance in the Western Pacific Region in 2019, guiding countries on implementing sustained and forward-looking solutions, drawing on participation from all sectors of society. AMR is also included as one of the thematic priorities of WHO in the Western Pacific Region to fulfill the vision of building the healthiest and safest region.

However, progress so far is mixed. A WHO global survey shows that, only 50% of countries have a functional AMR multisectoral coordination mechanism to help prioritize, cost, implement and monitor AMR national action plans. Among the 86% of countries who have developed multisectoral AMR national action plans, only 20% of them are actively monitoring their implementation. While 91% of countries noted that they have laws and regulations on the prescription and sale of antimicrobials for human use, only 55% of them have systems that monitor sales of antimicrobials at the national level and use at sub-national level.  23% of countries have no systems in place to monitor antimicrobial use in human health. And only 56% of countries conduct limited and small-scale AMR awareness campaigns.

To explore pathway to stimulate actions in the region, WHO Regional Office for the Western Pacific organized a side event at the seventy-third session of the Regional Committee for the Western Pacific in 2022 brought together policy makers across sectors to discuss the importance and urgency of moving from commitment to actions to fight AMR. They identified a need to be more creative and innovative, particularly on sustaining momentum and cross-sectoral partnership, resource mobilization, using new technologies, and changing social norms through effective communication.

In September 2024, the UN General Assembly will hold the second High-Level Meeting on Antimicrobial Resistance, providing an important opportunity for WHO, the Member States and global leaders to revisit the current strategy and identify further measures to intensify the fight against AMR. The Global Action Plan for AMR will be updated leading up to the 2024 UNGA High Level Meeting, to align with changes in the global AMR response architecture, political attention, member state requests, and identified challenges and gaps. An updated regional action agenda was also proposed to further translate the updated global commitment and action plan into concrete actions in the Western Pacific Region and operationalize multisectoral coordination through the “One Health” approach.

To contribute to the development of the updated regional action agenda, WHO Regional Office of Western Pacific developed an idea of partnering with an external consulting firm or academic research team to research on key gaps and its root cause for AMR at country-level and identify potential priorities to focus on in the next 10 years. The identified gaps and priorities will contribute to gaps and priorities analysis at regional level for the updated action agenda and will also be used as leverage points in engaging country offices and member state governments in establishing high-level buy-in and future actions.

REQUIREMENTS/WORK TO BE PERFORMED

1. Desk Review current status of AMR, including but not limited to: