2022-10-30-世界卫生组织-Antimicrobial_resistance_TrACSS_Somalia_2022_country_profile_10页_282kb

报告摘要

Summary of Somalia's 2022 TrACSS Country Report

Core Content

The Tracking AMR Country Self-Assessment Survey (TrACSS) is a global initiative aimed at monitoring the implementation of National Action Plans on Antimicrobial Resistance (NAPs). Somalia participated in the 2022 TrACSS, which is part of a broader Quadripartite effort involving WHO, FAO, WOAH, and UNEP. The survey uses a five-point scale (A to E) to assess national capacity and progress in AMR-related indicators across various sectors. Somalia's responses were compared to global averages, revealing significant gaps in capacity and implementation.

Key Sectors and Indicators

Human Health

AMR National Action Plan: Somalia has developed a NAP on AMR.
Training and Education: Limited progress in AMR training for healthcare workers.
Antimicrobial Consumption Monitoring: No national monitoring system in place.
Surveillance System: No national AMR surveillance system established.
Infection Prevention and Control (IPC): Limited IPC implementation.
Optimizing Antimicrobial Use: No national guidelines or AWaRe classification adoption.
Laboratories and Diagnostics:
- AST Capacity: Limited reference labs performing AST.
- Continuity of Services: Stockouts reported but no mechanism for reporting.
- Standardized AST Guidelines: Not used by labs.
- External Quality Assurance (EQA): EQA is compulsory and implemented in all labs.

Animal Health

Training and Education: Limited progress in AMR training for the veterinary and aquatic animal health sectors.
Surveillance System: No national AMR surveillance system in place for terrestrial or aquatic animals.
Laboratories Integration: Only some labs are integrated into AMR surveillance.
Biosecurity and Husbandry Practices: Limited implementation of practices to reduce antimicrobial use.
Legislation: No laws or regulations on prescription and sale of antimicrobials for terrestrial or aquatic animals.
Medicated Feed Regulation: No laws on medicated feed.
Growth Promotion Prohibition: No laws prohibiting antibiotics for growth promotion without risk analysis.
Pesticide Regulation: No legislation on the registration and use of pesticides with antimicrobial effects.

Food and Agriculture

Training and Education: Limited AMR training in agriculture, food production, and environmental sectors.
Surveillance System: No national AMR surveillance system in place.
Laboratories Integration: Limited standardization and harmonization of procedures.
Data Management: Limited technical level of data management.
Good Manufacturing Practices: No established practices to reduce AMR in food processing.
Pesticide Use Optimization: No laws or regulations on optimizing antimicrobial pesticide use in plant production.

Environment

Risk Assessment: No national assessment of antimicrobial residues and resistant pathogens in the environment.
Legislation: No laws to prevent antimicrobial contamination of the environment.
Water Quality Monitoring: No system for regular monitoring of antimicrobial compounds and resistant bacteria in water quality.

Main Findings and Key Messages

Limited Capacity: Somalia's capacity across most AMR indicators is limited, with many indicators rated at B or C.
Slow Progress: Progress in AMR implementation has been uneven and slow, particularly in monitoring systems and legislation.
Need for Multisectoral Coordination: Somalia lacks a formalized multisectoral coordination mechanism, which is essential for effective AMR management.
Awareness Campaigns: There is a need for nationwide awareness campaigns to educate the public and stakeholders about AMR.
Data Utilization: Only a minority of countries (60% for AMU data, 65% for AMR data) use such data to inform policy and decision-making.
Legislative Gaps: Somalia has no laws or regulations on the prescription, sale, or use of antimicrobials in both human and animal health sectors.
One Health Approach: Integration of AMR into broader national strategies (e.g., WASH, food safety, climate change) is needed for sustainable implementation.
Stewardship and Surveillance: Establishing a robust antimicrobial use and resistance surveillance system is critical for effective AMR control.

Global Comparison

Somalia's responses are generally below the global average for most indicators, highlighting the need for urgent improvements in capacity and implementation.
The global average for TrACSS indicators is calculated using a five-point scale (A=1, B=2, etc.), and Somalia's responses are often at the lower end of the scale.

Recommendations

Strengthen Capacity: Develop and implement national AMR action plans with clear priorities, costings, and monitoring mechanisms.
Formalize Coordination: Establish a formalized multisectoral coordination mechanism with dedicated leadership and funding.
Enhance Training: Systematically incorporate AMR into training curricula for healthcare and veterinary professionals.
Improve Surveillance: Develop national AMR surveillance systems and ensure integration of laboratories.
Legislate and Monitor: Implement laws and regulations on antimicrobial use and ensure the capacity to monitor and enforce them.
Promote Awareness: Launch nationwide AMR awareness campaigns, with a focus on youth education.
Use Data Effectively: Utilize AMR and antimicrobial use data to guide policy and decision-making.
Adopt One Health Strategies: Integrate AMR into existing national strategies such as WASH, food safety, and climate change initiatives.