MP State action Plan for Containment of Antimicrobial Resistance
MPSAPCAR: The journey
……………………………………………………………………………..
Introduction:
Anti-Microbial Resistance (AMR) is an eminent global threat to mankind. Identifying the nuance of ever increasing AMR, Global Action Plan on Anti-Microbial Resistance (GAP-AMR) was announced by World Health Organisation (WHO) and seconded by its 194 member countries. India as a signatory to GAPAMR, rolled out the National Action Plan on Anti-Microbial Resistance (NAP-AMR) in April 2017 by the Union Ministry of Health And Family Welfare https://ncdc.gov.in/WriteReadData/l892s/File645.pdf. In addition to the 5 priorities of GAP-AMR, the strategic objectives of NAP-AMR has a sixth priority that is India-specific dealing with India’s leadership on AMR – including international, national and sub-national collaborations on AMR. Subsequently, all the states and UTs of India were encouraged to develop their own customised state action plan for containment of AMR.
The Inception- MP state workshop on 13 November 2017:
The Madhya Pradesh State Workshop on AMR was organized by the Directorate of Health Services, Madhya Pradesh at Bhopal on 13 November 2017, with support from NCDC and WHO Country Office for India. The theme for the workshop was ‘Combating AMR in Madhya Pradesh – Towards an Agenda for Action’. The workshop aimed at awareness generation on AMR. Among all representatives and participants, as well as to discuss various options for formulation of the Madhya Pradesh State Action Plan for Containment of Antimicrobial Resistance (MP‐SAPCAR), aligned to the NAP‐AMR.
The event brought together stakeholders from human health (public and private), animal / food sector, Food and Drugs Administration, Pollution Control Board, environment, research and state health administration on one forum, thereby emphasizing upon the importance of a cross‐sectoral approach towards containing AMR.
The Awakening- The World Antibiotic Awareness Week 20018 at AIIMS Bhopal:
With an inertia for more than one year, Dr. Pankaj Shukla, State Nodal Officer, Quality Assurance, Prof. Dr. Saraman Singh, Director AIIMS Bhopal and Dr. Sagar Khadanga, Associate Professor in General Medicine, AIIMS Bhopal were in a perfect gel to carry the momentum forward. On the occasion of World Antibiotic awareness week (WAAW) there was a high level joint meeting amongst all the stake holders of AMR (human health, nursing, private doctor’s association, chemist association, Department of Veterinary, medical education, pollution control board). The meeting was also attended by Dr. Kamini Walia from ICMR. The meeting was highly successful and provided the much needed impetus for the final push for state action plan. The meeting was followed by a series of measurable outcome based deliverables.
|
|
|
Time to act- The MP State Antibiotic Policy:
The Quality Assurance team brought out the 1st ever MP state antibiotic policy, based on the antibiogram of AIIMS Bhopal. The policy document was written by team from AIIMS Bhopal, GMC Bhopal and Directorate of Health Services and NHM Madhya Pradesh. The document was launched by the then Chief Minister Shri Shiv Raj Singh Chauhan Ji. Subsequently the policy was disseminated to all the PHC, CHC and DH of the state.
Developing the Man power- Division level master trainers:
Identifying the need of extensive training among the medical officers of the state, a series of half day long AMR Awareness Activities were planned in all the 8 divisions (Rewa, Sagar, Indore, Ujjain, Bhopal, Gwalior…). About 1000 master trainers were created during these awareness activities with an intent to transmission of knowledge to PHC, CHC and DH. Additionally, all the batches of newly appointed Medical officers were trained for Syndromic approach for empirical antibiotic usage” during their induction training curriculum. All professional bodies like IMA, IPA, FOGSI were roped into the AMR containment movement in the state.
|
|
|
|
|
|
The hard decision- Embracing the Nursing Homes:
It’s time to embrace Private Health Care Delivery Systems for containment of AMR. The sate identified their contribution and identified a chain of Nursing Homes in 3 major cities of the state for the pilot project of development of Antibiogram of the state in collaboration with AIIMS Bhopal and ICMR.
|
|
|
|
The unthinkable: Training of Chemists:
There was a deliberate attempt for awareness activities for the private chemists of the state. With the collaboration of Chemist’s association of MP, the 1st awareness activity was organised in Bhopal, at Hotel Ashoka on 10th March 2021. The event was attended by approximately 75 chemists of the city. Awareness activities were also conducted for young pharmacists during their induction programs similar to that of Medical Officers. Similar activities are planned in near future across all major cities of MP.
|
|
|
|
Time to include Animal Health- Identifying District Veterinary Nodal Officers:
It is well known that antibiotic practices in India among Veterinary sector is largely unregulated. We organised a state level Veterinary workshop at Bhopal on 25th February 2020. The workshop was an unique platform to interact with the veterinary practitioners of the state to that from Kerala. The event was followed many such brain storming sessions. We have identified our district nodal officers and we are working on various modalities to decrease antibiotic usage in animals.
|
|
|
|
Public movement- Extensive media coverage:
All possible opportunity is being utilised for the public awareness activity with wide media coverage. Particularly the World Antibiotic Awareness Week is being celebrated in the state at each step of human and animal health care provision. The AMR movement in Madhya Pradesh has turned out to be a movement among the common man with wide print and electronic media.
|
|
|
|
|
|
MPSAPCAR- The Collaboration:
The state is working in close collaboration with NCDC, WHO country office of India and ICMR. The development of Madhya Pradesh State Action Plan for Containment of Anti-microbial Resistance (MPSAPCAR) could not have been successful with the much needed collaborative support. MPSAPCAR is a document of trans-scectorial commitment of the state for the larger scenario of AMR. The state administration showed all possible commitment, while five different ministers signing on the Bhopal Declaration of MPSAPCAR on 26th July 2019.
|
|
|
|
|
|
MPSAPCAR- The success Mantra:
-
Commitment of top administration
-
Identifying your right team and leaders
-
Extensive training and manpower development
-
Bring the animal health practitioners on the board
-
Reach to private practitioners and chemists
-
Collaboration in the state and at national level
-
Dedicated funding
