Antimicrobial resistance (AMR) is a silent pandemic that has already arrived. The World Health Organisation (WHO) stresses that countries must formulate national action plans for AMR control if they are to prevent national and global crises. National action plans are developed in accordance with the WHO’s AMR Global Action Plan; these plans guide effective antibiotic use, access and sustainability through involving a wide variety of stakeholders and local communities. Low- and middle-income countries (LMICs) are often resource-limited settings with overstretched medical infrastructures, which brings additional challenges when it comes to controlling and preventing AMR. Unregulated systems open the doors to unregulated and counterfeit antibiotic trade, known to increase AMR evolution.

Despite facing infrastructural and resource constraints, Ghana is a leader among Sub-Saharan African countries in prioritising AMR action. Since 2014, Ghana has encouraged all countries without national action plans to devise one and has promoted the usage of a multisectoral approach for implementing national plans. Ghana’s own AMR Policy and National Action Plan for Antimicrobial Use and Resistance has been informed by situational analysis reports. These reports uncovered multiple underlying issues such as a lack of policy regarding antimicrobial access and use, unregulated access to antimicrobials,  an absence of or poor surveillance, and poor knowledge on AMR generally. 

The Ministry of Health, ten further ministries and additional national agencies (covering health, food and agriculture, environment and defence) have contributed or supported the development of Ghana’s AMR Policy and National Action Plan. This collaborative and multisectoral stance follows the WHO’s Global Action Plan advice of ‘whole-of-society engagement including a One Health approach’ and ensures an array of stakeholders are involved in the policy making process.

Importantly, Ghana’s National Action Plan now provides a blueprint and set of guidelines for other LMICs facing similar AMR challenges (particular in Sub-Saharan Africa) to replicate. In the fight against AMR, LMICs typically face more resource limitations than higher income countries, yet efforts in Ghana show us that there are ways to overcome these limitations and tackle AMR as a society.

Ghana is a clear example of a forward thinking and proactive country with respect to AMR action, however navigating resource and infrastructure limitations will impact upon policy implementation. A study on Sweden’s policy approach over 20 years determined that achieving long-term changes to AMR incidence and antibiotic practices is dependent on implementing bottom-up approaches, specifically ‘working closely with prescribers at the local level’. Although more arduous than a top-down approach, a bottom-up process is necessary for educational, cohesion and consolidatory purposes. By focusing on this approach and engaging communities, Ghana will be able to fully initiate AMR action and realise the National Action Plan at a local level, in turn, providing a gold-standard example for other LMICs to follow.