COUNTRY PRESENTATION ON RECENT ACTIVITIES CARRIED OUT BY FOCAL POINT BHUTAN Regional Seminar for OIE National Focal Points for Veterinary Products (4th Cycle) Tokyo, Japan, 2-4 March 2016 1
Background/General information Animal Health Services - Provided free of cost through 224 animal health service centres and includes: 1 National Centre for Animal Health (NCAH) 1 National Animal Hospital 1 City Veterinary Hospital 4 Regional & 4 Satellite Veterinary Laboratories 20 District Veterinary Hospitals Livestock Extension Centres Under Department of Livestock, Ministry of Agriculture & Forests 2
Background/General information National Centre for Animal Health (NCAH) Nodal agency for all Animal Health Programs Focal agency for procurement and supply of veterinary drugs, vaccines and equipment Mandated by Drug, Vaccine & Equipment Unit (DVEU) 3
Background/General information Essential Veterinary Drug Program (EVDP) Centralized system of procurement, distribution and management of medicines, vaccines and equipment Initiated during 2009-2010 DVEU created under NCAH with mandates to look after overall management and coordination of EVDP System similar to EDP of MoH 196 medicine and 10 vaccine items currently included in the EVD list Classified under 37 categories 4
Background/General information Essential Veterinary Drug Program (Contd) Use and application of veterinary medicines governed by the Drug Regulatory Authority (DRA) of Bhutan National Veterinary Drug Committee (NVDC) is the highest technical advisory body for EVDP Chairperson of NVDC is the ex-officio member of Drug Technical Advisory Committee (DTAC) 5
Recent activities carried out by Focal Point Revised strategies for Essential Veterinary Drug Program Implemented since FY 2014-15 Budgetary ceilings for Districts/Farms/Central Agencies Revised management cycle for EVDP Revised distribution modality for EVDP Identification of Regional and District Focal Persons for EVDP Permanent team for drug verification and inspection Taking ownership and fixing accountability for EVDP 6
Recent activities carried out by Focal Point G2C Database for EVDP G2C Database for EVDP developed and released Database pertains to system applications at different levels for annual indenting and requisition of veterinary medicines, vaccines and equipment Training of Trainers and System Testing of G2C Database for EVDP in Bhutan conducted from 15 th 21 st June 2015 System enhancement process currently underway for immediate implementation 7
Recent activities carried out by Focal Point National Consultative & Awareness Workshop on Antimicrobial Resistance (AMR) in Livestock Sector Joining the global move towards fight against AMR Held on 11 th to 13 th August 2015 35 participants attended the workshop representing from: DOL NCAH, NAH, RLDCs, DVH & DVL Central Farms: NJBC, NPBC, RPBC Outside agencies: MOH, DRA, BAFRA, NCD & CNR. Observers: WHO & FAO country Offices Funded by WHO 8
Key Outcomes of the National Consultative & Awareness Workshop on AMR in Livestock Sector Monitoring mechanisms for antimicrobial usages in animals Monitoring mechanisms for antimicrobial usages at National animal hospital, City veterinary hospital, District veterinary hospitals & Livestock extension centres Monitoring antimicrobial usages in poultry, piggery & dairy farms Monitoring mechanisms for antimicrobial usages in animal feeds Need for a policy and regulatory framework Develop SOPs and guidelines Risk analysis Surveillance for antimicrobials in animal feeds 9
Key Outcomes of the National Consultative & Awareness Workshop on AMR in Livestock Sector Laboratory based AMR surveillance Adopt standard test protocol on ABST Antibiotics of ABST to base on the essential veterinary drug list (EVDL) Initiate reporting system on ABST - For updating EVDL Stakeholders and their specific roles and responsibilities for regulation of antibiotics in animal feeds identified 10
Recent activities carried out by Focal Point Categorization of Antimicrobials as per OIE Sl. No. Class of Antimicrobials A Aminoglycosides 4 B Amphenicols 1 VCIA VHIA VIA C Cephalosporins 5 3 D Macrolides 2 E Penicillins 9 F Quinolones 4 G Sulfonamides/Sulf onamides+diamin opyrimidines/diam inopyrimidines 10 H Tetracyclines 4 TOTAL 39 3 Class Antimicrobial Action Aminoglycosid es Cephalosporins Amikacin Gentamicin Streptomycin Cephalexin Cefotaxine Ceftriaxone Binding to 30S and 50S RSU β-lactam, Inhibit cell wall synthesis Macrolides Erythromycin Inhibit protein biosynthesis (50S) Penicillins Quinolones Sulfonamides Amoxycillin Ampicillin Cloxacillin Penicillin G Tazobactum Enrofloxacin Levofloxacin Sulfadimidine Trimethoprim Sulfadiazine Sulfamethoxazole β-lactam, Inhibit cell wall synthesis Inhibit DNA gyrase Inhibit enzyme synthesis Tetracyclines Tetracycline Binding to 30S RSU Oxytetracycline Others Metronidazole Production of toxic free radicals 11
Recent activities carried out by Focal Point Quantities of antimicrobials used in animals (2013-14) for Submission to OIE Class of antimicrobials Total qty (Kg) Oral (Kg) Inject. (kg) Other s (Kg) Aminoglycosides 4 0 4 0 Penicillins 36 16 16 4 Cephalosporins (all generations) 12 12 0 2 Fluoroquinolones 2 0 1.5 0 Sulfonamides (including 465 449 14 2 trimethoprim) Tetracyclines 72 30 42 0 Others 40 0 40 0 Total 631 507 117 8 Nu (Million) 8.000 7.000 6.000 5.000 4.000 3.000 2.000 1.000 0.000 Amount of Antimicrobials Consumption/Year (Million Nu) 5.797 5.792 2013-14 2014-15 2015-16 7.287 12
Recent activities carried out by Focal Point Participation on AMR awareness week Circulated the communication materials on AMR prepared by OIE to all the stakeholders under the Department of Livestock Posted the message from OIE in the MOAF website-through ICS Participated in panel discussion in Bhutan Broadcasting Service (BBS) along with MOH officials Endorsement of Antimicrobial Policy & National Action Plan Review of Antimicrobial policy & national action plan within the DOL, MOAF Endorsed the Antimicrobial policy & national action plan from the MOAF side in December 2015 13
What worked well Well established institutional set-up in terms of regulation and technical advisory bodies amongst various competent authorities for veterinary products Well established network of veterinary product experts at district, regional and national level Good regulatory system and mechanisms for import/export and usage of veterinary products Bhutan One Health Strategy 2015 recently endorsed Platform used for veterinary products too DTAC designated as AMR steering committee 14
Challenges Linkages and networking poor for veterinary product experts at international level AMR policy and action plans finalized by MoAF and MoH but yet to be endorsed by Bhutan Medicine Board and Cabinet AMR activities initiated under flagship of WHO and led by MoH MoAF taken on board but chances of dependency Fund constraints and possibility of not achieving the targets as per the action plans Inadequate capacities in terms of resources and man power AMR surveillance capacities, antibiotic residue testing, antimicrobial screening in animal feeds, referral labs for AMR, etc So Near and Yet So Far Develop Antibiotic Guidelines for Animals Develop Standard Treatment Guidelines in Animals Develop Standard Test Protocols and SOPs for ABST Develop frameworks, standard test protocols, SOPs for feed testing...etc 15
Thank you for your kind attention! 16