Ghana’s NPAR

The Ministry of Health in Ghana has created the National Platform on Antimicrobial Resistance (NPAR) as the driving institution behind the AMR agenda (ReAct, n.d. 1). Ghana serves as an example to other low- and middle-income countries (LMICs) on how to use a multi-stakeholder platform to develop a policy on AMR, as described in Case Study 1 and Figure 1.

Case Study 1: Ghana’s NPAR (adapted from ReAct, n.d. 1)

The NPAR

The Ministry of Health in Ghana – with support from the Swedish International Development Cooperation Agency (SIDA) through ReAct – established the NPAR to bring together government institutions and civil society organisations to lead Ghana’s efforts in tackling AMR.

The platform includes representation of key stakeholders with an interest in AMR-related issues, such as the national agency responsible for developing pharmaceutical policies in Ghana and the Ghana National Drugs Programme (GNDP). A management team steers the efforts with a small group of about eight people from the Ministry of Health, led by the Director of Pharmaceutical Services.

Gathering data

In order to inform the policy process, data was needed on (among other things):

  • resistance levels
  • antibiotic consumption
  • healthcare-associated infections
  • the quality of antibiotics
  • social-behavioural factors.

Because only limited data existed, the NPAR prioritised gathering local evidence and information, and so carried out a stakeholder analysis, a KAPP (knowledge, attitudes, practices and perceptions) study, a baseline resistance study, and a situational analysis.

The studies were conducted by universities that were part of the NPAR, and the stakeholder and situational analyses were carried out by selected NPAR members.

Policy development

The management team used the information gathered to develop the basis of a broad policy framework and an implementation plan. The broad policy perspective covered areas such as:

  • responsible antimicrobial use (AMU)
  • veterinary and aquaculture
  • manufacturing, supply, distribution and disposal
  • regulation and enforcement
  • national surveillance
  • infection-prevention and control
  • laboratory services
  • research and development
  • stakeholder collaboration and governance of AMR.

It also ensured that there were community education and socio-cultural change interventions, which were seen as especially important in the African setting.

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Figure 1 Policy process for AMR policy in Ghana (Nortey, 2019).
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A schematic diagram representing the process of developing, implementing and monitoring policy related to AMR in Ghana, the stakeholders that are involved, and the way that the available AMR data is fed into the policy process.

Figure 1 Policy process for AMR policy in Ghana (Nortey, 2019).

This example demonstrates how, even with limited data, making data-gathering the priority can help to build a broad policy framework.

1.3 Real-world examples

Thailand’s ASU programme