Zimbabwe successfully hosts continental WAAW events

The Quadripartite partners consisting of the Food and Agriculture Organization (United Nations FAO), the United Nations Environment Programme (UNEP), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH), in partnership with African Union agencies, Africa CDC and African Union Interafrican Bureau for Animal Resources (AU IBAR) together with the Government of Zimbabwe, this year hosted the continental celebration of the World Antimicrobial Resistance (AMR) Awareness Week (WAAW) 2023 in Harare, Zimbabwe. 

The factors driving the emergence of AMR are complex and multifactorial therefore requiring the use of a multidisciplinary approach to address them. Accordingly, AMR requires a collective and practical response. To mitigate AMR risks with a holistic approach, the Africa Union agencies i.e. Africa Centres for Disease Control and Prevention (Africa-CDC) and the Interafrican Bureau for Animal Resources (AU-IBAR), the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH) are working closely together at all levels to achieve this. The One Health approach is a holistic approach that aims to sustainably balance and optimize the health of people, animals, ecosystems, and the wider environment. It mobilizes multiple sectors, disciplines, and communities to work together to foster well-being and tackle threats to health and ecosystems. Taking a ‘One Health’ approach has many benefits, such as complementarity for amplified impact, cost savings incurred by addressing multiple threats simultaneously etc.

This year’s celebration was dedicated to showcasing the value of the One Health approach in preventing AMR in Africa and highlighting the progressive collaboration between the Africa Quadripartite and AU Agencies on combatting AMR. Furthermore, recognizing Zimbabwe’s very active role on combatting AMR, through Government intervention and partners such as the Multi-Party Trust Fund (MPTF) and the Fleming Fund. A notable success story is the preliminary production of the BOLVAC vaccine, against theileriosis, an alternative to the use of antimicrobials.

Specific objectives of the 5th WAAW were to:

1. improve awareness and understanding by disseminating and transferring knowledge of AMR among all stakeholders, with focus on the youth and public education sectors,
2. encourage best practices among the public, One Health stakeholders and policymakers in reducing the further emergence and spread of AMR, with emphasis on the emerging animal production sector,
3. inform AMR policy and attract funding for further implementation of AMR interventions for the continent,
4. promote alternatives to antimicrobial use,
5. enhance multisectoral collaboration and AMR Governance,
6. promote and embrace Public-Private Partnerships (PPPs),
7. establish an understanding of environmental dimensions of AMR and the necessary guidelines for protecting the environment from the threat of AMR.

The week-long event had a diverse set of activities that were linked to the overall objectives of AMR strategies and contributed to the advancement of combatting AMR in Africa. The activities included

1. promoting alternatives to antimicrobial use,
2. AMR sensitisation and awareness for youth and public education systems,
3. AMR advocacy through social media, radio, TV & newspapers,
4. public-private partnerships,
5. AMR knowledge dissemination,
6. AMR policies,
7. AMR good practices,
8. implementation of National Action Plans (NAPs)
9. AMR governance and the
10. environmental dimensions of AMR.  

The WAAW Africa commemorations kicked off with a media briefing at the Harare International Convention Centre that was attended by 40 media representatives from six national broadcasters, four international media bureaus and independent journalists. The Government of Zimbabwe, represented by Dr Pious Makaya (Ministry of Agriculture) and Dr Chikodzore (Ministry of Health and Child Care) highlighted Zimbabwe’s achievements of the National Action Plan (NAP) for AMR (2017-2022) and updated the audience on the draft for a new 5-year NAP (2023-2028) that is linked to the national blueprints including the livestock policy. 

The Africa Quadripartite and African Union Agencies highlighted the activities of the week and delivered an overview of antibiotics, the beginnings of antibiotic resistance, leading up to global research and development of the global action plan for AMR, with some emphasis on collective and specific sectorial AMR strategies. The African Union mentioned the efforts of the AU in establishing and advocating for a common and collective position of African countries on AMR to be presented at the upcoming UN Assembly of 2024. Following the panel’s briefing, an interactive discussion and questions from the media and the floor were taken.  Considering the importance of social media, Africa-CDC hosted a live conversation on AMR on X (formerly Twitter) Spaces to raise awareness of AMR and promoting behavioural change through public communication programmes that target different audiences in human health, animal health and agricultural practice, as well as consumers.   

Panelists answering the media (fltr) Mohamed Sirdar (WOAH), Irene Ouoba (FAO), Yewande Alimi (Africa CDC), Walter Fuller (WHO), Ali Yahaya (WHO), Chikodzore (Ministry of Health and Child Care, Zimbabwe) and Dr Makaya (Ministry of Agriculture, Zimbabwe) Picture (c) communication (woah) 2023.

The high-level official opening ceremony was followed by two sessions on:

1. AMR One Health Multisectoral Collaboration and Governance which was led by WHO and the Ministry of Health, Zimbabwe and
2. Policy Dialogue: Accelerating Progress in African Countries in AMR NAP Implementation: A Case of the Animal Health Sector led by AU-IBAR and the Ministry of Agriculture, Zimbabwe.  

The two sessions emphasised the role of multisectoral collaborations in AMR NAP implementation in Africa. The 1st panel discussion drew participation from Cabo Verde, Congo (Dem. Rep.), Kenya and Zimbabwe. The 2nd policy dialogue featured animal health panellists including

1. Dr Columba Vakuru (WOAH Delegate of Nigeria);
2. Dr Mwapu Ndahi (WOAH Veterinary Products and AMR Focal Point for Nigeria);
3. Dr Sami Darkaoui (AMR Focal Point of Morocco);
4. Dr Emmanuel Isingoma (WOAH Veterinary Products and AMR Focal Point for Uganda);
5. Dr Tinashe Hodobo (AMR Focal Point for Zimbabwe) and
6. Dr Ilo Ramahatafandry (WOAH Veterinary Products and AMR Focal point Madagascar).

In his keynote address, Dr Vakuru emphasized the opportunity to identify common areas in the NAPs of various countries for strategic continental interventions.

In his presentation, Dr Shrivastava spoke about PPPs to contain AMR through identification of AMR supply chains and how public and private sectors can work together to combat AMR. Dr Graham shared the detailed experience of Ireland on PPP in the dairy sector. Further discussions and experience sharing were observed with a panel of national experts including

1. Dr Tinashe Hodobo, Veterinary Research Officer, BOLVAC Vaccine Team, Ministry of Agriculture, Animal Health Representative in the One Health AMR Secretariat,
2. Dr Tapfumanei Mashe, Human Health, Laboratories specialist, AMR MPTF National Coordinator,
3. Mr Tafadzwa Charumbira, Chairman : Harare Poultry Business Cooperative Company (Zimbabwe Poultry Association-Harare Chapter – Small- Medium Poultry Producers),
4. Dr Mildred Shumba, Veterinary Pharmacist, Animal Health Industry Committee and
5. Dr Samuel Swiswa, Veterinary Research Officer, Veterinary clinician, Ministry of Health.

The last webinar showcased the environmental dimensions of AMR and was jointly delivered by UNEP and the Ministry of Environment in Zimbabwe. The presentation from the Ministry of Environment underlined that the country had put in place the Environmental Management Agency Laboratory which is mandated to carry out tests on AMR in the environment. However, the country is still grappling with implementation of policies to control pollution of water systems and the environment in general with medical and industrial waste.  

The WHO, in collaboration with the Ministry of Health in Zimbabwe and with the kind sponsorship of FAO, convened a high-level awards ceremony for various categories of themes and topics. The occasion was graced by the Permanent Secretary of the Minister of Health and Childcare and the WHO Assistant Regional Director, Dr Lindiwe Makubalo. Awards were presented to the top players of the winning football teams from the AMR Soccer Tournament and the winning country teams for the AMR Youth Debate. 

The 5th WAAW Africa ended on a high note, starting with laboratory visits to the antimicrobial resistance-related sections of the Laboratory units at the Veterinary Services (animal health) and the Harare Central Hospital (human health). Both of these laboratories are the principal referral laboratories for animal and human health and have been refurbished with funds from the Fleming Fund project. It was impressive to observe the upgrade in the facilities and the state-of-the-art equipment for AMR testing. Laboratory visits were followed by the AMR Walkathon organised by the national One Health AMR Secretariat, in collaboration with the University of Zimbabwe medical school students. The Walkathon was roughly 1.5 kms routing through the central business district of Harare and ending at Unity Square grounds.  Approximately 500 people joined the Walkathon. Walkers were branded with WAAW T-shirts, caps, umbrellas and bags. The WAAW was officially closed at the Unity Square grounds, with closing remarks delivered by representatives from the Quadripartite and AU, the students, and Dr Pious Makaya on behalf of the Government of Zimbabwe.  

Communiqué, for the 5th Africa Continental World Antimicrobial Resistance (AMR) Awareness Week 2023  

Preventing Antimicrobial Resistance Together 

We, the African Leadership of the:

• Africa Centres for Disease Control and Prevention (Africa CDC)
• African Union Inter-African Bureau for Animal Resources (AU-IBAR)
• Food and Agriculture Organization of the United Nations (FAO), Regional Office for Africa
• Food and Agriculture Organization of the United Nations (FAO), Regional Office for Near East and North Africa
• United Nations Environment Programme (UNEP), Regional Office for Africa
• World Health Organization (WHO), Regional Office for Africa
• World Health Organization (WHO), Regional Office for the Eastern Mediterranean
• World Organization for Animal Health (WOAH), Regional Office for Africa

Have convened for the 5th Africa Continental World AMR Awareness Week (WAAW) 2023 to raise awareness, catalyse actions on antimicrobial resistance (AMR) governance, and assess progress in the region towards mitigating antimicrobial resistance.

NOTE that antimicrobial agents, including antibiotics, antifungals, antiparasitic, and antivirals have saved millions of lives globally and substantially reducing the burden of diseases in people, animals, and plants/crops, improving quality of life, contributing to better food security and safety, and enhancing life expectancy.

RECOGNISE that the emergence and spread of AMR in diverse microorganisms is reversing these benefits and further complicating the management of many infectious diseases.

EXPRESS our concern over AMR as a significant threat to human development and the fight against infectious diseases that also jeopardizes animal health and welfare and food production, and adversely affects the functioning of human, animal, and plant health systems and economies.

CONCERNED by uncontrolled antimicrobial overuse and misuse across the African Continent, including the inadequate use of antimicrobials and the use of falsified and proliferation of substandard and counterfeit medicines in the context of inadequate oversight on production, procurement, quality, and surveillance.

NOTE the importance of antimicrobials as front-line treatments in combating a host of diseases in humans, animals (terrestrial and aquatic) and plants/crops, while also supporting and enhancing agricultural and environmental practices to reduce the risk of disease transmission.

ACKNOWLEDGE that the lack of awareness of AMR continues to hamper efforts for transformational changes in practices, regulations, and oversight.

RECOGNISE that effective AMR governance is essential to promote sustainable actions which should include both proper institutional arrangements and strong societal demand from both public and private sectors for the successful governance of antimicrobials at both global and regional levels.

ACKNOWLEDGE that several promising first steps have been taken to strengthen AMR governance at global, regional, and national levels.

UNDERSCORE the importance of adopting a comprehensive and multisectoral “One Health’ approach to address the rising threat of AMR through integrated actions across human, animal (terrestrial and aquatic), plant/crop, and environmental health sectors.

RECALL the existing global and continental commitments including the Global Action Plan on Antimicrobial Resistance 2015, Africa Common Position on Antimicrobial Resistance, Africa Union Framework for Antimicrobial Resistance Control, FAO’s Action Plan on Antimicrobial Resistance, and WOAH Strategy on Antimicrobial Resistance and the Prudent Use of Antimicrobials.

MINDFUL that tackling AMR is a crucial Sustainable Development Agenda issue and will be critical in achieving the Sustainable Development Goals (SDGs) and improving food and nutrition security and livelihoods in Africa’s predominantly farming-based economies.

We, the African Leadership of Africa CDC, AU-IBAR, FAO, WOAH, WHO, and UNEP, commit to:

• Strengthen and accelerate the implementation of previous commitments to tackle AMR including relevant resolutions of the governing bodies of the African Union (Africa CDC & AU-IBAR), the Quadripartite (FAO, UNEP, WHO and WOAH), and other relevant agencies, and AMR multisectoral national action plans.
• Advance political leadership at regional, national, and sub-national levels to ensure effective governance of AMR by supporting robust institutional arrangements in both public and private sectors by developing and enforcing appropriate regulatory frameworks.
• Foster the “One Health” approach through multisectoral and multidisciplinary coordination and collaboration leveraging our comparative mandates and strengths to effectively combat AMR.
• Continue to support African Member States to address the growing global threat of AMR through developing national multisectoral AMR action plans in line with the Global Plan of Action, with an emphasis on full funding, implementation, and evaluation.
• Develop and implement a comprehensive and coordinated regional advocacy and communications strategy to tackle AMR by increasing awareness, understanding, and encouraging behaviour change through sharing of best practices and scientific knowledge, with engagement with academia and research institutions, the private sector, civil society, and the media.
• Maintain and strengthen appropriate stewardship of antimicrobials, including through Infection Prevention and Control (IPC), Water, Sanitation, and Hygiene (WASH) biosecurity measures, and routine immunization. We will advocate for equitable access to vaccines to prevent infectious diseases.
• Maintain and strengthen good agricultural and food safety practices including safe processing, animal vaccination, and farm biosecurity; farm waste management and infection control.
• Integrate AMR considerations into all efforts and programs related to epidemic and pandemic prevention, preparedness and response, health systems strengthening, animal and environmental health, infection prevention and control, Water, Sanitation, and Hygiene (WASH) in sustainable food systems, food safety, and food security.
• Evaluate the implementation of these commitments to tackle AMR through ongoing work with the existing governance mechanisms of the African Union (Africa CDC & AU-IBAR), the Quadripartite (FAO, UNEP, WHO, and WOAH) and sharing of lessons learned, best practices, challenges, and opportunities.

The Leaderships’ signatures below record their joint acceptance and commitment to this communiqué dated 24th November 2023.

Adopted on 24th November 2023 in Harare, Zimbabwe