The Pacific region marked a significant milestone in managing the threat of ‘superbugs’ as the inaugural Pacific One Health and Antimicrobial Resistance (AMR) Symposium kicked off in Fiji last month.
The symposium is a major milestone of a jointly funded ACIAR and Department of Foreign Affairs (DFAT) 5-year project aiming to improve policies around antimicrobial resistance and stewardship at local, national and regional levels.
With over 150 participants from Australia, Fiji, New Zealand, Papua New Guinea, Samoa and Solomon Islands, the 2-day symposium has enabled regional stakeholders to get together for the first time to share and learn about the unique challenges of AMR across the region.
Findings from the symposium will enable Pacific leaders to strengthen collaborative, multi-sectoral and transdisciplinary approach to health security.
Led by CSIRO, Australia’s national science agency, the project has previously supported research to improve the management of AMR in Fiji, leading to the launch of the country's renewed National Action Plan 2022-2025 (NAP) on AMR in February 2023.
The NAP is a national policy that guides the project on the key strategic areas to be considered when collaborating with the Government of Fiji and other stakeholders to manage AMR sustainably.
Project leader and CSIRO researcher Dr Walter Okelo explained that AMR is one of the greatest threats facing human and animal health today.
‘Pathogens such as bacteria, viruses, fungi, and parasites are acquiring and developing increased resistance to the drugs designed to kill them and left unchecked, this could result in the evolution of ‘superbugs’ that do not respond to standard treatments and can cause infections that cannot be treated or contained’, said Dr Okelo.
Growing concern in the Pacific
For many years, it was assumed that AMR was not a problem for Pacific Island countries, due to their small human and animal populations. However, recent analysis has found that AMR is present, and its occurrence is increasing.
‘The threat of antimicrobial resistance is no longer a distant problem but one that most healthcare facilities deal with daily,' said Dr Okelo.
Recent studies show that the dreaded occurrence of carbapenem resistance, which was almost unheard of a decade ago, is becoming a common occurrence.
Dr Walter Okelo
Project leader and CSIRO researcher
‘Recent studies show that the dreaded occurrence of carbapenem resistance, which was almost unheard of a decade ago, is becoming a common occurrence,’ said Dr Okelo.
Carbapenem is considered a ‘last resort’ antibiotic used to treat hospital-acquired infections such as ventilator-associated pneumonia, bloodstream infections and urinary tract infections.
‘AMR is a complex issue that requires a coordinated response among multiple stakeholders,’ said Dr Okelo. Challenges persist when it comes to addressing AMR in Pacific Island countries, such as sustainable resourcing, scientific capacity and surveillance gaps.
Even though there are mounting challenges, Dr Okelo and his research team believe progress is being made.
‘Despite the challenges, the Pacific is making headway in addressing AMR. Fiji became one of the first countries in the region to develop a national AMR action plan, and the symposium enabled key regional stakeholders to share lessons learned in implementing the NAP and identify the areas of work left to be explored,’ added Dr Okelo.
‘For the first time, relevant stakeholders can gather to share lessons learned in improving the integrated management of AMR through improved surveillance, build the capacity of institutions to diagnose cases and help inform management policies at a local, national and regional level.
Collaborating for a regional approach
The Fiji Pharmaceutical Society president Mr Reenal Chand added that the symposium has been helpful in advocating the fight against AMR.
‘More advocacy is needed to raise awareness that AMR is considered to be a significant threat to the public health systems in developing countries and globally. As pharmacists and health professionals, our role includes tackling AMR to use our influence and platforms to promote awareness,’ said Mr Chand.
The symposium enabled stakeholders to discuss a wide range of issues, including raising awareness of AMR advocacy, strengthening One Health Integrated AMR surveillance, integrating infection prevention and control and enhancing governance through better policies and regulations.
ACIAR Research Program Manager for Livestock Systems, Dr Anna Okello, said ACIAR was proud to support AMR strengthening initiatives in the region including the development of the NAP which is a vital document supporting Fiji’s policymakers in preparing for future outbreaks.
‘This project, through a strong partnership and collaboration, is aimed at strengthening the overall health systems not only in Fiji but the whole region to manage, respond to monitor disease outbreaks,’ said Dr Okello.
‘This symposium demonstrated the value of regional technical partnerships between Australia and our Pacific partners in addressing regional public goods such as AMR.
‘ACIAR has a long history of investing in programs that address the linkages between food security and human health through a One Health approach.’
Dr Okello said that the project would continue strengthening the cross-sectoral collaboration between human health, animal health and the environmental sector and, in the future, will have the potential to scale out to other Pacific island countries, including Samoa.
'Enhancing the management of antimicrobial resistance in Fiji’ is a five-year project implemented by CSIRO through the Research for One Health Systems Strengthening Program in partnership with the Indo-Pacific Centre for Health Security, the University of Technology Sydney, the University of South Australia, the Fiji Ministry of Health and Medical Services and Fiji National University.