巴基斯坦：国家抗菌素耐药性行动计划2.0（2024-2028）

Implementing Agencies I.Ministry of NationalHealthServicesRegulation andCoordinationII.Ministry of NationalFoodSecurity andResearchIII.Ministry of Climate ChangeIV.Pakistan Council of Research in Water Resources(PCRWR)V.Environmental Protection Agency/National Agricultural Research Centre/Aquaculture Abbreviations AHC–Animal Health CenterAMC–Antimicrobial ConsumptionAMR–Antimicrobial ResistanceAWaRe–Access, Watch, Reserve (antibiotic classification)CRE–Carbapenem-Resistant EnterobacteriaceaeCSSD–Central Sterile Services DepartmentDAI–Development Alternatives, Inc.DRAP–Drug Regulatory Authority of PakistanDTLs–Drug Testing LaboratoriesEML–Essential Medicines ListEQA–External Quality AssuranceFAO–Food and Agriculture OrganizationGAP–Global Action Plan (on AMR)GLASS–Global Antimicrobial Resistance and Use Surveillance SystemHCAI–Healthcare-Associated InfectionsHEC–Higher Education CommissionHRI–Health Research InstituteIHME–Institute for Health Metrics and EvaluationIPC–Infection Prevention and ControlJEE–Joint External EvaluationLMICs–Low-and Middle-Income CountriesM&E–Monitoring and EvaluationMDR–Multidrug-ResistantMoNHSRC–Ministry of National Health Services, Regulations, and CoordinationMRSA–Methicillin-Resistant Staphylococcus aureus NAP–National Action PlanNDM-1–New Delhi Metallo-beta-lactamase-1NEQAS–National External Quality Assurance SchemeNIH–National Institute of HealthNRL–National Reference LaboratoryPASS–Pakistan AMR Surveillance SystemPDR–Pan-Drug ResistantPHRC–Pakistan Health Research CouncilPPS–Point Prevalence SurveySDGs–Sustainable Development GoalsSWOT–Strengths, Weaknesses, Opportunities, ThreatsTrACSS–Tripartite AMR Country Self-Assessment SurveyTWG–Technical Working GroupUNEP–United Nations Environment ProgrammeUNGA–United Nations General AssemblyVPDs–Vaccine-Preventable DiseasesVRE–Vancomycin-Resistant EnterococciWASH–Water, Sanitation, and HygieneWHO–World Health OrganizationWOAH–World Organisation for Animal Health (formerly OIE)XDR–Extensively Drug-Resistant Foreword Antimicrobial resistance (AMR) poses one of the most urgent and complex public health challenges ofour time, threatening to undermine decades of medical progress and jeopardizing global healthsecurity.In Pakistan,the growing burden of drug-resistant infections demands immediate,coordinated,and multisectoral action to safeguard the health of our people,animals,andenvironment.ThisNational Action Plan on Antimicrobial Resistance(NAP-AMR 2024–2028)represents Pakistan’s steadfast commitment to combating AMR through aOne Healthapproach, aligning with global frameworks while addressing our unique national priorities. The Government of Pakistan recognizes that AMR is not just a health issue but a socioeconomic threatthat requires collaboration across human health, animal health, agriculture, and environmentalsectors. Building upon the achievements ofNAP-AMR 2017–2022, this updated plan integrates lessonslearned, emerging evidence, and innovative strategies to strengthen governance, surveillance,infection prevention, and antimicrobial stewardship. Our vision is clear: topreserve the effectivenessof antimicrobialsfor future generations while ensuring equitable access to safe and effectivetreatments for all. We extend our gratitude to all stakeholders, federal and provincial governments, internationalpartners, healthcare professionals, researchers, and civil society, for their invaluable contributions inshapingthis plan.TheMinistry of National Health Services,Regulations&Coordination(MoNHSRC)will ensure full support for its implementation, working closely with theNational Instituteof Health (NIH),Drug Regulatory Authority of Pakistan (DRAP), and other key institutions includingprovincial health departments. However, success depends on collective action, national, provincial,academicians, public health workers, animal health workers, policymakers,practitioners, and thepublic must all play their part in reducing unnecessary antimicrobial use, improving hygiene practices,and fostering responsiblebehaviours. As we embark on this important journey, let us reaffirm our commitment to aresilient and sustainablehealth system. By prioritizing AMR prevention and control, we not only protect our citizens but alsocontribute to global efforts in combating this silent pandemic. Together, we can turn the tide againstantimicrobial resistance and secure a healthier future for Pakistan. DirectorGeneralHealth Ministry of National Health Services, Regulations &Coordination Government of Pakistan Acknowledgement The Ministry of National Health Services, Regulations and Coordination (MoNHSR&C) and the NationalInstitute of Health (NIH) acknowledge with deep appreciation the dedicatedengagement and valuablecontributions of all stakeholders who actively participated in the NAP 2.0 development process fromMay 2024 to February 2025. We extend our gratitude to the Ministry of National Food Security andResearch, Ministry of Climate Change, Pakistan