40 JULY-AUGUST 2025 | THE FOREIGN SERVICE JOURNAL Implementing a Regional AMR Strategy Addressing AMR in Central America requires a comprehensive, coordinated strategy that integrates health diplomacy, scientific cooperation, and policy harmonization. As the region’s primary governance mechanism, SICA is well placed to align policies, mobilize resources, and foster cross-sector collaboration. This strategy presents an opportunity to reshape how these nations tackle public health threats. To succeed, strong political will, cooperation, community engagement, and key partnerships are essential. Establishing an AMR strategy within this framework would provide a structured, effective response to the crisis and contribute to building a more resilient and robust public health infrastructure. We recommend the following seven priority actions for immediate implementation: 1. Establish a harmonized regional AMR surveillance system. Fragmented surveillance hinders the ability to track and respond to resistant pathogens. Addressing this requires diplomatic engagement and policy alignment. A regional strategy, supported by PAHO and the World Health Organization (WHO), should standardize data collection, establish shared protocols, and enable real-time information exchange for enhanced detection and response, even in security-compromised areas. A unified AMR database will strengthen monitoring and serve as a strategic tool for policymaking and international cooperation. 2. Strengthen antimicrobial stewardship across sectors. Reducing antibiotic misuse requires comprehensive stewardship programs that integrate health care, agriculture, and environmental policies. Key actions include enforcing prescription regulations, phasing out antibiotics as livestock growth promoters, and, crucially, raising community engagement and public awareness to promote responsible antibiotic use. Investing in rapid diagnostic tools will further curb unnecessary prescriptions by ensuring antibiotics are used only when medically necessary. Establishing laboratories and acquiring advanced diagnostic equipment, crucial for identifying emerging resistant bacteria, will likely require international financial and technical support. 3. Integrate AMR policies into broader strategies. SICA can powerfully address the intertwined crises of climate change and antimicrobial resistance by integrating AMR interventions into existing regional frameworks. By recognizing shared drivers like unsustainable agriculture and environmental degradation, SICA can leverage established programs such as the Initiative for Climate Action Transparency (ICAT) and the Central American Commission on Environment and Development (CCAD) to incorporate AMR objectives. Expanding frameworks like climate-smart agriculture and the AFOLU 2040 plan to restore degraded land and ecosystems in SICA countries so that they include promotion of antibiotic stewardship can create synergies that simultaneously strengthen regional health initiatives and advance broader diplomatic goals. 4. Expand international cooperation on AMR. To effectively implement an AMR strategy, the subregion must expand international cooperation and health diplomacy. Collaboration with PAHO/WHO is crucial for capacity-building and policy development. Building on the recently announced partnership between PAHO and the Global Antibiotic Research and Development Partnership (GARDP), a Swiss nonprofit, a focused subregional effort is essential to maximize its impact and ensure access to new antimicrobial treatments. A subregional strategy provides a more structured and sustainable framework than broader regional efforts. 5. Prioritize research and development for AMR solutions. Lasting AMR progress depends on strengthening R&D through funding for new treatments and diagnostics, reducing reliance on external markets, and driving innovation. Publicprivate partnerships, stronger academic institutions, and a decentralized research approach can overcome political constraints and expand regional capacity. Securing support from organizations such as the International Development Research Centre (IDRC), a Canadian government organization that promotes and funds research in developing countries worldwide, is crucial for strengthening scientific cooperation, workforce development, and research infrastructure. 6. Strengthen capacity through targeted training. Central America must enhance regional capacity to combat AMR effectively. This requires standardized AMR education across medical, veterinary, and agriculture sectors to optimize antibiotic use and infection control. Adopting proven global training models and integrating AMR curricula into university programs will efficiently build a skilled workforce. Supporting exchange programs and biomedical research fellowships will further strengthen expertise and collaboration. 7. Ensure financial sustainability and governance. For long-term success, Central America’s AMR strategy must adopt a multistakeholder funding model. A dedicated fund within SICA can streamline resource allocation, while sustained global health investments can support research, monitoring, and policy innovation. Strengthening governance and addressing institutional weaknesses will be vital in overcoming past implementation challenges. This requires targeted capacity building, including training in advanced diagnostics and susceptibility testing; data analysis; coordination across human,
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