The FAO-implemented and Republic of Korea-funded Action to support implementation of Codex AMR Texts (ACT) project has conducted a pilot exercise in Nepal to assess the country’s legislation as it pertains to Antimicrobial Resistance (AMR) and Antimicrobial Use (AMU) in the country. The exercise involved an assessment tool, known as the ACT Tool, that helps to identify the strengths in a country’s legislation relevant to AMR and AMU, as well as aspects of legislation that could be improved. This tool is  one of the instruments  adopted by the Project to help address the threat of foodborne AMR.

The ACT Tool consists of a detailed questionnaire, which is based on the published Codex Alimentarius standards  to combat foodborne AMR along the entire food chain. It asks respondents to examine several key legislative and technical areas that are central to containing AMR along the food chain, including the institutional framework, surveillance, food chain responsibilities, antimicrobial sales, veterinary products quality control, and prescriptions.

Anurag Devkota, a national legal consultant for the ACT Tool pilot in Nepal played a key role in assessing the country’s legislation in relation to AMU/AMR: “As a legal consultant of the piloting of the ACT tool in Nepal, I had the opportunity to interact with relevant government authorities and FAO personnel to examine and understand Nepal’s legislative framework regarding foodborne AMR,” he said. “This examination revealed some gaps or weaknesses in policies as well as ongoing efforts from all sectors regarding AMR. I believe these findings and recommendations will provide the relevant authorities in Nepal with valuable insights to support their efforts to address this pressing food safety and public health concern.”

The ACT Tool deployment exercise took place in late 2023 and early 2024, during which time the ACT project team worked with government officials from human health, animal health, plant health and the food sector in Nepal to gather information, explore the country’s current framework, and identify potential areas where the current legislation relevant to AMR/AMU along the food chain could be strengthened. The ACT project team then convened a review meeting in May 2024, with key government agencies, to discuss the main findings of the initial assessment.

“FAO’s continued support to the government of Nepal has been remarkable. The ACT Tool exercise brought together all sectors to summarize the relevant AMR policies and legislation, which also helps in understanding and addressing the clarity of roles and authorities of competent authorities beyond AMR,” remarked Dr Umesh Dahal from the Department of Livestock Services.

Participants in the review meeting highlighted the need to develop a two-stage strategy that addresses both short- and medium-term goals related to bolstering Nepal’s relevant legislation. It was also agreed that this strategy needs to align with Nepal’s recently endorsed National Action Plan on AMR. In the short term, there may be opportunities to undertake targeted efforts to amend certain provisions in regulations to improve alignment with Codex guidelines, such as improving antimicrobial registration, regulating advertising, upgrading record keeping, reporting, and labelling and ensuring compliance of producers regarding waste management. Recommendations for longer term priorities included tightening antimicrobial prescription requirements, setting maximum residue limits of veterinary drugs in food and food products, introducing a pharmacovigilance system, an epidemiological unit and a data analysis system, building a stronger legal basis for the surveillance system, improving data management, data sharing reporting and data utilization and strengthening the National Coordination Center for decision making, although that role is yet to be defined. Also in the longer term, stakeholders may consider pursuing more extensive legislative amendments or enactments, which would require extensive buy-in from the relevant sectors. The representatives from each of the sectors suggested continuing the review process to monitor progress in meeting these objectives.

“This report has given us insights on the existing status of polices and legislation relevant to AMR/AMU in Nepal. This will be very informative on the follow up to address the gaps by aligning the vision of our National Action Plan on AMR. All sectors need to come together with a coordinated approach” said Ms Usha Tandukar senior drug administrator from the Quality, Standards and Regulation Division (QSRD), Ministry of Health and Population (MoHP).

Dr Matina Joshi Vaidya, Director General of the Department of Food Technology and Quality Control (DFTQC), the government focal point for the ACT project in Nepal said: “As the Codex Focal Point of Nepal, DFTQC acknowledges the importance of the adoption and implementation of Codex Standards to ensure food safety, safeguard public health, and promote fair trade. AMR is everybody’s business and the food sector is committed to playing its part. The gaps and recommendations that emerged from the ACT Tool deployment report need to be well discussed among the One Health actors to bring clarity and to facilitate policy implementation.”

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The ACT Project
ACT in Nepal
Codex AMR texts

Photo © FAO/Sakar Shivakoti