Enhancing the Management of Antimicrobial Resistance in Fiji and Samoa
In partnership with the governments of Fiji and Samoa, and with our research collaborators, we are working to increase the resilience of communities against antimicrobial resistance across both countries.
The EMAR project began with a focus on reducing the risk of antimicrobial resistance (AMR) in Fiji, developing strategies that could be scaled to other countries in the future. Building on these successes, the current phase of the project continues this vital work in Fiji while extending efforts to Samoa, broadening the impact across the Pacific region.
Antibiotic resistance – one of humanity’s greatest threats
Antimicrobial resistance (AMR) is one of the greatest threats facing humanity. It is a complex and multi-faceted problem that affects people, animals, and the environment. Resistant bacteria can be found in people, animals, food, water and soil. They can spread between people and animals, environment and animals, and environment and people.
Developing countries are expected to feel the impact of AMR greater than developed countries because of a range of drivers including unnecessary use of antibiotics, lack of regulation, limited resources, and climate change. Several countries in the world have developed national action plans to manage AMR. However, developing countries have limited resources (both workforce and monetary) to implement such plans.
In the Western Pacific region, it is estimated that the economic cost of AMR could be as high as USD1.35 trillion over the next 10 years. Given AMR can spread regionally and globally, it is in countries’ best interests to pool resources together to tackle the problem, irrespective of their AMR status.
The AMR problem in Fiji and Samoa
Fiji
Recent reviews in Fiji indicate that drug resistant micro-organisms are present in hospitals. The country has one of the highest bacterial infection rates in the world, cases of diabetic amputations occur at a rate of 1 every 12 hours, and tuberculosis (both human and animal) are some of the highest globally. These health issues result in Fiji having a greater need for antibiotics, further increasing the risk of AMR. Recognising these challenges, Fiji was the first country in the Pacific to develop a National Action Plan against AMR but faces several challenges implementing it. Although information on the occurrence of AMR in people is available (but limited), information on the occurrence of AMR in agriculture and the environment is still lacking. Furthermore, the economic impact of AMR in the Pacific region remains understudied.
Samoa
AMR is an increasing health challenge in Samoa, with mortality linked to drug-resistant infections rising steadily over the past three decades. Between 1990 and 2021, AMR-related deaths grew by 20% for attributable cases and nearly 10% for associated cases. Older adults are particularly affected, carrying the greatest burden of AMR-related deaths. To address this growing threat, Samoa launched its National Action Plan on AMR in 2023, focusing on strengthening surveillance, antimicrobial stewardship, and infection prevention, but faces similar challenges to Fiji in terms of infrastructure and workforce capacity. Also like Fiji, information on AMR in agriculture and the environment including its economic impact is lacking.
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Funding acknowledgements
Current
2023-2027 – Phase 2 is funded by the Australian Centre for International Agricultural Research.
Previous
2018-2023 – The scoping study (2018-2019) and Phase 1 (2019-2023) was funded by the Australian Centre for International Agricultural Research in partnership with the Department of Foreign Affairs and Trade Indo-Pacific Centre for Health Security.
This CSIRO-led project is being delivered in partnership with the University of Technology Sydney, University of South Australia, Fiji National AMR Committee, Fiji National University and Scientific Research Organisation of Samoa.