Understanding the Implementation of Antimicrobial Policies: Lessons from the Hong Kong Strategy and Action Plan

Antibiotics (Basel). 2022 May 10;11(5):636. doi: 10.3390/antibiotics11050636.

Abstract

In 2017, the Hong Kong Strategy and Action Plan on Antimicrobial Resistance 2017-2022 (HKSAP) was announced with the aim of tackling the growing threat of antimicrobial resistance (AMR) in Hong Kong. However, little is known about how the planned activities have been implemented. In this study, we examine the status of implementation of the HKSAP using the Smith Policy Implementation Process Model. Semi-structured interviews with 17 informants found that important achievements have been made, including launching educational and training activities targeting the public, farmers, and healthcare professionals; upgrading the AMR surveillance system; and strengthening AMR stewardship and infection control. Nevertheless, participants also identified barriers to greater implementation, such as tensions across sectors, ongoing inappropriate drug use and prescription habits, insufficient human and technical resources, as well as a weak accountability framework. Environmental factors such as the COVID-19 pandemic also affected the implementation of HKSAP. Our study indicated that expanding engagement with the public and professionals, creating a collaborative environment for policy implementation, and building a well-functioning monitoring and evaluation system should be areas to focus on in future AMR policies.

Keywords: Hong Kong; One Health; antimicrobial resistance; national action plan; policy implementation.

Grants and funding

This study is part of The Development and Implementation of National Action Plans on Antimicrobial Resistance in Bangladesh, Cambodia, China, Hong Kong, the Philippines, and Singapore: Challenges and Lessons Learned for Policy Makers, an international project funded by the Asia Pacific Observatory on Health Systems and Policies (2020/100217).