{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T04:55:58Z","timestamp":1764478558408,"version":"3.46.0"},"reference-count":29,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000683","name":"Royal Society of Tropical Medicine and Hygiene","doi-asserted-by":"publisher","award":["Early Career Grants Programme 2022"],"award-info":[{"award-number":["Early Career Grants Programme 2022"]}],"id":[{"id":"10.13039\/501100000683","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2025,11,12]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Drug-resistant tuberculosis (DR-TB) heavily contributes to the global challenge of antimicrobial resistance (AMR), resulting in increased morbidity among tuberculosis cases. The Association of Southeast Asian Nations is home to approximately 10% of the world\u2019s population, accounting for almost 15% of the annual global TB incidence. Thus, this study aimed to evaluate the existing national policies on DR-TB in the region using the governance framework approach for AMR and the WHO Health System Building Blocks. A thorough search for DR-TB-related national policies was performed on the websites of official health ministries and international health organisations. A total of 118 policy documents were identified after the systematic searches, and 38 policy documents were included in the data analysis. Utilising the governance framework approach, we found that the least frequently addressed domains were antimicrobial research, equity and medicine regulation for monitoring and evaluation, policy design and implementation tools, respectively. While health workforce strategies were often detailed in these national policies, we found that financing schemes were the least frequently addressed health system building blocks. The findings of our study support the need to establish a comprehensive and consolidated policy development system following the governance framework approach and to strengthen the health system building blocks in order to achieve integrated care for patients with DR-TB as espoused by the principles of universal healthcare.<\/jats:p>","DOI":"10.1136\/bmjgh-2024-016346","type":"journal-article","created":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T04:55:15Z","timestamp":1764478515000},"page":"e016346","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Policy analysis on drug-resistant tuberculosis in ASEAN member countries using a governance framework approach: a scoping review"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9166-8134","authenticated-orcid":false,"given":"Nicole Rose","family":"Alberto","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Philippine General Hospital, Manila, Philippines"},{"name":"College of Medicine, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle Rose I","family":"Alberto","sequence":"additional","affiliation":[{"name":"College of Medicine, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ianne Keziah","family":"Agripo","sequence":"additional","affiliation":[{"name":"College of Medicine, University of the Philippines Manila, Manila, Philippines"},{"name":"Department of Surgery, Philippine General Hospital, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle P","family":"Flores","sequence":"additional","affiliation":[{"name":"Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeleine Nicole G","family":"Bernardo","sequence":"additional","affiliation":[{"name":"College of Medicine, University of the Philippines Manila, Manila, Philippines"},{"name":"Department of Orthopedics, Philippine General Hospital, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare Therese F","family":"Gascon","sequence":"additional","affiliation":[{"name":"College of Medicine, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent Andrew G","family":"Viray","sequence":"additional","affiliation":[{"name":"Department of Surgery, Philippine General Hospital, Manila, Philippines"},{"name":"Cavite State University, Indang, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Don Eliseo","family":"Lucero-Prisno","sequence":"additional","affiliation":[{"name":"Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Office for Research, Innovation and Extension Services, Southern Leyte State University, Sogod, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"2025112920550466000_10.11.e016346.1","doi-asserted-by":"crossref","unstructured":"Silva BPM da , Almeida AS de , S\u00e9rgio MG de M , et al . Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance. Rev Bras Enferm 2023;76. doi:10.1590\/0034-7167-2022-0803","DOI":"10.1590\/0034-7167-2022-0803"},{"key":"2025112920550466000_10.11.e016346.2","doi-asserted-by":"crossref","DOI":"10.3389\/fcimb.2022.943545","article-title":"Drug resistant tuberculosis: Implications for transmission, diagnosis, and disease management","volume":"12","author":"Liebenberg","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"2025112920550466000_10.11.e016346.3","unstructured":"Institute of Health Metrics and Evaluation . Global burden of disease (gbd). 2020. Available: https:\/\/www.healthdata.org\/data-tools-practices\/interactive-visuals\/gbd-results [Accessed 13 Mar 2024]."},{"key":"2025112920550466000_10.11.e016346.4","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.26018","article-title":"Impact of the COVID-19 pandemic on TB services at ART programmes in low- and middle-income countries: a multi-cohort survey","volume":"25","author":"Marti","year":"2022","journal-title":"J Int AIDS Soc"},{"key":"2025112920550466000_10.11.e016346.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30415-3"},{"key":"2025112920550466000_10.11.e016346.6","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/1758-5899.13081","article-title":"Taking Systems Thinking to the Global Level: Using the WHO Building Blocks to Describe and Appraise the Global Health System in Relation to COVID-19","volume":"13","author":"Borghi","year":"2022","journal-title":"Glob Policy"},{"key":"2025112920550466000_10.11.e016346.7","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/9.4.353"},{"key":"2025112920550466000_10.11.e016346.8","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1017\/S0143814X00003068","article-title":"John W. Kingdon, Agendas, Alternatives, and Public Policies, Boston: Little, Brown, 1984","volume":"5","author":"King","year":"1985","journal-title":"J Pub Pol"},{"key":"2025112920550466000_10.11.e016346.9","doi-asserted-by":"crossref","unstructured":"Tam G , Lai SW . Is Singapore on track to eliminate tuberculosis by 2030? A policy case study. SAGE Open Med 2019;7. doi:10.1177\/2050312119851331","DOI":"10.1177\/2050312119851331"},{"key":"2025112920550466000_10.11.e016346.10","unstructured":"Ministry of health malaysia . NATIONAL strategic plan for tuberculosis control (2016-2020). 2016."},{"key":"2025112920550466000_10.11.e016346.11","unstructured":"World Health Organization . National action plan for containment of antimicrobial resistance: myanmar 2017-2022. 2017."},{"key":"2025112920550466000_10.11.e016346.12","unstructured":"Agri-Food & Veterinary Authority of Singapore, Ministry of Health, National Environment Agency . National strategic action plan on antimicrobial resistance. 2017."},{"key":"2025112920550466000_10.11.e016346.13","unstructured":"LAO PDR Ministry of Health . National tb strategic plan update 2017-2020. 2017."},{"key":"2025112920550466000_10.11.e016346.14","unstructured":"National Tuberculosis Program - Department of Health . Implementation of the revised programmatic management of drug-resistant tuberculosis (pmdt) guidelines. 2019."},{"key":"2025112920550466000_10.11.e016346.15","unstructured":"National Centre for Tuberculosis and Leprosy Control . National strategic plan to end tuberculosis in cambodia 2021-2030. 2021."},{"key":"2025112920550466000_10.11.e016346.16","unstructured":"World Health Organization . Thailand\u2019s national strategic plan on antimicrobial resistance 2017-2021. 2017."},{"key":"2025112920550466000_10.11.e016346.17","unstructured":"World health organization, Regional Office for South-East Asia . Ending drug-resistant tb in who south-east asia region: eleventh meeting of the regional mdr-tb advisory committee (\u200erglc sear). 2019."},{"key":"2025112920550466000_10.11.e016346.18","unstructured":"Department of Health . Updated 2010\u20132016 philippine plan of action to control tuberculosis. Sta. Cruz, Manila, 2014."},{"key":"2025112920550466000_10.11.e016346.19","unstructured":"Cambodian Ministry of Health, National Center for Tuberculosis and Leprosy Control . National health policies and strategies for tuberculosis control in the kingdom of cambodia 2011-2015. 2010."},{"key":"2025112920550466000_10.11.e016346.20","doi-asserted-by":"crossref","first-page":"10","DOI":"10.4103\/0970-0218.62546","article-title":"Concept of essential medicines and rational use in public health","volume":"35","author":"Kar","year":"2010","journal-title":"Indian J Community Med"},{"key":"2025112920550466000_10.11.e016346.21","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1177\/0141076817722049","article-title":"Investigating the ways in which health information technology can promote antimicrobial stewardship: a conceptual overview","volume":"110","author":"King","year":"2017","journal-title":"J R Soc Med"},{"key":"2025112920550466000_10.11.e016346.22","unstructured":"Ministry of Health and Sports . National strategic plan 2021\u20132025 national tb programme. 2020."},{"key":"2025112920550466000_10.11.e016346.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2007.08.005"},{"key":"2025112920550466000_10.11.e016346.24","doi-asserted-by":"crossref","DOI":"10.3402\/gha.v7.25856","article-title":"Progress toward universal health coverage in ASEAN","volume":"7","author":"Van Minh","year":"2014","journal-title":"Glob Health Action"},{"key":"2025112920550466000_10.11.e016346.25","unstructured":"World Health Organization . WHO consolidated guidelines on tuberculosis. module 4: treatment - drug-resistant tuberculosis treatment, 2022 update. 2022. 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