Fiji: An Antimicrobial Resistance Country Profile
Fiji: An AMR Success Story
In November 2015, during the very first World Antibiotic Awareness Week, Fiji became the first Pacific country to develop and launch a national plan for antimicrobial resistance. Recognizing the long term and disastrous effect AMR would have on the country’s health and economic systems, Fiji’s 3 year plan highlighted the prioritization of action against AMR, including the 5 objectives outlined in the Global Action Plan on AMR.
To date 16 Member States/areas have developed national action plans in the Western Pacific Region.
Fiji’s National AMR Committee (NARC), comprised of multi-agency members, across sectors, is a stepping stone to effectively implement the aspirations of the National Action Plan. The NARC has been incorporated as a sub-committee of the Fiji Medicinal Products Board under the Medicinal Products Act, with the objective being to protect the health and safety of the public by regulating medicinal products, devices, poisons and similar products.
Addressing Objective One of the Global Action Plan on AMR, Fiji has been diligent in actively advocating and created greater public awareness on AMR through its Consumer council. Since 2015, the country has marked World Antibiotic Awareness Week annually, and the Fiji Consumer Council has engaged in AMR programme consumer awareness activities through a variety of initiatives.
The challenges
Having made leaps and bounds as a Pacific country addressing AMR, Fiji has also acknowledged a number of significant challenges faced while implementing the objectives of the Global Action Plan on AMR.
Surveillance
Overwhelmingly, a major barrier to Fiji’s action on AMR is the absence of a national surveillance system on antimicrobial resistance.
“Fiji is committed to helping forward global data on AMR surveillance, but at this time lacks the necessary capacity and capability to develop its own national AMR surveillance system,” Dr. Eric Rafai, Deputy Secretary Public Health, Ministry of Health & Medical Services, Fiji.
“There are major gaps in our technical capabilities, education and laboratory facilities.”
On a global scale, WHO’s Global Antimicrobial Resistance Surveillance System (GLASS) aims to foster national AMR surveillance systems and to enable the collection, integrated analysis and sharing of standardized and validated data on antimicrobial resistance. These data will help to inform national, regional and global decision-making, strategies and advocacy on AMR.
As of May 2018, 70 countries have enrolled to participate in GLASS, including Australia, Japan, Malaysia, New Zealand, Philippines, Republic of Korea and Singapore in the Western Pacific Region.
In acknowledgement to the barrier faced, Fiji has highlighted that the key to overcoming this issue depends on increased international assistance with the establishment of GLASS, or an AMR surveillance system that is sustainable in the long term.
Consumption
Another key barrier for the country is the absence of a central system of monitoring for antimicrobial consumption.
“Across public and private sectors, we again see a significant lack of capacity and resources to effectively monitor consumption of antibiotics.”
While this is a reality for many nations, there is reason to believe that global monitoring of consumption is becoming an easier task for countries to fulfil.
Based on the WHO Report on Surveillance of Antibiotic Consumption, released on Monday, there is indication that collecting national data is possible on a low-budget scale.
Since 2016, WHO has been working on an ongoing basis with Low and Middle Income Countries (LMICs) to increase capacity for antimicrobial consumption. An impressive 16 LMIC countries were able to provide their data for the latest report, suggesting that in the coming years, it could be possible for data to be collected from an even wider range of developing countries.
Health Systems
More generally, a large proportion of Fiji’s barriers come with the need to address issues in the national health system.
Speaking at 71st World Health Assembly side event, Dr. Rafai highlighted a number of challenges Fiji faces, “In a nutshell, the areas of our focus for actions in AMR are related strongly to the Health System building blocks.”
These areas include the need to strengthen; hospital infectious control practices and procedures, antimicrobial stewardship, AMR risk management measures, and the medicine regulatory system.
“Empowering the multisectoral committee (NARC), with support and assistance through national and international networks and partnerships is key to Fiji taking the next steps to effectively address AMR as an ongoing global health concern”
