The three countries stressed the need to increase collaboration between the human, animal and environmental health sectors as well as the need to mobilize resources for sustainable actions to translate policy into action.

Antimicrobial resistance is a global threat that undermines not only health but also development as a whole. In Cambodia, the Lao People's Democratic Republic and Viet Nam, AMR is a growing concern due to the incorrect use of antimicrobial drugs in humans and animals, and the lack of awareness among health workers, food animal producers and the public. Legal and regulatory frameworks and systems are currently insufficient to combat, monitor and avert AMR across the sectors. Policy coherence and concerted action across sectors is necessary.

Infections that are resistant to all existing antibiotics are increasingly being observed in the three countries. In addition, the increasing cross-border movement of humans, animals and medical products including antibiotics among the three countries highlights the need for collective action in the region.

Cambodia, the Lao People's Democratic Republic and Viet Nam take action

The three countries have already laid the groundwork to fight AMR.

Viet Nam was the first of the three countries to put in place a national action plan on AMR in 2013. Other initiatives have included: monitoring antibiotic use and consumption, National Antibiotic Stewardship Programme; quality and post-marketing surveillance and strengthening of regulations for antibiotic registration, distribution, sale and marketing in both the human and animal sectors.

Cambodia developed a national action plan on AMR in 2014 and in 2015, the agriculture sector put in place a national strategy complementing the national action plan and highlighting the urgent need for tackling antimicrobial resistance in both the human and animal sectors.

The Lao People's Democratic Republic is in the process of finalizing its multisectoral national action plan that was jointly developed by the Ministry of Health and the Ministry of Agriculture and Forestry. The process is a good example of close collaboration between the two ministries.

In addition, initiatives have been undertaken to set up AMR coordination committees and the organization of an Antibiotics Awareness Week since 2015 has further sparked discussion in the three countries.

It nevertheless remains a challenge for antibiotic resistance to be recognized as a threat to human and animal health and economies with associated implications to health security and economic costs to individuals and society in the three Mekong countries. Participants noted that insufficient political will, a lack of awareness among the public and a shortage of resources make the fight against AMR an uphill struggle. Moreover, these also hamper the development and implementation of national action plans.

The importance of increasing awareness was also underscored as key for behavioural change among professionals and the public as well as to drive commitment and action at the political level. Representatives from the three countries shared their experiences from past campaigns and agreed that the use of technology and social media will have an important role to play in continued awareness-raising and advocacy.

WHO, FAO and OIE form a tripartite role to support countries

The meeting on multisectoral action on antimicrobial resistance in Viet Nam is jointly organized by WHO, the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) and supported by the Fleming Fund. The tripartite group is strongly committed to supporting the countries' efforts to combat AMR. The collaboration aims to help countries with the multisectoral action that will be needed. Each of the three organizations brings its own comparative advantage in being able to engage with stakeholders across multiple sectors.

"We are seeing cases of untreatable infections in both developed and developing countries. AMR does not stop at the border, and alarmingly, there are now concerns that resistance to last-resort antibiotics is happening. We risk being faced with a world where simple infections can become life-threating complications unless we act together across the sectors, fast," said Dr Vivian Lin, Director of Health Systems of WHO’s Western Pacific Regional Office.

"FAO is committed to supporting the agriculture and food sector to combating AMR. The agriculture sector faces many challenges and need to balance adequate production for food security with appropriate use of antimicrobials. Prevention of diseases and good management practices are key and antibiotics should be mainly used to treat infections. The use of antibiotics as growth promoters need to urgently be phased out," said Dr Katinka de Balogh, Senior Animal Health and Production Officer of the FAO Regional Office for Asia and the Pacific.

"Getting the veterinarians and animal health workers on board is extremely important to fight AMR. OIE has developed quality assessment tools for veterinary services and we are collecting data on the use of antimicrobial in animals," explains Dr Pennapa Matayompong, South East Asia Programme Coordinator, OIE Sub-regional Representation for South-East Asia.

For further information, please contact:

Mr Ruel Serrano
Public Information Office
Email: serranor@who.int

Allan Dow
FAO Communication Officer (Asia-Pacific)
Email: Allan.Dow@fao.org

Catherine Bertrand-Ferrandis
OIE Communications Unit Head
Email: c.bertrand-ferrandis@oie.int