One Health Communication Strategy for Antimicrobial Resistance 2024 - 2027

One Health Communication Strategy for Antimicrobial Resistance 2024 - 2027 Table of Contents Acknowledgment .................................................................................................................. 1 List of contributors .............................................................................................................. 2 List of abbreviations ............................................................................................................ 3 Introduction and Background ............................................................................................. 4 Vision ..................................................................................................................................... 7 Mission .................................................................................................................................. 7 Communication Strategy’ Goals ......................................................................................... 7 Methodology ......................................................................................................................... 7 Target participants in the workshops ................................................................................. 8 SWOT Analysis for the Communication Strategy ............................................................. 8 One Health Communication Strategy Matrix for AMR .................................................... 10 Public Health centered: .................................................................................................... 10 Animal Health centered: ................................................................................................... 12 Environmental Health centered: ....................................................................................... 14 Joint Activities for the Communication Strategy Matrix ................................................ 15 Workplan for the Joint Activities ...................................................................................... 17 Four-Year Workplan Timeline for Joint Activities ........................................................... 19 References .......................................................................................................................... 24 1 Acknowledgment This communication strategy represents a culmination of collaborative efforts involving representatives from various ministries and authorities dedicated to combating Antimicrobial Resistance using the One Health Approach. These include the Ministry of Health and Population, the Ministry of Agriculture and Land Reclamation, the Ministry of Environment, the Ministry of Higher Education and Scientific Research, the Egyptian Drug Authority, and the National Food Safety Authority, in conjunction with esteemed partners including the Food and Agriculture Organization (FAO) and the World Health Organization (WHO). We express our sincere gratitude to all participants for their tireless dedication and contributions towards supporting the One Health Communication Strategy for Antimicrobial Resistance. Special appreciation is also extended to the participants of the workshops convened in 2018 and 2024, where stakeholders came together to shape this strategy in combating Antimicrobial Resistance. We would like to extend our heartfelt gratitude to the Food and Agriculture Organization of the United Nations (FAO) Egypt for their invaluable contribution and unwavering support in the development of this document. The One Health Communication Strategy for Antimicrobial Resistance represents a significant step forward in the fight against this urgent global health challenge. 2 List of contributors The One Health Communication Strategy for AMR aims to address the growing threat of AMR by promoting a unified approach to communication and education. The creation of this strategy involved the participation of experts and professionals from various fields who participated in workshops held in 2018 and 2024. The participants shared their knowledge, insights, and experiences through these workshops and worked together to develop a comprehensive and effective communication strategy to combat AMR. Ministry of Health and Population: Dr. Marwa Nabil, Dr. Baher El Desouky, Dr. Sherif Shamseldein, Dr. Noura Asal, Dr. Khaled Rady, Dr. Adham Hashish, Dr. Shereen Elghazaly, Dr. Shaimaa Fouad, Dr. Mariam Abdelsabour, Dr. Zakaria Khalil, Dr. Ola Ahmed, Dr. Fatma AbdelKhalek, Dr. Mohamed Sharaf, Dr. Shereen George, Dr. Amira El Nakeeb, Mr. Ahmed Yasser, Ms. Sara Gomaa, Mr. Adel Salem, and Dr. Amr Kandeel. Ministry of Agriculture and Land Reclamation: Dr. Rabab El Sawah, Dr. Safaa El Fadaly, Dr. Ahmed Hany, Dr. Mohamed Wadea, Dr. Mohamed Attia, Dr. Ahmed Habashi, Dr. Hend Mohamed, Dr. Shaimaa Ramadan, and Dr. Momtaz Shaheen. Ministry of Environment: Dr. Rehab Mohamed, Dr. Luay Elsayed, Dr. Fatma Abdel Baset, Dr. Mona Samir, Mr. Mohamed Said, and Dr. Reham Lotfi. Ministry of Higher Education and Scientific Research: Dr. Ghada Ismail, Dr. Mona Moheyeldin, Dr. Ahmed Soliman, and Dr. Ghada ElGendy. Egyptian Durg Authority: Dr. Abeer Elbehairy National Food Safety Authority: Dr. Fagelnour Elnoamany Food and Agriculture Organization: Dr. Ahmed Saad, Dr. Lofti Allal, Dr. Samah Ali, Dr. Noura Hassan, Dr. Amira Abdelnabi, Dr. Engy Hamed, Ms. Rawya El Dabi, Mr. Mohamed Moussa, Ms. Salma Al Shinetty, and Mr. Hamada Soliman. World Health Organization: Dr. Liz Tayler, Dr. Reem Gouda, Ms. Heba Abou Bakr, Ms. Yasmeen Ali, and Dr. Yara Khalaf. USAID: Dr. Waleed El Fiky 3 List of abbreviations AHRI: Animal Health Research Institute AM: Antimicrobial AMR: Antimicrobial Resistance AMU: Antimicrobial Use AWaRe: Access, Watch, Reserve (classification by the World Health Organization) EDA: Egyptian Drug Authority FAO: Food and Agriculture Organization GAP: Global Action Plan GOVS: General Organization for Veterinary Services IPC: Infection Prevention and Control KAP: Knowledge, Attitude, Practice MOALR: Ministry of Agriculture and Land Reclamation MOHE: Ministry of Higher Education and Scientific Research MOHP: Ministry of Health and Population NAP: National Action Plan NFSA: National Food Safety Authority OH: One Health SDGs: Sustainable Development Goals UN: United Nations WAAW: World AMR Awareness Week WHO: World Health Organization WOAH: World Organization of Animal Health 4 Introduction and Background The One Health (OH) approach is a collaborative, multi-sectoral, and multidisciplinary approach that encompasses all national, regional, and global levels and aims to achieve optimal human health outcomes while considering preserving animal and plant health and improving environmental health. One Health focuses on investing in health research and setting up and implementing multi sectorial programs, policies, and legislation to address the health threats facing humans, animals, plants, and the environment and develop new and improved concepts to produce viable and long-lasting solutions. Over the past few years, the government of Egypt has made noteworthy advancements in setting up mechanisms for coordination between various sectors such as human, animal, environmental, and other related sectors, including the endorsement and launching of the National One Health Strategic Framework 2023 - 2027 by the government of Egypt in April 2023 with the support of different national and international agencies Ministry of Health and Population (MOHP), Ministry of Agriculture and Land reclamation (MOALR), Ministry of Higher Education and Scientific Research (MOHE), Ministry of Local Development (MOLD), Egyptian drug authority (EDA), National food safety authority (NFSA), World Health Organization (WHO) and Food and Agriculture Organization (FAO) and it guides the implementation of One Health through five themes; curbing the silent pandemic of Antimicrobial Resistance (AMR), controlling and eliminating Zoonotic, and vector-borne diseases, joint assessment, management and communication of risks affecting food and water safety, Integrating the environment into One Health and enhancing One Health capacities that ensure collaborative and coordinated activities to prevent health threats. Figure (1): Themes of National One Health Strategic Framework 5 Furthermore, the strategic framework includes seven different technical pillars: Governance and Leadership, Enhancing One Health Capacities, Surveillance, Early Warning and Joint Risk Assessment, Joint Planning for Preparedness and Response, Effective Risk Communication and Community Engagement, Cross-Border partnership and Networking, and Applied Research and Innovation. Figure (2): Technical Pillars of National One Health Strategic Framework Moreover, in 2019, the World Bank reported that the bulk of antimicrobial use in many countries occurs in the agriculture sector, particularly in livestock. Although data is not available specific to Egypt, the World Bank estimated that antibiotic use as a livestock feed additive increased from 16 percent to 48 percent of total use, representing a fifty-fold rise in their use for growth promotion in animal rations. Studies estimated that livestock's global consumption of antimicrobials will continue to increase by 67 percent between 2010 and 2030, as in Pulling Together to Beat Superbugs Knowledge and Implementation Gaps in Addressing Antimicrobial Resistance. In Addition, after recognizing the magnitude and rising threats posed by AMR, world leaders passed a resolution to curb the spread of AMR. The Global Action Plan (GAP) on AMR was endorsed in the 71st session of the United Nations (UN) General Assembly held in September 2016. The General Assembly created a political declaration asking all countries to consolidate their efforts in combating AMR using the One Health approach. The WHO developed the GAP in collaboration with FAO and the World Organization of Animal Health (WOAH, formerly OIE) to serve as a blueprint and guide Member States in developing their national action plans (NAP) through the One Health (OH) approach. Subsequently, Egypt developed its NAP on AMR in 2018 through a consultative process demonstrating the country’s commitment to mitigate the threats and impacts of AMR. 6 The Global Action Plan has defined the following five strategic objectives for containment of AMR: 1. Improve awareness and understanding of antimicrobial resistance 2. Strengthen knowledge through surveillance and research 3. Reduce the incidence of infection 4. Optimize the use of antimicrobial agents 5. Develop an economic case for sustainable investment based on country needs and increase investment in new vaccines, diagnostics, and other interventions. Raising awareness of the misuse of antibiotics in various sectors is one of the most important steps in bringing about a sustainable behavior change. Many healthcare planners and policymakers assume that increasing awareness will result in behavioral change, especially since there is a government commitment to AMR along with the availability of adequate technical expertise and a strong mass media presence (60 percent of the population rely on TV as their source of information) and an ever-growing social media presence. However, great attention should be directed to tackling prevailing cultural myths and beliefs regarding the use of antibiotics, meek enforcement of existing laws, and rare awareness programs. However, increasing awareness alone does not result in significant behavioral change unless the issues are addressed holistically and based on evidence. Behavioral change is expected to be the final fruit of a long and hopefully dynamic process. This process should rest on four pillars: • Adequate awareness • Robust regulatory environment • Emotional or material incentives • Enabling social structure With this background, Egypt’s National Action Plan 2018-2022 has set out four goals by emphasizing the importance of promoting awareness on AMR. The four goals of Egypt’s NAP include: 1) Improve public awareness, understanding of antibiotic use, and antimicrobial resistance; 2) Slow the emergence of new resistant patterns and control the spread of resistant pathogens via optimizing the use of antimicrobial medicines in human and animal health; 3) Strengthen national One-Health surveillance efforts to combat resistance that can arise in humans, animals, and the environment; and 4) Implement evidence-based infection control practices that can prevent the spread of resistant pathogens. Therefore, developing a One Health Communication strategy for Antimicrobial Resistance was essential, as it will guide the improvement of awareness through risk communication and education as well as a joint work plan to prioritize the activities and monitor them with a set of indicators to track the implementation of the activities. 7 Vision "To envision our Egypt where the health and well-being of humans, animals, and the environment are protected through concerted efforts, robust communication, and collaborative action against Antimicrobial Resistance (AMR), ensuring a sustainable future for generations to come." Mission "Our mission is to develop and implement a tailored One Health communication strategy for AMR in Egypt, leveraging interdisciplinary collaboration among healthcare professionals, veterinarians, policymakers, researchers, and community leaders. Through targeted communication campaigns, education initiatives, and stakeholder engagement, we aim to raise awareness, promote responsible antimicrobial use practices, and drive policy changes to combat AMR effectively. By fostering a culture of cooperation and shared responsibility, we strive to safeguard public health, preserve animal welfare, and protect the environment, thereby securing a healthier future for all Egyptians." Communication Strategy’ Goals • Raise public awareness about the causes, risks, and consequences of Antimicrobial Resistance (AMR). • Enhance Interdisciplinary Collaboration to facilitate a coordinated One Health approach to combat AMR effectively. • Promote responsible antimicrobial use in both human and animal health sectors. • Advocate for Policy Changes to combat AMR effectively. Methodology A participatory approach has been adopted in the development of the One Health Communication Strategy for AMR. Two consultative workshops were held in this context, with several roundtable discussions in between with the relevant stakeholders. The first two-day workshop was held in Ismailia from 23-24 August 2021, where the first draft of the communication strategy was introduced. A second consultative two-day workshop was organized in Cairo from 6-7 March 2024 in accordance with what was agreed upon at the meeting held in 2021 to revise and update the existing draft of the communication strategy and develop the joint workplan for a period of four years aligned with both the strategic framework and the national operational plan for one health. Participants presented their ideas in relation to the different components of this Strategy, such as target audiences, communication objectives, messages, communication channels, and tools. These ideas were extracted via participatory facilitation tools. Results are presented in the following sections of this document. 8 The workshops were based on working groups for brainstorming and discussions in plenary on the topics. Target participants in the workshops Participants have attended the workshops representing MOHP, MOALR (GOVS & AHRI), MOE, MOHE, WHO, FAO, USAID, and communication officers from these entities. SWOT Analysis for the Communication Strategy Strengths: Comprehensive Approach: Utilizing a One Health approach acknowledges the interconnectedness of human, animal, and environmental health, allowing for a more holistic understanding and response to AMR. Multisectoral Collaboration: Involving stakeholders from various sectors such as health, agriculture, environment, and policy enhances the effectiveness and reach of communication efforts. Long-Term Perspective: A four-year workplan allows for sustained and consistent communication efforts, ensuring that messages are reinforced over time and enabling the implementation of multifaceted strategies. Potential for Innovation: Long-term planning provides opportunities to explore and integrate innovative communication technologies and strategies, such as social media campaigns, interactive websites, and educational apps, to engage diverse audiences. Weaknesses: Resource Intensive: Maintaining a four-year communication plan requires significant financial, human, and technological resources, which may pose challenges in terms of funding and sustainability. Coordination Challenges: Alignment priorities, mandates, and communication styles with different logistical challenges and delayed implementation when coordinating efforts across multiple sectors and organizations. Complexity of Message: Communicating about AMR using a One Health approach involves conveying complex scientific concepts in a clear and accessible manner to diverse audiences, which may require specialized expertise and tailored messaging strategies. Resistance to Behavioral Change: Encouraging behavior change, such as appropriate antibiotic use in humans and animals, may face resistance due to entrenched practices, cultural beliefs, and economic interests. 9 Opportunities: Policy Support: Increasing global awareness and political momentum around AMR and the One Health approach, together with the presence of a national One Health strategic framework considering AMR as one of its main themes and risk communication and community engagement as one of the main pillars, present opportunities to align communication efforts with policy initiatives and leverage support for interventions at national and international levels. Education and Awareness: Long-term communication strategies can build public awareness, knowledge, and understanding of AMR, fostering a culture of responsible antimicrobial use and stewardship. Partnerships and Alliances: Collaborating with key stakeholders, including government agencies, academic institutions, healthcare providers, industry partners, and community organizations, can amplify the impact of communication efforts and facilitate knowledge exchange and capacity building. Behavioral Insights: Utilizing insights from behavioral science and social marketing can inform the design of targeted communication campaigns that effectively motivate behavior change and promote adherence to best practices in antimicrobial stewardship. Threats: Misinformation and Misconceptions: AMR communication efforts may face challenges from misinformation, skepticism, and conflicting messages disseminated through various channels, including social media and traditional media outlets. Complacency: Despite growing awareness, there is a risk of public and stakeholder fatigue or complacency regarding the threat of AMR, particularly if progress is not visibly demonstrated or if competing health priorities emerge. Economic Pressures: Economic considerations, such as cost constraints and competing budget priorities, may limit investments in communication activities and hinder the implementation of comprehensive AMR strategies. Global Health Emergencies: The emergence of new infectious diseases or other global health crises may divert attention and resources away from AMR communication efforts, highlighting the need for flexibility and adaptability in long-term planning. This SWOT analysis provides a starting point for assessing the internal and external factors that may influence the development and implementation of a four-year workplan for communication about antimicrobial resistance using a One Health approach. It can inform strategic decision-making and help identify opportunities to maximize the effectiveness and impact of communication efforts in addressing this critical public health challenge. 10 One Health Communication Strategy Matrix for AMR Public Health centered: Target audiences Messages Channels and tools Health Care Providers • What is AMR? • How to protect yourself from AMR • What is antimicrobial stewardship • AMR affects medical cost • What are AMR defense mechanisms/ what and how are the proper AMU • No action today, no cure tomorrow • Antibiotics should be prescribed only when necessary • Importance of good IPC measures to reduce cross infection • Discharging AM drugs into the environment increases AMR • Adherence to good drug and pharmaceutical importation, manufacturing, distribution, and disposal guidelines/practices is imperative • Promotion of accredited drug dispensing outlet systems to improve access to quality medicines and pharmaceutical services is required • Proper infection control measures can prevent the spread of AMR in both humans and animals • The importance of providing alternatives to AMs • AMs to be used when a microbial infection is confirmed • Increase awareness of the WHO AWaRe classification Channels • Trainings • Workshops • Meetings • Study tours • Door-to-door visits Tools • Training material • Power Point Presentations • Digital material • Brochures • Posters and flyers • Guidelines Physicians Pharmacists Nurses Health educators Dentists Pharmaceutical companies with AMR awareness (selective multi nationals) Medical syndicates Decision makers (parliamentarians, ministries, legislative entities and governmental authorities) • AMR as a global threat – a silent pandemic • Financial/economic burden/cost of antimicrobials misuse Channels • Official letters • Orientation meetings • Coordination meetings • Round table discussions Tools • Policy briefs • Power Point Presentations 11 Community members • What are the proper uses of antibiotics • Importance of rational use of antibiotics • What is the concept of One Health • Healthy lifestyle protects from infection and enriches the proper AMU • Importance of hand hygiene in preventing infection • Misuse of antibiotics reduces its effectiveness • Impacts of antibiotics misuse • Protection/prevention is better than medication • AMR is a health risk • Get vaccinated to prevent infection • AMR prevention is a shared responsibility Channels • TV • Workshops /trainings • Social media • Mass media • Influencers • Community meetings Tools • Leaflets/ brochures • Posters • Awareness spots (animated) • Social Media cards • Short videos • Competitions Students (schools and universities and fresh postgraduates) Youth centers Community Healthcare workers (Raedat refiaat) Influencers (including religious leaders) NGOs Private sector Customer protection associations 12 Animal Health centered: Target audiences Messages Channels and tools General public (including pet owners) Fishers syndicate Farmers syndicate Poultry and pet merchants • What is AMR? • What is biosecurity? • What are antimicrobials • What is antimicrobial misuse • AMR is costly and risky • When does AMR occur • Impact of AMR on our lives • Protect yourself and your family from AMR risks • Antibiotics do not prevent or treat viral infections; these work on bacterial infections only. • Food should be stored and prepared in a clean environment to avoid cross-contamination • Antimicrobials should be prescribed by a vet • Diagnostic tools are available. Use them before you take antibiotics. Channels • TV, radio, print and online news • Workshops • Drama • Social media • Community meetings • WhatsApp groups • Training workshops • Field demonstrations • Farmer based organizations • Churches and mosques (Friday prayers) • Giveaways • Events and campaigns Tools • Policy briefs • Reports • Brochures • Training material • Awareness videos • Posters • Flyers • Info graphs • WhatsApp messages • Guidelines • TV drama series Farmers (small scale and large scale) • AMR health risks • Safe production • You have an important role in providing safe food to communities • Repeated and excess use of antibiotics make pathogens incurable • Use antibiotics as a last resort • Enhance biosecurity to minimize use of antibiotics • Biosecurity measures are the first line of defense against microbial pathogens • Biosecurity measures protect livestock and poultry from AMR • Don’t use antibiotics for preventing diseases • Pesticides to be prescribed as a last resort • AMR can be transferred between animals and humans • AMs should be prescribed by the vet • You have an important role in providing safe food to the community 13 • Keep high biosecurity metasearch all the time • Vaccinate your animals at the right time and space • Never use AMs for growth • Do not use antibiotics that were prescribed for humans on animals • Messaging on cost/benefit of animal vaccination Veterinary doctors Veterinary pharmacists • AMR is a health risk • Antibiotics should be given with a prescription • Antibiotics should be prescribed only when necessary • Importance of good IPC measures to reduce cross infection Veterinary students • AMR is a health risk • Antibiotics should be given with a prescription • What are the principles of the safe use of antibiotics Vet extension officers • Misuse of AMs such as pesticides leads to AMR • Increased resistance leads to increased losses and mortality in animals and humans • GAP (biosecurity, vaccinations, IPC, IPM reduce the need for AMs including pesticides). Feed producers • AMR is a health risk • Antimicrobials should not be used as a preventive measure nor as a food additive • What is the safe use of antibiotics • Limiting the access of medicated feed to veterinary prescription is imperative • Adherence to best practices guidelines to combat AMR Decision makers (parliamentarians, ministries, legislative entities, and governmental authorities) • The need for national regulations to be enhanced 14 Environmental Health centered: Target audiences Messages Channels and tools Workers: Poultry and large animal’s sector Slaughterhouses Dairy factories Fish farms On boats • Protect our children and their health by rationalizing the use of antibiotics in our environment • Increased use of antibiotics means a loss in our resources (birds and fishes) • Importance of personal hygiene as a preventive measure • Pesticides to be prescribed as a last resort • The need to adhere to appropriate waste management practices of AM Channels • TV • Goodwill Ambassadors • Celebrities • Mobiles • Social media • Community meetings Tools • Giveaway material (T-shirts, mugs, caps, etc.) • WhatsApp messages • Awareness videos • Board games (snakes and ladder, monopoly, etc.) • Social media posts • Power Point Presentations Fishermen and hunters • Mistreatment of wasted animals in sea and on land can be reduced and eventually stopped after awareness Tourist companies (internal environment tourism) Local communities (Siwa, Sinai, Eastern and Western Deserts) Rural communities Slums Academia (including school teachers and academic researchers) • The need for AMU/AMR data generation • Working with decision makers is imperative • AMR to be a mandatory subject in curriculum Channels • Meetings Tools • Outline of a new curriculum that includes info on AMR 15 Joint Activities for the Communication Strategy Matrix Target audiences Messages Channels and tools General Public • What are the proper uses of antibiotics • Importance of rational use of antibiotics • What is the concept of One Health • Healthy lifestyle protects from infection and enriches the proper AMU • Importance of hand hygiene in preventing infection • Misuse of antibiotics reduces its effectiveness • Impacts of antibiotics misuse • Protection/prevention is better than medication • AMR is a health risk • Get vaccinated to prevent infection • AMR prevention is a shared responsibility • What are antimicrobials • AMR is costly and risky • When does AMR occur • Protect yourself and your family from AMR risks • Antibiotics do not prevent or treat viral infections; these work on bacterial infections only. • Food should be stored and prepared in a clean environment to avoid cross-contamination • Antibiotics should be given with a prescription • What are the principles of the safe use of antibiotics Channels • TV, radio, print and online news • Workshops/trainings • Social media • Mass media • Influencers • Community meetings • WhatsApp groups • Field demonstrations • Farmer based organizations • Churches and mosques Tools • Leaflets/brochures • Posters • Awareness spots (animated) • Social Media cards • Short videos • Policy briefs • Reports • Brochures • Training material • Awareness videos • Flyers • Info graphs • WhatsApp messages • Guidelines • TV drama series 16 Decision makers • AMR is a silent pandemic that needs to be avoided Channels • Round Table Discussions • Mass Media • Social Media • Bilateral meetings with key decision makers • Coordination meetings • Press conferences Tools • Presentations, info graphs, short videos, policy briefs. Academia • Risks of AMR on health, food and the environment • Principles of the safe use of antibiotics • Concept of One Health Channels • Workshops • Social Media • Goodwill Ambassadors/celebrities • Events Tools • Tweets, awareness spots in TV and radio, posters, leaflets, info graphs, short videos, technical reports on AMR 17 Workplan for the Joint Activities Goal: Improve the awareness of AMR to reduce its negative impact on humans, animals, and the environment. Contribution to Sustainable Development Goals (SDGs, Targets): SDG 3, SDG 4, SDG 6, SDG 13, SDG 14, SDG 15. Outcome Indicator(s) and target at the end of the period. • Rational use of antibiotics. • Increase knowledge of AMR. Objective 1: 20% increase in AMR awareness of the General Public (includes rural and urban communities, NGOs, religious leaders, media, private sector) over 4 years. Activities • Baseline assessment. • Develop educational materials on AMR. • Training of trainers (common team from different sectors) • Campaigns (WAAW, social media campaign, lectures in universities and schools, religious leaders in Mosques and Churches, face to face, competitions between entities on high communication performance, etc...) • Workshops (influencers – mapping them, scenario writers) • Workshops for (NGOs and Syndicates) • Short educational videos (Animations, TV awareness spots, etc.) • Drama on AMR. • Annual intermediary check/evaluation or after 1.5 years. • Specialized one health page. Time frame 2024 – 2027 Geographic Scope National Performance Indicator (s) • KAP study done. • Educational materials developed. • No. of trainings implemented, No. of trainees, and geographical areas covered. • No. of target audience receiving awareness. • Average view duration of videos (video duration/no. of plays). • Engagement rate (total likes, saves, shares, comments by no. of followers). • Rational use and increased awareness. • No. of media stories. • Awareness on the indications of antibiotics in reserve groups in human and animal sector. • Awareness regarding adherence to the Law of Waste Management. Mean (s) of verification • KAP study report. • TV stations. • Reports from agencies implementing the joint activities. • Social media statistics. • Media analysis reports by specialized companies. 18 Objective 2: • 10% increase in AMR awareness of Decision Makers (includes Ministries, Specialized Authorities, Parliamentarians) over 4 years. Activities • Map the existing regulations to identify which are being implemented and which not (what are the existing antibiotic policies in the private and public sectors). • Roundtable discussions with decision makers from the three sectors on modifying and activating regulations related to AMR. • Production of Policy briefs explaining how AMR is a silent pandemic and how to curb its negative impacts. • Periodic briefs on AMR situation. • Conferences and workshops for Parliamentarians & consultative council. Time frame 2024-2027 Geographic Scope National Performance Indicator (s) • Roundtable discussions conducted. • No. of Policy briefs. • No. of briefs. Mean (s) of verification • Official announcements of AMR regulations. • Ministerial declarations. • Media coverage analysis versus KAP study findings. Objective 3: • 30% increase in AMR awareness of Academia (includes Universities, Schools, Research entities) over 4 years. Activities • Workshops for research entities and university reps on AMR. • Peer to peer trainings (youth - awareness campaigns by Student unions/associations). • Develop activities and games for school children. • Research by youth. • Competitions amongst university students on AMR research and projects. • Conference for academia regarding AMR curriculum. • Production of AMR curriculum to be included in universities and schools. Time frame 2024-2027 Geographic Scope National Performance Indicator (s) • No. of events. • No. of participants. • No. of youth trainees. • Curriculum published. Mean (s) of verification • Reports on WAAW activities in schools and universities. • Reports of workshops conducted with fresh university graduates. • Reports on lectures that took place in schools and universities. • Curriculum that includes information on AMR. 19 Four-Year Workplan Timeline for Joint Activities Activity Timeline Year One Year Two Year Three Year Four Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Conduct baseline assessments of AMR awareness among the general public, decision-makers, and academia. * * Develop tailored communication materials for each target audience, including fact sheets, infographics, and educational videos. * * * * * Launch initial awareness campaigns targeting the general public through social media, community events, and healthcare facilities. * * Expand outreach efforts to reach decision-makers through policy forums, workshops, and briefing sessions. * * * * Initiate partnerships with academic institutions to integrate AMR awareness into curricula and research programs. * * Conduct focus groups and surveys to evaluate the effectiveness of the previous quarter. * * * * * * * * * * * * * * * Intensify awareness campaigns targeting the general public using traditional media, such as radio, television, and print. * * * * 20 Activity Timeline Year One Year Two Year Three Year Four Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Engage decision-makers in discussions on the societal and economic impacts of AMR, highlighting the importance of policy interventions. * * * * Facilitate workshops and seminars for academia to raise awareness of AMR research and educational initiatives. * * * * Assess intermediate outcomes of awareness campaigns. * * * * Develop plans for scaling up educational programs and advocacy efforts for the next year * * * * Scale up educational programs targeting the general public, decision makers, and academia, including webinars, training sessions, and educational toolkits. * * Expand partnerships with community based organizations, professional associations, and industry stakeholders. * * * * Launch digital platforms and e learning initiatives to disseminate AMR educational content to a wider audience. * * Advocate for policy change by engaging decision-makers in policy dialogues, legislative briefings, and advocacy campaigns. * * 21 Activity Timeline Year One Year Two Year Three Year Four Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Strengthen collaboration between academia, government agencies, and industry partners on interdisciplinary AMR research projects. * * * * Continue awareness campaigns targeting the general public through targeted social media campaigns, public events, and community outreach activities. * * * * Mobilize support for AMR initiatives among decision-makers through evidence-based recommendations and case studies. * * Foster interdisciplinary research collaborations within academia to address key gaps in AMR knowledge and promote One Health approaches. * * Refine communication strategies based on evaluation findings and stakeholder feedback. * * * * Advocate for integrating AMR awareness into national and regional health policies and action plans. * * Document success stories and best practices to showcase the impact of joint activities on AMR awareness. * * Develop a sustainability plan to ensure the continued momentum of AMR awareness activities beyond the four-year timeframe. * * 22 Activity Timeline Year One Year Two Year Three Year Four Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Finalize plans for the culminating event or campaign, including logistics, promotion, and stakeholder engagement. * * * * Mobilize support for ongoing AMR initiatives and inspire continued collaboration towards addressing AMR through a One Health approach. * * * * Prepare for the culminating event or campaign to celebrate achievements in year 4. * Sustain momentum by continuing awareness campaigns and educational programs, focusing on reinforcing key messages and addressing remaining knowledge gaps. * * * * Strengthen partnerships with international organizations, neighboring countries, and regional networks to leverage resources and expertise in combating AMR. * * * * Advocate for sustained investment in AMR awareness and control efforts by highlighting the long-term benefits of addressing antimicrobial resistance. * * Evaluate the long-term impact of the One Health communication strategy on AMR awareness and assess progress towards the 20% increase in awareness among the general public, decision-makers, and academia. * * 23 Activity Timeline Year One Year Two Year Three Year Four Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Empower stakeholders to take ownership of AMR communication efforts by providing training, resources, and ongoing support. * * Foster collaboration between academia, government agencies, industry partners, and civil society to address emerging challenges and opportunities in the fight against AMR. * * * * Evaluate the overall impact of the four-year workplan on AMR awareness and behavior change and identify areas for future focus and improvement. * * 24 References – FAO, UNEP, WHO, and WOAH. Global Plan of Action on One Health: Towards a More Comprehensive One Health Approach to Global Health Threats at the Human Animal-Environment Interface. Rome; 2022. Available from: https://doi.org/10.4060/cc2289en. – FAO. National Action Plan for Antimicrobial Resistance 2018-2022. Available from: https://faolex.fao.org/docs/pdf/egy204655E.pdf. – National Strategic Framework for One Health 2023-2027. – World bank. Pulling Together to Beat Superbugs. Available from: [https://documents1.worldbank.org/curated/en/430051570735014540/pdf/Pulling Together-to-Beat-Superbugs-Knowledge-and-Implementation-Gaps-in-Addressing Antimicrobial-Resistance.pdf]. – World Health Organization. Global Action Plan on Antimicrobial Resistance. Geneva, Switzerland; 2015. Available from: https://www.who.int/publications/i/item/9789241509763. – World Health Organization. One Health Joint Plan of Action (2022-2026): Working Together for the Health of Humans, Animals, Plants, and the Environment. Geneva, Switzerland; 2022. https://doi.org/10.4060/cc2289en https://faolex.fao.org/docs/pdf/egy204655E.pdf https://www.who.int/publications/i/item/9789241509763 One Health Communication Strategy for Antimicrobial Resistance 2024 - 2027