Fleming Fund Phase II Country Grant (AMR,AMU and AMC Surveillance)
Support: Country Grantee: FHI 360
Partner: GTA
Status: Completed
Project Summary:
Antimicrobial resistance (AMR) is a leading global public health threat, with disproportionate impacts on low and middle-income countries. In response, Nepal developed the National Action Plan on AMR (NAP-AMR) 2024-2028, emphasizing a one health approach integrating human, animal, and environment sectors to strengthen surveillance, stewardship, and policy interventions.
In alignment with NAP-AMR, GTA, as a local implementation partner of FFGCN Phase II,
in collaboration with FHI 360, successfully implemented AMR, antimicrobial use (AMU), and antimicrobial consumption (AMC) activities across human, animal, and environment sectors in Nepal. The project strengthened surveillance systems, generated evidence, and engaged stakeholders in decision making processes to mitigate AMR under the one health approach.
GTA worked closely with Ministry of Health and Population (MoHP), Quality and Standards Regulation Division (QSRD), Department of Livestock Services (DLS), Department of Drug Administration (DDA), Department of Environment (DoE), Department of Food Technology and Quality Control (DFTQC), National Public Health Laboratory (NPHL), Veterinary Standards and Drug Regulations Laboratory (VSDRL), Central Veterinary Laboratory (CVL), FF supported laboratories, hospitals. and other national, and provincial stakeholders to ensure successful implementation, sustainability, and policy relevance.
Goal:
To effectively manage and mitigate AMR by producing and disseminating high-quality data on AMR, AMU, and AMC in human health (HH), animal health (AH), and the environmental sector, thereby informing and influencing policy and practice for sustainable and responsible antimicrobial use.
List of activities:
1. Conduct active AMR surveillance in poultry and cattle and disseminate final report to stakeholders
2. Provide orientation to site staff on equipment management and inventory management; Update monthly working status of microbiology equipment to ensure optimal used
3. Calibrate annual biosafety equipment for participating laboratories and maintain equipment parts (HH, AH, and food)
4. Conduct AMU PPS at 12 sites and disseminate findings
5. Conduct AMU survey in poultry and AMU pilot survey in dairy cattle and disseminate final report to stakeholders
6. Gather and report quality AMC data from human health
7. Conduct Integrated AMR surveillance and disseminate results
8. Host content on respective departmental websites with AMR/AMU/AMC information and share data through workshops and a conference
9. Conduct AMR/U/C data sharing workshops with stakeholders and practitioners across sectors (Aqua, food, env.)
10. Print/Upload treatment guideline to the mobile app for prescribers; conduct workshops with veterinary practitioners and agro vet owners to promote rational use; review AMU data from veterinary hospitals and share AMU surveillance findings for improvement in prescribing and use.
Key achievements
- Implemented one round of active AMR surveillance in poultry across 7 provinces
- Conducted inventory management training for the microbiology laboratory staff at HH, AH, environmental, and food sites
- Regular maintenance and calibration of equipment across the FF supported sites
- Conducted AMU Point Prevalence Survey across 12 hospitals (HH)
- Completed nationwide farm-level AMU surveillance across 660 poultry farms
- Trained pharmaceutical manufacturers, wholesalers, suppliers, vendors, and importers on using the WHO AMC Excel template for data collection, entry, and reporting to the Global Antimicrobial Resistance and Use Surveillance System (GLASS)
- Implemented joint surveillance across human, animal, and environment sectors under the One Health approach
- Developed and distributed Information Education and Communication (IEC) materials to poultry farmers, government, and non-government stakeholders
- Conducted a national-level one health conference on AMU, AMC, and AMR
- Developed an interoperability plan for the One Health database and shared it with QSRD, MoHP; delivered IT equipment to QSRD, MoHP
Sustaining the impact
Collectively, these achievements mark a significant strengthening of Nepal’s national capacity to address AMR. The evidence generated has improved understanding of AMU patterns, the systems established have expanded surveillance coverage, and the institutional capacities developed have laid the groundwork for sustained implementation. Moving ahead, embedding these systems within government structures, investing in continuous workforce development, ensuring intersectoral collaboration, and securing reliable financing will be critical to safeguarding and expanding the progress achieved. The foundation built by this project provides a strong platform for Nepal to accelerate integrated AMR surveillance and contribute to regional and global efforts in combating AMR.