This National Action Plan on AMR is a 5-year nationwide multi-stakeholder Plan, involving the health, agriculture, and environment sectors that are impacted directly by the crisis of antimicrobial resistance. It is developed in response to the World Health Assembly that in May 2015 adopted a Global Action Plan on Antimicrobial Resistance and urged member states to develop their own National Action Plans. Better implementation will require closer cooperation by adopting the One Health approach as a guiding principle for working together on AMR. The Plan aims at achieving the national Mission of minimizing the spread of drug resistance so that the country can continue to benefit from effective antimicrobials. The overall goal can be reached through the following 5 Strategic Objectives (i) establish and ensure governance, sustainable investment, and actions to combat antimicrobial resistance; (ii) improve awareness and understanding of antimicrobial resistance through effective communication, education and training; (iii) strengthen surveillance, diagnostic capacity and research on AMR; (iv) strengthen sanitation, hygiene and infection prevention and control across all sectors; and (v) strengthen appropriate access and optimize the use of antimicrobial medicines in all sectors.
To make agriculture more productive and sustainable, the Nap aims to (i) promote good infection control and biosecurity practices in animal husbandry; (ii) promote prescription-only use and veterinary supervision of the use of antimicrobials in the animal husbandry sector and aquaculture sector; (iii) legislate against feeding offal to animals to stop transmission of AMR in livestock; (iv) develop a roadmap to establish a Medicines Information Centre with emphasis on rational use of antimicrobials, including food and veterinary medicines; (v) conduct regular awareness-raising for farmers, food processors, and animal production officers; and (vi) conduct infection prevention and control in farms, slaughterhouses, and feed mills.
In order to increase the resilience of livelihoods to disasters, main actions will be directed to (i) assess medical disposal system including disposal of antimicrobials and recommend action to be taken; (ii) develop guidelines on disposal of unused antibiotics (including veterinary medicines); and (iii) establish a model site for the disposal a) pharmaceuticals, b) medical waste, and c) veterinary waste.
As for Governance, the lead government departments responsible for implementing this Plan are the National Department of Health (NDoH), Department of Agriculture and Livestock (DAL) and the Conservation and Environment Protection Authority (CEPA) as direct impact sectors of AMR. The National AMR Steering Committee (NAMRSC) is the highest level of governance with some degree of authority for AMR. Reporting to the Minister for Health, it has an annual rotating chair amongst the Secretary for Health, Secretary for Agriculture and Livestock, and Managing Director for Conservation and Environment Protection Authority (CEPA).