Antimicrobial resistance (AMR) is a global and national priority. Since 2017, Sudan's government has pushed transformative improvements across the country that strengthen and expand its ability to respond to the threats posed by AMR.

 In 2018, Sudan developed and launched a National Action Plan (NAP) against AMR, being only the fourth country in the WHO Eastern Mediterranean region to do so. The Plan takes a One Health approach, which recognizes the relationships between the health of humans, animals, plants, and the environment. The Plan set forth multisectoral links between Sudan's Federal Ministry of Health (FMoH), Ministry of Animal Resources and Fisheries, Ministry of Agriculture and Forestry, and WHO, in collaboration with the Food and Agriculture Organization (FAO), the World Organisation for Animal Health (OIE) and the United Nations Environment Programme. The NAP supports four main goals, which are to achieve:

1. Better understanding and improved awareness of AMR,
2. Stronger surveillance and research, and better prevention of AMR
3. Improved use of antimicrobial drugs in humans and animals sector
4. Sustainable investment in fighting AMR including infection Prevention and Control
   

WHO played various roles to support Sudan in accomplishing these goals.  In 2019 the WHO, FAO, and the OIE launched the Tripartite AMR Multi-Partner Trust Fund (AMR MPTF), which provided financial and technical support to implement Sudan's NAP. A notable accomplishment was setting up surveillance systems for AMR as the first step in implementing the NAP. To do this, Sudan enrolled in the Global Antimicrobial Resistance Surveillance System (GLASS) [1] in 2018 and received WHO training to develop the strategies to oversee antibiotic use and consumption at different levels. Just one year later, Sudan achieved a significant milestone by expanding new surveillance sites that reported 1 136 isolates/infections, including blood samples and several pathogens to GLASS. The evidence generated as part of a regional network survey called Point Prevalence Surveys (PPS) on the prevalence of antimicrobial use and healthcare-associated infections was used effectively across platforms to keep AMR on the radar and as a priority public health issue for the country.

Sudan also launched a behaviour change pilot project in 2018, the Tailoring Antimicrobial Resistance Programs (TAP), which focused on modifying prescription practices among farmers, veterinarians, prescribers, dispensers, and antibiotics consumers in rural communities. The AMR unit of the WHO Regional Office for the Eastern Mediterranean collaborated with the FAO and WHO Country Office in Sudan to support TAP implementation. Early evaluation of WHO-supported TAP in February 2020 showed a decrease of 19.3% in broad-spectrum antibiotics prescription, demonstrating the feasibility of positive behaviour change in antimicrobial practice. Discussion is underway to scale up TAP to other regions in Sudan. Other joint FAO-WHO initiatives to promote prudent antimicrobial use in Sudan include an innovative phone video competition, "Video for change in AMR", and technical workshops with poultry and dairy producers. WHO and FAO also compiled and distributed reliable information about the COVID-19 pandemic and its impact on food safety and AMR.

Another way WHO supports Sudan's AMR national plan is using social media to improve population awareness and understanding of antimicrobial resistance.  In November 2020, WHO Country Office in Sudan collaborated with the FMoH, Ministry of Animal Resources and Fisheries, and Ministry of Agriculture on an awareness campaign during the World Antibiotic Awareness Week (WAAW). The campaign disseminated information to relevant stakeholders on different topics concerning AMR in Sudan, including EML and the use of WHO 'AWaRe' classification. More than 16 000 participants attended the event.

Although much remains to do, progress shown in the WHO-supported TAP and Sudan's functioning surveillance system increases optimism that Sudan can win the battle against AMR.