Antimicrobial Resistance National Strategy and Action Plan for the Cayman Islands

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Antimicrobial medicines are used around the world to treat infections of all types, both in animals and in humans. Resistance to antimicrobials has been gradually evolving since the introduction of the first antibiotics, the Penicillins; however, recent times have seen antimicrobials becoming less and less effective, with many everyday infections or diseases being untreatable and causing mortalities.

According to the World Health Organization (WHO), we are currently facing a global health crisis, as antimicrobial resistance (AMR) becomes increasingly present and we run the risk of returning to a pre-antibiotic era. The WHO estimates that unless drastic measures are taken to reduce antimicrobial resistance, in 2050, antimicrobial resistance will be the largest cause of death worldwide, causing the death of 10 million people annually.

The main contributing factor in the increase in antimicrobial resistance has been the chronic overuse and imprudent use of antibiotics across the human and animal health sectors. In May 2014, the WHO developed a global action plan to be implemented in 2017 to reduce the use of antimicrobial agents and control the emergence and spread of resistance. In alignment with this global action plan, nations are called on to develop nation action plans which will incorporate five main strategic objectives:

  1. Improve awareness and understanding of antimicrobial resistance through effective communication, education, and training
  2. Strengthen the knowledge and evidence base through surveillance and research
  3. Reduce the incidence of infection through effective sanitation, hygiene, and infection prevention measures
  4. Optimise the use of antimicrobial medicines in human and animal health
  5. Develop the economic case for sustainable investments that takes account of needs of all countries, and increase investment of new medicines, diagnostic tools, vaccines, and other interventions

This action plan recognises that AMR is a "one health" problem, and highlights the need for an effective "one health" approach. Subsequently, it has been developed because of a coordinated and collaborative effort among major stakeholders and actors, namely government representatives from; public health, agriculture/animal health, environmental health, pharmacy, infection control, and laboratory services.

The action plan also recognises achievements and gains made by the Cayman Islands as it relates to AMR and the five strategic objectives outlined above. Other aspects addressed within the action plan speak to the resources available to combat AMR, economic factors related to AMR, drivers of AMR, and a detailed analysis of what needs to be done to further mitigate the problem.

AMR cannot be eradicated, and will remain a force to contend with for the foreseeable future. However, a multi­ disciplinary approach to increase knowledge, education, surveillance, research, and governance surrounding AMR will limit its risks and minimise its impact on health, economics, and societal welfare, both now and in the future.

Given the severity of this issue, it will be imperative that all sectors respond to the call for action as outlined in this action plan if we are to successfully address this public health threat and preserve the future healthcare of The Cayman Islands.

The Honourable Alden McLaughlin, Jr: MBE, JP, MLA Premier of the Cayman Islands
Minister of Home Affairs, Health, and Culture

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