LOS BAÑOS, Laguna, Philippines – The Southeast Asian Regional Center for Graduate Study and Research in Agriculture (SEARCA) conducted its 24th SEARCA Online Learning and Virtual Engagement (SOLVE) webinar titled Antimicrobial Resistance (AMR) through One Health Approach: Priority Actions for Best Practice Policies and Surveillance Innovations on 24 February 2021 via Zoom and Facebook Live.
The 24th SOLVE speakers (l-r): Dr. Susan Yurismono, Dr. Abbie Stephanie Uy, and Dr. Flavie Luce Goutard
The presenters include Dr. Susan Noor, Senior Researcher at the Indonesian Centre for Veterinary Research and Development, Indonesian Agency for Agriculture Research and Development, Indonesian Ministry of Agriculture; Dr. Abbie Stephanie Uy, Veterinarian II of the National Veterinary Quarantine Services Division, Bureau of Animal Industry, Philippine Department of Agriculture (DA-BAI); and Dr. Flavie Luce Goutard, Researcher Epidemiologist and Coordinator of the GREASE platform of the French Agricultural Research Center for International Development (CIRAD).
Dr. Noor shared the Indonesian perspective of handling, monitoring, and surveillance to reduce the effects of AMR in the animal sector. She reported that the large population and many islands make the occurrence of AMR inevitable because of multiple bacterial interaction. With these, the Indonesian government started implementing the Global Action Plan on AMR for the surveillance and monitoring of AMR prevalence and antimicrobial use (AMU) in animal husbandry. They started their efforts to strengthen the surveillance system of AMR and AMU in 2016. It was a five-year process from identification and needs assessment, down to developing clinical surveillance systems. Two National Action Plans have already been implemented, with the strategic objective of strengthening knowledge and database through surveillance and research. They have put in place regulations and policies that control, regulate, and reduce the effects of AMR. They also implemented capacity development for AMR and AMU surveillance through surveys, sharing activities, trainings, and studies among key animal industry players and stakeholders. Further, they strengthened their network by establishing a consortium of AMR and AMU researchers in the field of animal husbandry and animal health. Despite these efforts, however, the Indonesian government still experienced barriers to effective surveillance mechanism such as having few guidelines and standards for surveillance of AMR and AMU on some sectors, lack of available data due to limited surveillance systems in general communities, and lack of connection between consumption data of AMU and resistance pattern of AMR. For their current National Action Plan (2020-2024), the Indonesian government envisions a healthy country from the impact of AMR through a One Health approach. They have identified increasing knowledge and scientific evidence through surveillance and research as a priority area, especially in overcoming the barriers mentioned.
Dr. Uy followed the discussion by providing some updates on the Philippine government’s AMR program on the animal health sector. Since drivers of AMR are complex and multisectoral, a One Health strategy is needed, and this is what the Philippine government has been doing. In 2014, the government created an inter-agency committee for the formulation, development, and implementation of the National Action Plan to combat AMR in the Philippines. This is co-chaired by the Department of Agriculture and Department of Health and has members from the Department of Interior and Local Government, Department of Science and Technology, and Department of Trade and Industry. To date, they are also working on having the Department of Environment and Natural Resources on board. In 2015, the first Philippine Action Plan to Combat AMR: One Health Approach was launched, and by 2019, a second version was introduced. Several key strategies for the animal sector were identified. These include strengthening surveillance and laboratory capacity; regulating and promoting the rational use of antimicrobials; reducing incidence of infection through sanitation, hygiene, and infection prevention and control across all settings; promoting innovation and research in AMR; and improving awareness and understanding of AMR through effective communication and education. For 2021, the government through DA-BAI has an on-going knowledge, attitude, and practices (KAP) survey on AMR and AMU in collaboration with veterinary universities. Plans are afoot to extend the Philippine AMR Surveillance Plan in the Animal Health Sector (2021-23), and to update the Philippine National Veterinary Drug Formulary to give recommendations on which antimicrobials are suited for which disease. Lastly, through the iAMResponsible campaign, the government continues in retooling and training animal disease surveillance personnel to help on the AMR program in the country.
Dr. Goutard discussed knowledge and awareness for AMR policy interventions in Southeast Asia. She noted that for National Action Plans to become successful, effective governance is needed. This refers to having health policies in place and collective actions are made, understood, accepted, and implemented by the different actors of the antibiotic supply chain. CIRAD is implementing a network called GREASE where they promote focus on actors involved in the production and use of antibiotics, especially targeting small and medium livestock producers. They also advocate change in AMU and direct initiatives towards a shift in practices, beliefs, and opinions. Further, they determine the barriers and motivations of actors to change their practice when it comes to AMU. As many countries try to implement new health policies and National Action Plans, GREASE is working to understand the relationship and the posture of different actors of the antibiotic supply chain involving AMR surveillance network when facing new regulations. They use social science tools to gather and analyze qualitative information to determine whose interests should be considered when developing and implementing a policy or program. Co-developing innovative strategies is also a key component for AMR policy intervention. Dr. Goutard emphasized that engaging all actors of the animal and drug production chain is important to encourage the rational use of antimicrobials. This will help influence antimicrobial and animal health management decision making systems and develop strategies to encourage prudent AMU.
In the open forum that followed, the speakers addressed questions and comments from participants about the challenges AMR campaigns experience in spreading knowledge and awareness on the use of antimicrobials. This included the challenge of trying to overcome misconceptions and misunderstanding to change the behavioral mindset of small and medium holders towards believing that there are benefits to AMR control.
Towards the end of the discussion, Dr. Goutard related the importance of containing AMR and controlling AMU through a One Health approach: “One Health collaborative surveillance network is needed to be able to measure the efficiency of any control measure in the different human, animal, and environment compartments. One Health is not only about walking at the different compartments; it is also an integration of the different sciences to be able to fight AMR. To produce surveillance control that is efficient, we need not only have biologists, veterinarians, and medical doctors but also social scientists, economists, and people that are linked with environment and biodiversity to be able to really target and understand what is happening and how to solve the AMR problem.”