Antimicrobial Resistance National Strategy Framework 2018 – 2024.

This National Antimicrobial Resistance Strategy Framework is a nationwide multi-sectoral document developed with the main purpose to (i) to define the principles and short to medium term interventions needed to preserve the effectiveness of antimicrobials for future generations; (ii) improve the appropriate use of antibiotics in human and animal health to limit the transfer of antimicrobial residues and AMR organisms in the food chain; (iii) improve the effective management of antibiotic-resistant organisms and prevent their transmission; (iv) create an enabling environment for the successful and sustainable implementation of the strategic objectives. The Strategy represents the interdepartmental collaboration from a One-Health perspective which highlights antimicrobial resistance surveillance in people, animals, and the environment at all levels of the agricultural food chain. To achieve the aforementioned goals, the Framework set out the following 5 Strategic Objectives (i) strengthen, coordinate, and institutionalize interdisciplinary and intersectoral efforts; (ii) improve the appropriate use of diagnostic investigations; (iii) optimize surveillance and early detection of AMR and antimicrobial use; (iv) enhance infection prevention and control and biosecurity; and (v) promote appropriate use of antimicrobials in human and animal health. To achieve these objectives, the Government will focus on (i) legislative and policy reforms; (ii) education; (iii) communication; and (iv) research.
To make agriculture more productive and sustainable, the Strategy proposes a number of interventions aiming to (i) focus surveillance on three categories of bacteria (indicator/commensal organisms, zoonotic organisms and selected veterinary pathogens) to aid in the early recognition of multi-drug resistant bacteria; (ii) promote primary animal health care programs facilitated through animal health technicians and Compulsory Community Service veterinarians; (iii) increase biosecurity in animal health for both large and small scale farms; (iv) guarantee farmers' access and availability of certain key antimicrobials under control of a veterinarian or animal health technician; (v) register all antimicrobials for animal use under a single Act and farmers should be allowed to have access to those that are critical through veterinarians or other authorized persons; (vi) limit the unrestricted supply of antimicrobials through veterinarian oversight of their use in food producing animals; (vii) provide guidelines that cover the type of documentation that should be kept, and by whom it should be kept, to ensure traceability; (viii) change current legislation to improve the control of prescribing and use of antimicrobials in the animal health sector; and (ix) create a new cadre of animal health technicians trained to monitor and control the distribution and use of antimicrobials in rural areas.
To increase the resilience of livelihoods to disasters, the document focuses on sanitary measures to (i) promote access to effective, safe, community-level water, sanitation, and hygiene (WaSH) services (including clean, safe water supplies, hand hygiene, food preparation safety, and good sanitation measures) to ensuring good hygiene in the community and reducing the spread of diseases between animals and humans ; (ii) promote monitoring and controlling environmental health activities as executed by local municipalities, including food control, water quality monitoring, accessibility of domestic water supply and sanitation services, waste management and general hygiene monitoring and control of communicable diseases.
As for Governance at the institutional level it is necessary (i) the establishment of a multi-disciplinary intersectoral Ministerial Advisory Committee on AMR (MAC-AMR) funded and mandated to coordinate intersectoral efforts nationally, provide advocacy and awareness as well as monitor and evaluation of the implementation of this Strategy Framework within the provinces and health facilities and production animal farms in the country; and (ii) the establishment of governance structures at the operational level for Provinces, Districts, health establishments, and veterinary services.