Table 1

Summary of key issues relating to AMR in PICTs

Issue related to AMR in PICTsStrengths/achievementsWeaknesses/limitations
National Action Plans (NAPs) for AMR
  • NAPs approved by government in Fiji and Cook Islands

  • Many PICTs remain without well-developed NAPs

Laboratory surveillance capacity
  • Long-standing Neisseria gonorrhoeae surveillance in select PICTs

  • Antimicrobial susceptibility testing typically only available in large centres

  • WHO GLASS report contains no data from PICTs

Surveillance of antimicrobial consumption (human)
  • Extensive use of mSupply in Pacific holds potential for real-time monitoring of consumption

  • WHO report on Surveillance of Antimicrobial Consumption contains no data from PICTs

Standard treatment guidelines (STGs)
  • Antimicrobial STGs available in at least eight PICTs

  • Fiji and Solomon Islands STGs freely available via smartphone app

  • Presence of STGs doesn’t guarantee adherence—adherence to STGs in Solomon Islands has improved but remains at 44%50

Community education
  • Most PICTs participate in ‘Antibiotic Awareness Week’ each November

  • No assessment of effectiveness of these campaigns

Surveillance of antimicrobial consumption (animal)
  • Fiji alone reports collecting data on antimicrobial use in animals down to farm and species level

  • Paucity of reported data

Animal health
  • Presence of Food and Agriculture Organisation of the United Nations, with subregional office in Samoa since 1996

  • Lack of government regulation restricting antimicrobial use in animals

  • AMR, antimicrobial resistance; GLASS, Global Antimicrobial Resistance Surveillance System; PICTs, Pacific Island countries and territories.