In May 2017, Pakistan’s Ministry of National Health Services, Regulations and Coordination submitted the newly drafted National Action Plan for Containment of Antimicrobial Resistance (NAP) to the WHO. The document was prepared after consultation with several concerned bodies, including representatives from the health, agriculture and veterinary sectors.

The major strategic priorities of the NAP include:

1. Development and implementation of a strategy to improve national awareness and behaviour change regarding antimicrobial resistance (AMR)

2. Establishment of an integrated national AMR surveillance system (use of antimicrobials and emerging resistance; human and animal)

3. Improvement of infection prevention and control in healthcare settings, the community, animal health, food, agriculture and the environment

4. Update and enforcement of regulations for human and veterinary antimicrobial use

5. Phase-out of antimicrobial use for growth promotion and provision of appropriate alternatives (such as prebiotics, probiotics) in food animals

6. Integration of AMR into all public health research agendas, including research on vaccines

7. Estimation of the health and economic burden of AMR, for use in decision-making

The NAP has proposed several actions be initiated at the national level to combat AMR, but in this writer’s opinion, the most important of them are:

Acknowledge that there is an urgent need to initiate measures to tackle the growing hazards of antibiotic resistance and irrational use of antibiotics, and join international efforts to control this threat Encourage and implement initiatives to improve infection control standards in hospitals Include structured training in rational antibiotic usage and infection control in the medical curriculum at undergraduate and postgraduate levels How successful the current government (whose most senior leader did establish a successful ‘model’ hospital, but has not yet been able to replicate that success elsewhere) will be at these goals remains to be seen.

That said, various institutions in Pakistan are currently developing intra-institution and regional guides on Hospital Acquired Infection Prevention and Control. One such guide (edited by Dr Maryam Riaz Tarar, Dr Shehnoor Azhar and Dr Javed Akram) was recently launched and distributed in Punjab in collaboration with the University of Health Sciences, Lahore.—UTM

Published in Dawn, EOS, February 2nd, 2020