Antimicrobial resistance management in Pacific Island countries: Current status, challenges, and strategic solutions

Antimicrobial resistance (AMR) is currently recognized as a major emerging threat to human and animal health. The burden of antimicrobial-resistant infections affects the economy in developed and developing countries. There is a rapid rise in AMR in human and veterinary medicine globally. AMR profiles are poorly documented in Fiji, and limited data are accessible. Fiji currently has no national veterinary antibiotic resistance surveillance network or regulations and guidelines on veterinary drug use. However, available literature shows that although human drugs are better managed than veterinary drugs, the knowledge is still constrained and dispersed. Furthermore, Fiji was chosen as a case study to develop a prototype AMR surveillance and control in the Pacific region. Pacific Island countries share similar geographic and climatic conditions. Currently, the Australian Centre for International Agricultural Research has funded an AMR project that addresses some gaps in managing AMR in the region. The project is the first to adopt the One Health approach to research the AMR in humans, animals, and the Pacific region's environment. Combating AMR needs human health and veterinary personnel to work with all other stakeholders. Continuous surveillance for resistant clinical isolates in humans and animals and the development of appropriate policy intervention measures in human and veterinary drug use are necessary to alleviate AMR burden. Therefore, there is a need to educate farmers, human patients, and the public on the fight against AMR. In addition, AMR data are necessary to develop effective AMR control strategies. This review gives a comprehensive information assessment on AMR in Fiji and the other South Pacific Islands in relation to global trends. Suggestions on the most appropriate ways of effectively managing AMR in Fiji have been made.