National Strategy for Containment of Antimicrobial Resistance in Turkmenistan, 2017-2025.

NATIONAL STRATEGY FOR CONTAINMENT OF ANTIMICROBIAL RESISTANCE IN TURKMENISTAN, 2017-2025 is a nationwide multi-sectoral policy document aimed at undertaking appropriate measures to contain antimicrobial resistance and continue scientific research with a view of filling knowledge gaps. Recognition of the existence of the AMR problem and creation of national efficiently working cross-sectoral groups of specialists is considered a significant step for successful implementation and intervention control of AMR.
The goal of the National Strategy shall be as follows: containment of development and spread of antimicrobial resistance, preservation of effectiveness of antimicrobial agents. The objectives of the National Strategy shall be as follows: (a) establishment of the national AMR surveillance system; (b) introduction of measures to ensure rational use of antimicrobials in public health and veterinary service; (c) estimate of the quantities of antimicrobial consumption; (d) improvement of quality control system for the use of antimicrobials; and (e) establishment of a system of medical notification on the development of resistance and a system for promotion of antimicrobials’ rational use among health specialists and population.
The Ministry of Health and Medical Industry of Turkmenistan considers it necessary to focus on the following key issues: (a) prevention and control of infectious diseases; (b) control of АМR; (c) control of access to antimicrobials; and (d) rational use of antimicrobials. Emphasis shall be made on strengthening interaction between clinical, laboratory and pharmaceutical specialists. A large spectrum of activities is planned within the frameworks of implementation of the above-mentioned areas of activities given that specifics of each area is taken in consideration.
The National Strategy has been developed based on the WHO Global Strategy on Containment of AMR, strategic goals of the European Strategic Plan of Action on Antibiotics, including technological, financial and educational aspects of the implementation. The National Strategy is focused on people and interventions are supposed to affect groups of people, engaged in the activities related to AMR. These people should be the part of a problem solution: health workers that prescribe medicines, pharmaceutical workers, veterinaries, consumers, policy developers in healthcare and in agriculture and in pharmaceutical industry.
The National Strategy's goal is targeted to solution of the AMR issues as a whole and not tackling the issue of a certain disease; in particular, the National Strategy is focused on resistance to antibacterials. Priorities in this area of activity should be harmonized with national realization. Improvement of the use of antimicrobials should be the first step on the way to contain resistance. Increasing of access to these drugs and change in behavior should be in the scope of activities, which definitely requires time.
Particular attention shall be paid to prevention of development and spread of antibiotic resistance in veterinary and agriculture through: (a) study of AMR prevalence patterns and use of antimicrobials in agricultural and domestic animals; (b) strengthening the normative -regulatory documents for reduction and prohibition, in the future, of the use of antibiotics as growth-promoting factors in veterinary and agriculture; (c) study of the possibility for establishment of a system of access to antibiotics for animals only when prescribed by a veterinarian; (d) establishment of integrated surveillance systems for antibiotic resistance (in humans, animals and food) and use of antibiotics in animal feed; (e) expanding coverage of veterinarians with educational/training programs; (f) expanding coverage with educational activities for specialists of various services and industries related to food safety, for preventing and controlling the spread of AMR through the food chain; (g) encouraging compliance with the required hygiene and infection control measures in order to reduce the need for antibiotics; and (h) strengthening cross-sectoral and international cooperation in this field.