Two-Year Plan for Antimicrobial Resistance (AMR) Management in Sindh Province

Objective 1: Strengthening Multisectoral Coordination for AMR Management

1. Year 1:
 Establish a Multisectoral Steering Committee for AMR, outlining roles and responsibilities.
 Allocate a budget for committee activities and secure funding sources.
 Conduct the first steering committee meeting to develop a roadmap for AMR National
Action Plan (NAP) implementation.
 Chalk Activities:
1. Formulate terms of reference for the Multisectoral Steering Committee.
2. Identify potential funding sources and establish a budget allocation
mechanism.
3. Initiate the first committee meeting to set objectives and action plans.
2. Year 2:
 Review progress and challenges in the second steering committee meeting.
 Ensure accountability by evaluating the impact of funded activities.
 Conduct quarterly meetings to provide updates and address emerging issues.
 Chalk Activities:
1. Review the committee's performance and make necessary adjustments.
2. Evaluate the impact of funded activities and provide transparent financial
reporting.
3. Continue quarterly meetings to share progress and address challenges.


Objective 2: Update AMR NAP in Line with Global Action Plan

3. Year 1:
 Convene a working group to assess the current AMR NAP and identify gaps.
 Prioritize activities aligned with the AMR Global Action Plan.
 Develop a revised NAP in consultation with stakeholders.
 Chalk Activities:
1. Form a working group with representatives from relevant sectors.
2. Conduct a gap analysis of the current AMR NAP and compile
recommendations.
3. Prioritize activities based on the AMR Global Action Plan.

4. Year 2:
 Disseminate the updated AMR NAP and ensure understanding among relevant sectors.
 Monitor the implementation of prioritized activities through regular reviews.
 Adjust the NAP as needed based on ongoing assessments.
1. Disseminate the updated NAP to all stakeholders for feedback.
2. Implement prioritized activities with a focus on collaboration and resource
optimization.
3. Conduct regular reviews and adjust the NAP as needed.
 

Objective 3: Enhance Internal Health Sector Coordination

5. Year 1:
 Foster collaboration between AMR, Universal Health Coverage (UHC), Primary Health Care
(PHC), and Health Emergencies stakeholders.
 Establish communication channels for seamless information sharing.
 Chalk Activities:
1. Organize workshops to facilitate communication and collaboration.
2. Establish cross-functional teams for joint projects.

6. Year 2:
 Conduct joint workshops to strengthen internal coordination.
 Evaluate the effectiveness of collaboration mechanisms.
 Chalk Activities:
1. Assess the effectiveness of communication channels and refine as necessary.
2. Share success stories of collaborative efforts to encourage ongoing
coordination.


Objective 4: Assess Existing Capacities for AMR Management

7. Year 1:
 Conduct a comprehensive assessment of awareness, training, surveillance, IPC, and antibiotic
stewardship capacities.
 Identify gaps and areas for improvement.
 Chalk Activities:
1. Conduct a baseline assessment of awareness, training, surveillance, IPC, and
stewardship capacities.
2. Identify gaps and create a detailed capacity-building plan.

8. Year 2:
 Develop targeted capacity-building programs based on the assessment.
 Monitor the implementation and impact of capacity-building initiatives.
 Chalk Activities:
1. Implement tailored training programs for different sectors.
2. Monitor the effectiveness of training through assessments and feedback
loops.


Objective 5: Provide Adequate Equipment for AMR Surveillance

9. Year 1:
 Procure necessary equipment for laboratories supporting AMR surveillance.
  Establish maintenance and supply protocols to ensure sustainability.
 Chalk Activities:
1. Procure necessary equipment based on laboratory requirements.
 Develop a maintenance schedule and supply chain management plan.
10. Year 2:
 Conduct regular audits of equipment and supplies to maintain functionality.
 Review and update procurement procedures as needed.
 Chalk Activities:
 Conduct regular equipment audits and ensure timely maintenance.
 Continuously update procurement procedures based on evolving needs.


Objective 6: Develop a National Surveillance System

11. Year 1:
 Establish a task force to develop a national surveillance system.
 Define protocols, targets, standards, and metrics.
 Chalk Activities:
1. Establish a task force with representatives from health, agriculture, and
environment sectors.
2. Develop detailed protocols, standards, and metrics for the surveillance
system.

12. Year 2:
 Pilot the surveillance system in selected areas of Sindh.
 Gather feedback and make necessary adjustments for full-scale implementation.
 Chalk Activities:
1. Pilot the surveillance system in identified areas.
 Gather feedback and refine protocols for full-scale implementation

Objective 7: Establish AMR Surveillance in the Environment

13. Year 1:
 Conduct a baseline study on AMR in sewage and high-risk areas.
 Develop protocols for ongoing surveillance.
 Chalk Activities:
1. Conduct a baseline study in sewage and high-risk areas.
2. Develop protocols for ongoing surveillance.

14. Year 2:
 Implement sewage sampling and surveillance in identified high-risk areas.
 Regularly analyze and report findings to relevant authorities.
 Chalk Activities:
1. Implement sewage sampling and surveillance in targeted areas.
 Regularly analyze and report findings, adjusting protocols as necessary.
 Objective 8: Strengthen Laboratory Capacities for AST

15. Year 1:
 Identify priority pathogens for AST.
 Develop a training program for laboratory technicians.
 Chalk Activities:
1. Identify priority pathogens and design a tailored training program.
2. Develop a continuous professional development plan for laboratory staff.

16. Year 2:
 Implement training programs and assess the impact on laboratory capacities.
 Establish a continuous professional development plan for laboratory staff.
 Chalk Activities:
1. Implement training programs and assess their impact on laboratory
capacities.
2. Review and enhance the continuous professional development plan based on
feedback.

Objective 1: Strengthening Multisectoral Coordination for AMR Management

1. Year 1 (Immediate):
 Form the Multisectoral Steering Committee, defining roles and responsibilities.
 Establish a budget allocation mechanism and secure initial funding.
 Initiate the first steering committee meeting to set immediate objectives.
2. Year 2 (Short Term):
 Conduct quarterly committee meetings, reviewing progress and addressing
immediate challenges.
 Begin developing a comprehensive AMR National Action Plan (NAP).
 Engage with international partners to secure additional funding.
3. Year 5 (Long Term):
 Institutionalize the Multisectoral Steering Committee as a permanent entity.
 Regularly update and refine the AMR NAP based on ongoing assessments.
 Strengthen collaboration with regional and global stakeholders through GHSA
networks.

Objective 2: Update AMR NAP in Line with Global Action Plan

4. Year 1 (Immediate):
  Form a working group to assess the current AMR NAP and identify gaps.
 Prioritize short-term activities aligned with the AMR Global Action Plan.
5. Year 3 (Short Term):
 Disseminate the updated AMR NAP for feedback and adjustments.
 Implement prioritized activities with a focus on immediate impact.
6. Year 5 (Long Term):
 Conduct a comprehensive review of the AMR NAP, ensuring alignment with
evolving global strategies.
 Strengthen collaboration with international organizations and neighboring
regions through GHSA platforms.

Objective 3: Enhance Internal Health Sector Coordination

7. Year 1 (Immediate):
 Organize cross-sectoral workshops to facilitate communication.
 Establish internal communication channels for seamless information sharing.
8. Year 3 (Short Term):
 Assess the effectiveness of internal coordination mechanisms and make
immediate adjustments.
 Collaborate with GHSA to align regional health sector coordination strategies.
9. Year 5 (Long Term):
 Institutionalize internal coordination mechanisms within the health sector.
 Participate in GHSA initiatives for cross-border health coordination and
information exchange.

Objective 4: Assess Existing Capacities for AMR Management

10. Year 1 (Immediate):

 Conduct a baseline assessment of capacities for awareness, training, surveillance,
IPC, and stewardship.
 Identify and prioritize immediate capacity-building needs.
11. Year 3 (Short Term):
 Implement targeted training programs for different sectors.
 Monitor the effectiveness of training through assessments and feedback loops.
12. Year 5 (Long Term):
 Institutionalize continuous capacity assessments and adjust training programs
accordingly.
 Collaborate with GHSA to share best practices and experiences with neighboring
regions.
 Objective 5: Provide Adequate Equipment for AMR Surveillance

13. Year 1 (Immediate):

 Procure necessary equipment based on laboratory requirements.
 Develop a maintenance schedule and supply chain management plan.
14. Year 3 (Short Term):
 Conduct regular equipment audits and ensure timely maintenance.
 Collaborate with GHSA for equipment sharing and joint procurement.
15. Year 5 (Long Term):
 Establish a regional equipment sharing network through GHSA.
 Continuously update procurement procedures based on evolving needs and
international standards.

Objective 6: Develop a National Surveillance System

16. Year 1 (Immediate):

 Establish a task force to develop a national surveillance system.
 Define protocols, standards, and metrics for immediate implementation.
17. Year 3 (Short Term):
 Pilot the surveillance system in identified areas and gather immediate feedback.
 Collaborate with GHSA to align national surveillance systems with global
standards.
18. Year 5 (Long Term):
 Expand the national surveillance system to cover all regions and sectors.
 Participate in GHSA initiatives for global health security and surveillance
standardization.

Objective 7: Establish AMR Surveillance in the Environment

19. Year 1 (Immediate):

 Conduct a baseline study in sewage and high-risk areas.
 Develop protocols for immediate implementation.
20. Year 3 (Short Term):
 Implement sewage sampling and surveillance in targeted areas.
 Collaborate with GHSA to share environmental surveillance best practices.
21. Year 5 (Long Term):
 Integrate environmental surveillance into routine public health practices.
 Collaborate with GHSA for regional environmental surveillance initiatives.

Objective 8: Strengthen Laboratory Capacities for AST

22. Year 1 (Immediate):
 Identify priority pathogens and design a tailored training program.
 Develop a continuous professional development plan for laboratory staff.
23. Year 3 (Short Term):
 Implement training programs and assess their immediate impact on laboratory
capacities.
 Collaborate with GHSA for joint training initiatives and knowledge exchange.
24. Year 5 (Long Term):
 Institutionalize continuous professional development plans for laboratory staff.
 Collaborate with GHSA for continuous improvement in laboratory standards and
practices.