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

2. 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

3. 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

4. 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.

5. 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.

6. 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

7. 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)

8. Thank you