09 004 chaudhary

Antibiotic resistance: national actions contribute to a global solution NEPAL Ram Janam Chaudhary Minister of Health Nepal

Timeline of GoN activities on AMR • 1978: GoN, Drug Act • 1995: GoN, National Drug Policy, Nepal • 1998: GoN, Infectious Disease Control Program launched – to develop a sustainable national surveillance of AMR,

• 1999: GoN, NPHL started Laboratory Based AMR Surveillance – Network of 13 laboratories

• 2001: National Drug Policy Amended- “prudent use of Antibiotics added” • 2014: GoN, National Antibiotics Treatment Guidelines

AMR actors • Ministry: Stewardship role • Existing Organisation – APUA Nepal • Awareness activities, Newsletters • Engaging DDA, more on rational use of Drugs (Research, Training)

– NPHL • Laboratory surveillance (Research, Training)

– GARP Nepal • Multidisciplinary/sectoral, Civil society-Government engagement • Research, Policy advocacy, Civil engagement • National Situation Analysis report 2014

Bitter Reality in Nepal • Excess antibiotic use is clearly a problem everywhere, including Nepal.

• Prescription-only’ laws not effectively implemented • In poor, remote areas of Nepal villagers may be far from clinics and have no choice but to purchase whatever antibiotics they think they need.

• Self-treatment with antibiotics purchased at a shop is prevalent • Antibiotics are freely available for purchase (Over The Counter), at least in some places.

AMR – as a priority for MOH • AMR, is a cross cutting issue relevant for all National Health programs – Child Health – Disease Control (TB/HIV/STI/NTDs) – Family Health

• Addressing AMR benefits all National Health Programs • Recently we launched National Antibiotic Treatment Guidelines 2014 • Coordination meetings with Ministries involving Agriculture & Livestock development regarding AMR held this year. Discussing on multisectoral approach.

Challenges & Way forward for MoH

• Private sector engagement is a challenge • National Coordination on AMR by MOH – Implementation Program at local levels – Monitoring & Evaluation at National level

• Planning for AMR activities keeping in mind the open border – Seeking support from GoI to join hands in strengthening the AMR activities in Bordering areas

How GARP Nepal can support GoN • Policy suggestion through Research based Policy briefs (Practice plans based on Research) • Implementation Research for National Antibiotic Guidelines 2014 at all levels • Play key role in Coordinating stakeholders in all sectors/Ministries for AMR (Prepare National Action Plan)

Thank you