title: Key informant interview on antimicrobial resistance (AMR) in some countries in the Western Pacific region.
abstract: BACKGROUND
  The World Health Organization (WHO) selected antimicrobial resistance (AMR) as the theme for World Health Day 2011. The slogan was "Combat Drug Resistance - No action today, no cure tomorrow" A six-point policy package was launched as a core product for World Health Day. It aimed to stimulate extensive and coherent action to overcome the many challenges presented by antimicrobial resistance.
  
  
  METHODS
  As a preparation for World Health Day, interviews were conducted with a series of key informants, mainly senior government staff, to assess their awareness of the topic and the interventions proposed in the policy package. Since the key informant interview methodology was used with a small number of interviewees, it may be difficult to demonstrate the validity of the findings.
  
  
  RESULTS
  Key informants from twelve out of fifteen countries responded, which included Fiji (n = 5), Kiribati (n = 1), Lao PDR (n = 2), Malaysia (n = 6), Micronesia (n = 3), Mongolia (n = 5), the Philippines (n = 5), Vietnam (n = 6), Vanuatu (n = 1), Solomon Islands (n = 3), Cambodia (n = 5) and Brunei (n = 1). There was a total of forty-three respondents (n = 43). AMR was widely recognized as a problem. Lack of a coherent, comprehensive and national plan or strategy was noted. Surveillance was often seen as weak and fragmented even where presented. Laboratory capacity was felt to be insufficient across all countries interviewed. The majority of respondents stressed the need for national and local plans to combat AMR including reliable estimates of the financial cost of combating and managing AMR, the need for legislation to control inappropriate use of antimicrobials in food animals and more serious efforts to promote Standard Treatment Guidelines (STGs) and Rational Prescription. Also, importance was highlighted of the need to include infection prevention and control (IPC) as a part of accreditation and registration of health institutions and programs to promote IPC to the general population.
  
  
  CONCLUSIONS
  A coalition of interested parties at the local, national and international levels need to generate and sustain the political will to organize a more comprehensive, sustainable, and coherent approach to AMR.
authors.affiliation: Health Services Development Unit, World Health Organization, Western Pacific Regional Office, United Nations Avenue, P.O. Box 2932, Manila, 1000, Philippines. leeyu@wpro.who.int
authors.forename: Yuri
authors.initials: Y
authors.lastname: Lee
authors.forename: Mami
authors.initials: M
authors.lastname: Wakabayashi
mesh_terms: D000846:Anniversaries and Special Events; D001210:Asia, Southeastern; D004352:Drug Resistance, Microbial; D014943:Global Health; D006801:Humans; D008986:Mongolia; D010139:Pacific Islands; D036301:Qualitative Research; D014944:World Health Organization
references.citation: JAMA. 2011 Mar 9;305(10):1027-8
references.pmid: 21343545
references.citation: Indian J Med Res. 2010 Nov;132:482-6
references.pmid: 21149995
references.citation: Br J Gen Pract. 2006 Sep;56(530):686-92
references.pmid: 16954001
references.citation: BMJ. 2010 May 18;340:c2096
references.pmid: 20483949
references.citation: JAMA. 2011 Jun 8;305(22):2293; author reply 2293-4
references.pmid: 21642680
references.citation: Clin Microbiol Infect. 2004 May;10(5):473-97
references.pmid: 15113331
references.citation: BMJ. 2010 May 18;340:c2115
references.pmid: 20483950
references.citation: N Engl J Med. 2009 Jan 29;360(5):439-43
references.pmid: 19179312
references.citation: Bull World Health Organ. 2011 May 1;89(5):390-2
references.pmid: 21556308
references.citation: Emerg Infect Dis. 2002 Mar;8(3):278-82
references.pmid: 11927025