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FAO-ICAR meeting on surveillance of AMR in human health and animal health sectors


A joint meeting of microbiologists and data management experts from human health and animal health sectors was co–organized by FAO and the Indian Council of Agriculture Research (ICAR) at National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru, India from 18-19 January, 2017.

The meeting was timed to synchronize with the drafting of India's National Action Plan (NAP) likely to be submitted to World Health Assembly before May 2017.

The meeting was attended by 36 experts who represented various leading health and veterinary institutes of India. The objectives of the meeting were:

1.     To review national capacity in antimicrobial resistance surveillance in human and animal health
2.     To suggest possible mechanisms for integrated surveillance and data management for AMR in India
3.     To discuss, mechanism to generate evidence for epidemiological linkages between resistant genes in animals and in humans.
4.     To identify research needs, potential institutes and funding sources to strengthen AMR surveillance in India.

The meeting was opened by Prof Parimal Roy, Director NIVEDI and closing comments were made by Dr Jyoti Misri, Principal Scientist, ICAR, New Delhi.

The participants deliberated on following issues in context of strengthening Antimicrobial Resistance (AMR) surveillance in India and articulating role as well as mechanism of surveillance in different sectors:

1. Surveillance of antimicrobial resistance (AMR) in India and its importance in draft NAP

2. Data management system of Indian Council of Medical Research (ICMR) and data management software WHONET

3. Standardization and harmonization of Antimicrobial susceptibility testing
4. Epidemiological linkages between resistance in pathogens causing diseases in animals and humans

5. Research priorities in AMR surveillance in India

Experts agreed on the need to promote collaboration between health and animal health sectors using standardized technologies and sharing of data.

Following recommendations were made:

1. a. Articulate in the National Action Plan (NAP) on AMR the urgent need to strengthen collaborative surveillance of AMR in human,   animal health and environment sectors to establish baseline of AMR burden in India and monitor trends on a sustainable basis.

1. b. Include in NAP establishment of national network(s), use of standardized technologies to generate quality data. To achieve this, necessary capacity building and enabling environment, especially appropriate infrastructure, must be made available.

1. c. Develop terms of reference at each level of lab and describe their horizontal and vertical linkages.

1. d. Enroll in WHO Global Antimicrobial Resistance Surveillance System. (GLASS)

1. e. Establish national repository for isolates that have been comprehensively characterized, catalogued, preserved, stored and made available to scientists on request under material transfer agreement

2. Encourage utilization of ICMR platform for data management across the country by gradually expanding its reach. It will require prior trainings, augmenting capacity and providing enabling environment.

Promote use of WHONET software till ICMR platform for data management is ready for migration of larger number of labs.

3. Revive and expand Indian National Surveillance of Antimicrobial Resistance by adding veterinary labs to it and avoiding any conflict with data generated through existing networks.
This network be merged into the existing national networks based upon its success

4. Develop and disseminate a uniform ICAR methodology for antimicrobial susceptibility testing in veterinary labs. Ensure that it is regularly updated and widely available. Use it for training veterinary microbiologists

5. Assess and augment capacity of selected veterinary labs in undertaking surveillance of AMR and related research

6. Promote and support research on various aspects of AMR including sustainability of antibiogram of species that have become susceptible to some agents after their discontinuation, clonality and impact on transmission of resistance, high impact event in animal sector that have big public health risks, emergence of resistance through traditional and local practices 

7. Undertake multisectoral "One Health" pilot projects to demonstrate efficacy of joint efforts by health, animal and environment sectors in a defined setting in context of AMR

FAO assured technical support in implementation of recommendations by the national agencies and other institutes as a part of its commitment to assist in national and global efforts in mitigating AMR