The 36 th Session of the Regional Workshop on the Use of Antimicrobials in Livestock Production and Antimicrobial Resistance in the Asia-Pacific
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1 The 36 th Session of the Regional Workshop on the Use of Antimicrobials in Livestock Production and Antimicrobial Resistance in the Asia-Pacific Region (Negombo, Sri Lanka, October 2012)
2 Contents 1. Overview of Indonesia 2. Overview of livestock production in Indonesia 3. Legal framework and institutional arrangements for regulating antimicrobial use in livestock production 4. Antimicrobial residue and AMR control program 5. The extent of antimicrobial use in livestock production 6. Results finding in monitoring program of antimicrobial residue and AMR 7. Conclusion
3 1. Overview of Indonesia
4 Located between 6 north latitude until 11 south latitude, and from 9 until 141 east altitude; Divided by EQUATOR LINE Indonesia territory is laid across 3,977 miles between India Ocean and Pacific Ocean and between two continents Asia and Australia/Oceania
5 REMARK (2010): Population : million Number of Islands : Land : km 2 Ocean : km 2 GDP (purchasing power parity) $1,054 billion (2010 est.) GDP/capita (PPP) $4,400 (2010 est.)
6 2. Overview of livestock production in Indonesia
7 LIVESTOCK POPULATION ( ) 2009) No. Species Year (000 heads) Beef Cattle 10,875 11,515 12,257 12,603 2 Dairy Cattle Buffalo 2,167 2,087 1,931 2,046 4 Goat 13,790 14,470 15,147 15,656 5 Sheep 8,980 9,514 9,605 10,472 6 Total non ruminant : eg. pigs*, horses, rabbits 6,616 7,820 7,979 8,779 7 Total poultry 1,221,295 1,318,067 1,301,452 1,352,369 Note: *95% of the category comprises pigs Source: Directorate General of Livestock Services
8 Total food consumption product of animal origin No. Food of Animal Product Consumption/capita/year 1 Meat 6,47 Kg 2 Egg 5,61 Kg 3 Total Dairy Products 9,53 Kg Directorate General of Livestock Services (2009)
9 3. Legal framework and institutional arrangements for regulating antimicrobial use in livestock production
10 MINISTRY OF AGRICULTURE DGLS Secretariat DIRECTORATE OF ANIMAL HEALTH DIRECTORATE OF VETERINARY PUBLIC HEALTH POST-HARVEST DIRECTORATE OF LIVESTOCK BREEDING DIRECTORATE OF LIVESTOCK FEED Disease Investigation Centre (DIC) at 8 regions DIRECTORATE OF ANIMAL HUSBANDARY
11 Legal aspect of veterinary drugs regulation in Indonesia First regulation: Ordinance no.432 and 435, 1912; Animal Health and Animal Husbandry Law No. 18, 2009 article 22, and article 49 54; Government Regulation no. 15, 1977 competency of the MoA to control the veterinary drugs; Government Regulation no. 78, 1992 control of veterinary drugs ; Decree of MoA no. 15, 1994 the veterinary Drugs Inspector; Decree of MoA no. 806, 1994 the veterinary drugs classifications; Decree of the Minister of Oceanic and Fisheries no. 26, 2002 and no. 4158, 2003 the veterinary drugs used in aquaculture.
12 Institutions involved in vet drugs regulation Sub directorate of Veterinary Drugs Control which belongs to Directorate of Animal Health of the DGLS control and administration of veterinary drugs; Veterinary Drugs Commission advices the policy related to veterinary drugs; Veterinary Drugs Assessment Committee conduct technical assessment on administration of veterinary drugs; Veterinary Drugs Assay Laboratory conduct lab test and to issue the quality certificate for the products to be approved that they meet the legal compliances; Veterinary Drugs Inspectors of local district and province carry out the control and inspections related to veterinary drugs
13 Legal aspect of quality control for livestock product Law no.18, 2009, Chapter IV, article no. 56 veterinary public health authority; and article no. 58 obligation of control, monitoring, testing, standardization and registration of food of animal origin; Food Law no. 7, 1996, article no.20 and 21 food quality assurance and laboratory testing for food; Consumer Protection Law no. 8, 1999, article no.19 responsibilities of the producers to protect consumers from deviations of their products; Government regulation no.22, 1983 the Veterinary Public Health aspects; Decree of MOA no. 426, 1994 establishment and operations of the Quality Control Laboratory for Livestock Products.
14 Institution involved in quality control of livestock product Sub-Directorate of Residues of the Directorate of Veterinary Public Health of the DGLS conducts the control policy of residue of veterinary drugs in livestock products; Quality Control Laboratory for Livestock Products lab analysis and confirmation of vet drugs residues and microbial contaminants in livestock products; There are 8 Laboratories of Animal Diseases Investigation Center promoted as Veterinary Assay Laboratories with additional competency on analysis of vet drugs residues and microbial contaminants; Veterinary Public Health Laboratory located in districts and provinces carry out simple lab tests of livestock product; Veterinary Public Health Inspectors of local district and provinces carry out the control and inspection related to the quality of livestock products; Livestock Products Sampling Officers carry out the sampling operations of livestock products for laboratory examinations; National Veterinary Research Laboratory conducts research and development of methods for lab analysis.
15 4. Antimicrobial residue and AMR control program
16 Antimicrobial residue control program Quality assurance program called "ASUH" meaning Aman (safe), Sehat (healthy), Utuh (wholesomeness) and Halal (edible under religious rules); Setting up the criteria for slaughter house under the inspection of the authorized officers; The animals are subjected to examination of the drug administration and health conditions under the control of veterinarians before their slaughtered; Veterinary Control Numbers are issued in order to improve the quality assurance of food safety by implementing the minimum requirements for sanitation and hygiene; HACCP principles were introduced and socialized since 1998; Monitoring and surveillance of residue and microbial contaminants, the programs called "PMSR" have been established since 1998; Laboratory accreditation programs based on ISO ; SNI-BMR is a national standard for maximum residue limit (MRL) of veterinary drugs which adopted from Codex MRL
17 Initiative control program of antimicrobial resistance DGLS have not yet had a regular program for monitoring and surveillance of antimicrobial resistance; In 2011, the QCLLP conducted a preliminary study to monitor the antimicrobial resistance in sentinel bacterial isolated from poultry meat from one of poultry pocket area in West Java; In 2012, the program of QCLLP was continued and expanded to all Java Island (still in progress); Hopefully, it will be proposed as a regular program in next year.
18 5. The extent of antimicrobial use in livestock production
19
20 MARKET SHARE OF VETERINARY DRUGS IN YEAR Value (billion Rp.) % Value (billion Rp.) % Biological agent Pharmaceutical Feed additive Total , Source: ASOHI, 2011
21 BALANCE OF EXPORT AND IMPORT OF VETERINARY DRUGS YEAR Year 2009 (USD) 2010 (USD) 2011* (USD) Eksport Import *Data were update up to August 2011; Source: Directorate General of Livestock Services
22 6. Results finding in monitoring program of antimicrobial residue and AMR
23
24
25 Prevalence of AMR in E. coli isolated from broiler meats in year 2011
26 Prevalence of MDR in E. coli isolated from broiler meats in year 2011
27 Recent paper report microbial pathogen resistance in human in Indonesia MASSI MN, ET AL. DRUG RESISTANCE AMONG TUBERCULOSIS PATIENTS ATTENDING DIAGNOSTIC AND TREATMENT CENTRES IN MAKASSAR, INDONESIA. INT J TUBERC LUNG DIS APR;15(4): NISHIBORI T, ET AL. PHENOTYPIC AND GENOTYPIC CHARACTERISATION OF VIBRIO CHOLERAE CLINICALLY ISOLATED IN SURABAYA, INDONESIA. JPN J INFECT DIS. 2011;64(1):7-12. LESTARI ES ETA L; GROUP ANTIMICROBIAL RESISTANCE IN INDONESIA PREVALENCE AND PREVENTION. DETERMINANTS OF RESISTANCE OF STAPHYLOCOCCUS AUREUS IN S AUREUS CARRIERS IN THE INDONESIAN POPULATION INSIDE AND OUTSIDE HOSPITALS. TROP MED INT HEALTH OCT;15(10): HERWANA E ET AL. SHIGELLA-ASSOCIATED DIARRHOEA IN CHILDREN IN SOUTH JAKARTA, INDONESIA. SOUTHEAST ASIAN J TROP MED PUBLIC HEALTH MAR;41(2): YANAGI D ET AL. EMERGENCE OF FLUOROQUINOLONE-RESISTANT SALMONELLA ENTERICA IN SURABAYA, INDONESIA. DIAGN MICROBIOL INFECT DIS AUG;64(4): DUERINK DO, ET AL; STUDY GROUP ANTIMICROBIAL RESISTANCE IN INDONESIA: PREVALENCE AND PREVENTION (AMRIN). DETERMINANTS OF CARRIAGE OF RESISTANT ESCHERICHIA COLI IN THE INDONESIAN POPULATION INSIDE AND OUTSIDE HOSPITALS. J ANTIMICROB CHEMOTHER AUG;60(2): SUTRISNA A, ET AL. INCREASING RESISTANCE TO CIPROFLOXACIN AND OTHER ANTIBIOTICS IN NEISSERIA GONORRHOEA FROM EAST JAVA AND PAPUA, INDONESIA IN INT J STD AIDS DEC;17(12):810-2.
28 7. Conclusion The system for the control of residues of veterinary drugs in Indonesia has been designed and established The intervention strategies for controlling antimicrobials used on farms should be reconsidered. It is required to set up a routine monitoring and surveillance program of AMR, and improve farming practices in order to reduce the development of antimicrobial resistance and minimize the likelihood of transfers of antimicrobial resistance genes to other microbes in the food chain.
29 TERIMA KASIH THANK YOU
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