The road way to National Action Plan for combating Antimicrobial resistance

By  -  The technical advisory group of SLCM for the development of NAP

Combating AMR was a long felt need of microbiologists. All the microbiologists were fighting with it at an individual level and collectively as the college. Several milestones of combating AMR in the recent history of SLCM include surveillance of blood culture isolates from 2009, surveillance of urine culture isolates from 2014 , strengthening the infection control  with preparation of a manual in 2005 which is currently undergoing revision, strengthening the laboratories with a lab manual in 2001 and the revision in 2011 etc. Majority of membership has contributed to research in the field of AMR which has shown the extent of resistance prevailing in the country.

During the last decade there was a developing global interest in combating AMR. In 2011 the Jaipur Declaration was signed by countries giving political commitment to the issue. After that the WHO strengthened the support to countries to have national action on AMR with the involvement of the government.  In Sri Lanka too the MoH with the support of the WHO started paying attention to the issue as agreed upon in Jaipur Declaration.

At a preliminary meeting held by the MoH which was supported by WHO in September 2015, the need to take action at national level to combat AMR was recognized. SLCM nominated following members, Dr. Jayanthi Elwitigala, Dr. Kumudu Karunaratne, Dr. Shirani Chandrasiri, Dr. Geethika Patabendige and Dr.Kushlani Jayatilleke as representatives to attend this meeting. Nomination of the members to represent college was based on involvement with different activities of the college with regard to AMR activities. At that meeting members were identified who would comprise a national multisectoral coordinating group (NMCG) for the said task.  The members in this group comprised the fields dealing with antimicrobials in human medicine, veterinary and agriculture sectors. Members for human medicine represented Ministry of Health (MoH), health education, epidemiology unit, national medicinal drug regulatory authority, professional colleges, pharmaceutical society, dental, private sector hospitals, general practitioners and pharmacologists.

Subsequent to that, again a meeting was called by the MoH with WHO in March 2016 for which the members nominated by SLCM was requested to participate. At this meeting the task of developing a draft National Action Plan (NAP) for combating Antimicrobial resistance (AMR) for the purpose to initiate discussion with NMCG was allocated to SLCM within a time limit of one month. SLCM allocated this task to the same 5 microbiologists who later identified as the technical advisory group for the purpose of development of draft national action plan. The technical advisory group developed the initial draft and submitted the draft to the MoH and the WHO within the stipulated time limit by 28.04.2016. As this draft was a comprehensive document in human medicine WHO requested to include a detailed input from the veterinary and agricultural sectors as well. Following another meeting with representatives from veterinary and agriculture sectors SLCM team was able to complete the gaps in the draft for discussion at the NMCG meeting.

This first draft was reviewed by members at the first NMCG meeting held on 27.05 2016. A decision was taken to widely circulate the second draft for comments among the necessary specialities. Currently this second draft is in circulation among all relevant stake holders including specialists of the membership of our college. The second meeting  of the NMCG is scheduled to be  held on 29.7.2016. At this meeting this draft is expected to be finalised. In addition there will be a discussion on   implementation and monitoring of the NAP as well.