National Strategic Framework for Containment of Antimicrobial Resistance (AMR)

The National Strategic Framework for Containment of Antimicrobial Resistance (AMR) is a national cross-sectoral framework of Pakistan. Its main objectives are to improve awareness and understanding of AMR through effective communication, education and training; strengthen the knowledge and evidence base through surveillance and research; reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimize the use of antimicrobial medicines in human and animal health; and develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
Among others, the document further provides that all relevant authorities and associations shall ensure Antibiotic Stewardship is promoted in institutions, community and veterinary settings; Drug Act 1976 and DRAP Act 2012 shall be fully implemented in true letter and spirit by relevant authorities with emphasis to limit the availability of antimicrobials to prescription only status as given in WHO Global Strategy for Containment of Antimicrobial Resistance; Monitoring of antimicrobial consumptions in humans, animals and plants shall be monitored at Federal and Provincial levels; relevant authorities and associations shall make sure that pharmacies have AMR awareness and personnel training for dispensing antibiotics; AMR awareness shall be created among them; ethical norms shall be promoted in order to discourage promotion of brands of antimicrobials; there shall be promotion of strong media campaign against in-appropriate use of Antibiotics; non-therapeutic use of antibiotics in livestock, poultry and plants shall be discouraged at all levels and evidence based use of antimicrobials shall be encouraged; health institutions and agriculture industry shall establish Antibiotic Stewardship Programs (ASPs) and shall develop mechanisms for auditing of antibiotic use in humans, livestock, milk products, poultry and plants; there shall be mandatory inclusion of relevant experts in infectious diseases, clinical and veterinary microbiology for approval of national formulary of drugs with reference to antimicrobials; relevant authorities shall randomly conduct testing for antibiotic residues in food items; the concept and details should be made part of curricula for teaching of all concerned tiers; and monitoring and availability for quality assured antimicrobials in humans, animals and plants should be done at local, federal and provincial levels.