Evaluating Jordan's Antimicrobial Resistance National Action Plan (2018-2022) Implementation: Progress and Recommendations

Background Antimicrobial resistance (AMR) is a pressing global public health challenge that requires coordinated multisectoral responses. In line with the Global Action Plan (GAP) on AMR, Jordan developed its first National Action Plan (NAP) for 2018–2022 to guide multisectoral efforts. This study aimed to evaluate the implementation of Jordan's AMR NAP, identify progress and challenges across its five strategic objectives, and suggest actionable recommendations for strengthening future AMR responses. Methods The Jordan Center for Disease Control (Jordan CDC) conducted a comprehensive 'end-term evaluation' for the NAP 2018–2022. Data were collected from approximately seventy national stakeholders through a national workshop and follow-up electronic communications. The evaluation tool included sector-specific and multisectoral indicators aligned with the NAP's five objectives. Descriptive statistical analysis was performed using SPSS to determine implementation rates across human, animal, and environmental health sectors, applying the One Health approach. Results The evaluation revealed uneven implementation across NAP objectives, with notable achievements in the rational use of antimicrobials (69%) completion, mainly in the human health sector. Infection prevention and control (IPC) efforts reached (63%), while surveillance-related activities achieved (56%). Awareness-related activities reported limited progress (47%), and no activities were implemented under the research and innovation objective. Multisectoral collaboration was limited, particularly in the animal and environmental sectors. Significant barriers included the absence of a unified communication strategy, lack of dedicated funding, insufficient investment in human resources and laboratories, and disruptions caused by the Coronavirus Disease 2019 (COVID-19) pandemic. Conclusions Despite progress in different areas, the overall implementation revealed significant challenges, particularly in research, multisectoral collaboration, and One Health integration. Future action should prioritize a unified national AMR policy framework for strategic planning, emphasizing resource distribution, active participation of all relevant sectors, and systematic monitoring and evaluation to inform policymaking. Strengthening coordination between human, animal, and environmental sectors is essential to achieving a robust, One Health-aligned AMR response in Jordan.