Thailand’s ASU programme

The start of the programme

The ASU programme started in 2007 as an action research project to promote rational AMU by strengthening human resources, improving health facility infrastructure and empowering communities.

Key stakeholders who initiated the ASU programme at the local level included physicians, pharmacists, nurses, health volunteers, local administrators and community leaders. They all promoted rational AMU in their various healthcare settings and communities.

The programme was taken to the national level via various community, local and provincial government structures, . However, the decentralised network with local ownership has remained in place, and has been considered crucial in maintaining sustainability – especially during financial and human resource constraints.

Integration into the national programme

The ASU programme was integrated into Thailand’s national programme to curb AMR, known as the Antimicrobial Resistance Containment Program (AMRCP), in 2012. The AMRCP was initiated in 2011 by a group of stakeholders with a shared vision of how to contain and prevent the emergence and spread of common antibiotic-resistant bacterial infections in Thailand with a One Health approach.

Becoming national policy

Having been scaled up to a national level, the ASU programme was first adopted into the Thai healthcare system’s Pay-for-Performance (P4P) policy. For close to a decade, Thai stakeholders committed to work on resistance at local and community levels without a national action plan (NAP). In 2017, a comprehensive national plan was developed, incorporating the ASU programme.

The National Strategic Plan on Antimicrobial Resistance (2017–21) promotes multisectoral collaboration to reduce antimicrobial consumption and AMR morbidity, and improve public awareness. The ASU programme is part of the stewardship component.