2 How to establish AMS structures at different levels

National-level structures are required for effective AMS. Governments should develop their own national action plan for AMR, ideally as part of a wider One Health governance structure that engages multiple government sectors to establish an AMS approach that is aligned across human, animal and environmental sectors.

AMS can be overseen by ministerial committees, multi-sectoral co-ordinating committees, and technical working groups, or similar structures appropriate to the national situation. The role of these government structures is to implement policies, develop guidelines and allocate funds. (For more information on national structures, see the Introducing a One Health approach to AMR course.)

In the human health sector, AMS is one of ‘three pillars’ of an integrated approach to combat AMR as part of an overall goal to strengthen health systems (WHO, 2019a). These pillars, which are also relevant in veterinary medicine, are:

• AMS
• infection prevention and control (IPC)
• medicine and patient safety.

These pillars should be applied alongside AMU surveillance and monitoring, together with adequate provision of quality-assured medicines at a national level. Education and training the relevant professionals, as well as raising awareness and understanding of the issues among the general public, are essential components of this programmatic approach (WHO, 2019a, 2021).