Antimicrobial resistance response hampered by poor governance, study finds

News brief

Resistant bacteria in petri dish — TopMicrobialStock / iStock

An analysis of national action plans (NAPs) on antimicrobial resistance (AMR) shows a "marked divide" in how high-income and low-income countries are able to respond to AMR, with low-income nations hampered by poor governance and systemic challenges, researchers reported yesterday in The Lancet Infectious Diseases.

For the analysis, a team of UK, US, and German researchers used a governance framework to assess 161 publicly available NAPs developed and implemented since 2017, when World Health Organization member states made a commitment to develop multisectoral NAPs using a One Health Approach. The framework consisted of 54 indicators pertaining to 18 domains that focus on three main areas relevant to global health governance: policy design, implementation tools, and monitoring and evaluation. A previous analysis by the same group in 2023 assessed 114 NAPs.

The researchers used national data from 2021-22 from five sources to generate composite scores for each country, ranked the countries by their mean score on a scale of 0 to 100, then evaluated the correlation between the country scores and various metrics on the burden of drug-resistant infections.

Higher governance scores linked to lower burden of AMR

Governance scores varied considerably across countries but were generally higher in high-income countries than low-income countries, indicating more effective and robust AMR control measures in countries with stronger economies, including the United States, United Kingdom, France, Sweden, and Denmark.

"The distribution of scores highlighted a trend whereby economic strength appeared closely aligned with both income levels and regional affiliation, emphasising a global inequality in antimicrobial resistance scores based on economic development," the study authors wrote. Countries with long-standing democratic traditions and more stable political environments also had higher scores.

In turn, higher governance scores were significantly associated with a lower burden of AMR-associated disability-adjusted life-years and death. Infection prevention and control, surveillance, and antimicrobial stewardship were the domains most strongly correlated with a lower burden of drug-resistant infections.

"These results should support policy makers to select priority actions for their respective action plans and to close the implementation gaps between countries and regions," the authors concluded.

New measles cases reported in Virginia, New Jersey

News brief

Chris Dall, MA

Health officials in New Jersey and Virginia yesterday reported new measles cases.

The New Jersey Department of Health (NJDOH) alerted residents to a new measles case in a resident of Bergen County that's not linked to any previously reported cases in the state. It’s the tenth measles case recorded in the state this year.

In Virginia, the Virginia Department of Health confirmed the state's fourth measles case this year is in a school-age student in the eastern region of the state who had recently traveled internationally.

Health officials in both states say they are working with local officials to identify and notify people who may been exposed to measles by the two patients.

In its weekly update yesterday, the Centers for Disease Control and Prevention said 1,431 confirmed measles cases have been reported in the United States since the beginning of the year. That's the highest number of cases reported since the country reached measles elimination status in 2000.