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This technical brief provides information to inform water, sanitation and hygiene (WASH) and wastewater elements within multi-sectoral antimicrobial resistance (AMR) national action plans (NAPs). It includes a summary of evidence and the co-benefits rationale for action in each sector and presents a menu of actions for consideration and refinement in each country context. The technical brief also identifies sector specific policy options and additional information, including knowledge gaps and research needs, as well as additional technical resources to support planning and implementation.

Where evidence is weak or lacking, actions proposed are cost-effective measures with wider co-benefits for health that plausibly contribute to combatting AMR.

The most relevant actions for any given country will depend on:
• the status of existing WASH and wastewater services in communities and health care facilities,
• patterns and intensity of animal and plant production,
• whether the country manufactures antimicrobials or procures them from abroad, and
• patterns of antimicrobial use in humans, animals and plants.

However, it is likely that in all countries some action is possible and needed in all sectors regardless of which one can do most to prevent unnecessary use of antimicrobials and/or the spread of AMR.

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