2022-10-30-世界卫生组织-Antimicrobial_resistance_TrACSS_Tonga_2022_country_profile_10页_278kb

报告摘要

Tonga TrACSS 2022 Country Report Summary

Core Content

The Tracking AMR Country Self-Assessment Survey (TrACSS) is an annual tool used to monitor the implementation of National Action Plans on Antimicrobial Resistance (NAPs). In 2022, 86% of countries participated, marking the highest response rate to date. This report evaluates Tonga’s performance across various sectors, including Human Health, Animal Health, Food and Agriculture, and Environment, and highlights key areas for improvement.

Tonga is classified as an upper middle-income country with a population of 106,759. Antimicrobial resistance (AMR) is a global threat, with nearly 5 million deaths attributed to AMR in 2019, including 1.27 million directly caused by it. The Global Action Plan on AMR (GAP-AMR), endorsed by multiple international bodies, aims to address this challenge through coordinated national action.

Main Points and Key Information

TrACSS Rating Scale

A five-point scale (A to E) is used to assess national capacity and progress.
A and B indicate limited capacity, while C to E suggest nationwide implementation.
Countries should aim for C to E on all indicators.

Human Health Sector

Training and Education: Tonga has C level capacity, indicating nationwide implementation of AMR training for healthcare workers.
Monitoring Antimicrobial Consumption: Tonga is at B level, suggesting limited progress in monitoring antimicrobial use.
Surveillance System: Tonga has a B level capacity for a national AMR surveillance system.
Infection Prevention and Control (IPC): At B level, indicating limited progress in IPC.
Optimizing Antimicrobial Use: Tonga has C level capacity, showing nationwide implementation of guidelines.
Adoption of AWaRe Classification: Not yet implemented (rating A).
Lab and Diagnostics:
- AST capacity for critically important bacteria is C.
- Continuity of services for clinical labs is C.
- Standardized AST guidelines are unknown.
- EQA programme is C, indicating nationwide implementation in reference labs.

Animal Health Sector

Training and Education: Tonga is at A level, indicating no capacity for AMR training in the veterinary sector.
Surveillance System: No national surveillance system is in place (rating A).
Biosecurity and Husbandry Practices: Tonga is at B level for both terrestrial and aquatic animal production, indicating limited progress.
Integration of Laboratories: Limited integration of labs into AMR surveillance (rating B).

Food and Agriculture Sector

Training and Education: Tonga is at B level, indicating limited progress in AMR education across relevant sectors.
Surveillance System: No national AMR surveillance system is in place (rating A).
Biosecurity and Husbandry Practices: Tonga is at B level for both terrestrial and aquatic animal production.
Good Manufacturing Practices: Limited progress (rating B).
Optimizing Antimicrobial Use: No progress in this area (rating A).

Environment Sector

Risk Assessment: Tonga has A level capacity, indicating no national assessment of AMR in the environment.
Legislation: Tonga has A level capacity for legislation to prevent antimicrobial contamination of the environment.
Water Quality Monitoring: No system for regular monitoring of antimicrobial residues and resistant bacteria (rating A).

Key Messages for Tonga

AMR National Action Plan Governance

Tonga has made commendable progress in developing its AMR NAP but needs to ensure it is prioritized, costed, and operationalized with a monitoring framework.
Integration into existing national strategies and budgets is essential for sustainability, including One Health, WASH, health systems, food safety, and climate change.

Multisectoral Coordination

A formalized multisectoral coordination mechanism is needed to ensure effective implementation of AMR NAPs.
Leadership capacity, technical working groups, and adequate funding are critical for this coordination.

AMR Awareness

Tonga needs nationwide awareness campaigns to educate the public and targeted stakeholders about AMR.
Youth education is a key intervention to increase long-term awareness, with less than 20% of countries currently implementing it.

Data Quality and Use

Tonga should improve the use of AMR and antimicrobial use data to inform decision-making and policy development.
While 60% of countries use antimicrobial consumption data, and 65% use AMR data, Tonga is not reported to be using these data (rating A).