2022-10-30-世界卫生组织-Antimicrobial_resistance_TrACSS_Bangladesh_2022_country_profile_10页_283kb

• Introduction to AMR: Antimicrobial resistance (AMR) is a major global threat affecting human health, poverty, food security, and the environment. Countries adopted the Global Action Plan on AMR and developed national action plans (NAP) to address it. The TrACSS survey monitors implementation progress.

• Global Context: AMR deaths reached nearly 5 million in 2019 globally. Progress has been uneven, highlighting the need for stronger political commitment, investment, technical capacity, and multisectoral coordination.

• Bangladesh Context: The survey assesses capacity across sectors. Bangladesh tracks progress under the OneHealth framework but faces challenges in areas such as surveillance, laboratories, AMR-specific legislation, and the identification/costing of interventions.

Human Health

• Training and Education: Training capacity has increased over time, averaging B-rating in 2022 (limited capacity).
• Important metrics:
  Infection prevention and control (IPC)* compliance is B (limited capacity).
  National AMR surveillance system remains D (consistent effort needed for development).
  Human Health sector indicates Gaps in the adoption of national (AWaRe) classification of antibiotics.

Animal Health

• Surveillance and Education: Foundational infrastructures for training, surveillance systems, and biosecurity have expanded slightly (from B to D rating). However, gaps remain, particularly for aquatic animals and AMR in aquatic environments.
• Legislation & Risk Management: Bangladesh has made progress in legal frameworks regulating veterinary antimicrobial use but needs to improve AMR risk assessments and surveillance systems for terrestrial and aquatic animals.

Food and Agriculture

• Surveillance and Biosecurity: Foodborne AMR surveillance remains a priority. While biosecurity measures to reduce AMR at farm level have slightly improved, capacities in surveillance and diagnostics are rated B/C (limited to moderate capacity).
• Agricultural Use of Antimicrobials: Training capacity is low, and monitoring of antimicrobial use is inconsistent.

Environment

• Assessment of AMR environmental risks remains limited, with less than 50% of Bangladesh’s relevant questionnaires answered.
• Although some regulations exist, there is no system for regular environmental monitoring of AMR residues or genes.

Cross-Cutting Issues: Legislation & Data Use

• Over 80% of relevant legislation has been initiated in key areas, but capacity to use available AMR/AMU data effectively is inconsistent.
• Integration into multisectoral coordination mechanisms is limited, though awareness campaigns have increased across offices and national platforms.

Capacity Trends

• From the years surveyed, progress increased steadily especially in human health training, AMR awareness, and multisectoral coordination structures.
• However, significant implementation gaps exist in laboratories, AMR surveillance, and onesectoral legistlation and monitoring.

Key Messages

• Multisectoral coordination and political commitment are needed to improve AMR management.
• Enhance capacities in surveillance, diagnostics, and laboratory networks.
• Integrate AMR action plans into existing budgets and national strategies, notably those related to climate, environment, agriculture, and hygiene.