National Antimicrobial Resistance Containment Action Plan Nepal 2016.

This National Antimicrobial Resistance Containment Action Plan is presented in three sections: The first section explains what antimicrobial resistance is, how it is spread and why it is a problem. Section two outlines the strategic areas of focus for the Government of Nepal and associated priority actions. The third section describes the roles and responsibilities of different agencies involved. Nepal’s action on antimicrobial resistance, including those addressing antimicrobial use, are aligned in line with international organizations guidelines and commitments. Government of Nepal Ministries, departments and agencies will work together and with other jurisdictions and sectors including private sectors to focus on reducing the public health risks and impacts of antimicrobial resistance.
Its goal is to protect Nepalese from the health risks related to antimicrobial resistance. The Government of Nepal, in collaboration with its partners, seeks to reduce the health risks associated with antimicrobial resistance by focusing its efforts on these five pillars: Awareness, Surveillance, Infection Prevention & Control, Stewardship, and Innovation. These pillars have been selected based on WHO resolution and Nepal’s commitments in different forums. 1. Improve awareness and understanding of AMR through effective communication, education and training. 2. Strengthen the knowledge and evidence base through research and surveillance. 3. Reduce the incidence of infection through effective hygiene and infection prevention measures. 4. Optimize the use of antimicrobial medicines in human and animal health. 5. Develop the economic case for sustainable investment that takes account of the needs of all countries, as well as the need for investment in new medicines, diagnostic tools, vaccines and other interventions.
Target by 2020: Provision of culture and diagnosis of selected bacterial pathogens and AMR surveillance will be available up to the district level. Monthly reporting of AMR data from district to NPHL/MOH will be mandatory, based on which a monthly update on AMR will be available on NPHL website for the reference of the treating physicians and related authorities. Hospitals with capacity of more than 100 beds and Medical college Hospitals will be under the AMR Surveillance Network. Protocols for management of infectious diseases and its proper implementation will be ensured at every level of the health system. Update data from AMR network sites in WHONET will be made mandatory. The National Antibiotic Guideline will be updated by MOH/DDA/NPHL annually on the basis of AMR surveillance data. National treatment protocol will be strictly adhered at all levels of the health system. Over the counter sale of antibiotics will be interrupted, through effective regulatory mechanism in place led by DDA supplemented with effective BCC activities on consumer awareness led by NHEICC and partners Non-therapeutic use of medically important antibiotics for growth promotion in animals will be eliminated.
Target by 2025: AMR surveillance will be expanded and made mandatory for both public and private sector health care providers. Veterinary, livestock and agriculture sectors will be incorporated under national AMR network for monthly reporting of the AMR status in each sector, contributing to one national AMR framework. DDA will have a strong regulatory mechanism in place for complete interruption of the non-prescription sale of antibiotics. No antibiotics will be distributed/sold without prescription so that over the counter sale of antibiotics is restricted.