Antimicrobial resistance: Here is how Malaysia endeavours to protect its people from AMR

Antimicrobial Resistance (AMR) remains a major public health crisis and is emerging as a global health threat. AMR refers to the ability of microrganisms such as bacteria, fungi, parasites and viruses to proliferate despite exposure to drugs designed to kill them or slow down their growth.

The indiscriminate use of antibiotics in factory-farmed animals leads to AMR in poultry and people. In Malaysia, factory-farming is one of the major contributors to the economy.

Broilers account for a major portion of factory farmed animals in the country. They are followed by broiler ducks, pigs, cattle, goats, sheep and buffalo, according to the data from the country’s department of veterinary services.

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The country’s Poison Act of 1952 mandates the registration of antimicrobials used in humans and animals with the National Pharmaceutical Regulatory Agency (NPRA). Animal feeds are also required to be registered with the Department of Veterinary Services under the Feed Act 2009.

Generally, antimicrobials are used for treating infections. However, they have been routinely used for disease prevention and for promoting growth.

Tetracyclines are the most widely used class of antimicrobials in Malaysia, according to the available data. It is followed by polypeptides, penicillin, macrolides, sulphonamides and aminoglycosides.

Many countries have policies to reduce the use of antimicrobials in industrially farmed animals.

WHO strongly recommends reducing the use of all classes of medically important antimicrobials in food-producing animals. It urges complete restriction of these antimicrobials for growth promotion and disease prevention.

Some initiatives

National Antimicrobial Resistance Committee:

In 2017, Malaysia established a National Antimicrobial Resistance Committee (NARC). The committee comprises members from various disciplines. The first phase of the Malaysian Action Plan on Antimicrobial Resistance for 2017–2021 was created in collaboration with NARC. The action plan’s implementation is carried out in stages through four technical working groups.

AMR surveillance:

Malaysia has conducted continuous AMR surveillance on foodborne pathogen Salmonella and commensal E.coli in food-producing animals.

In general, Salmonella and E.coli , isolated from broilers, pigs and chicken, were found to be highly resistant (above 50 per cent) to drugs such as — erythromycin, tetracycline ampicillin, chloramphenicol, streptomycin and sulfamethoxazole-trimethoprim. 

Policies on antimicrobial usage:

The government of Malaysia has established an AMR policy which aims at prohibiting the use of Critically Important Antimicrobials in humans and Veterinary Critically Important Antimicrobials in food-producing animals for growth promotion and prevention.

So far, Malaysia has completely banned the use of Nitrofuran, Chloramphenicol, Beta-agonists and Colistin. The use of six more antimicrobials as growth stimulants and prophylaxis in animal feed was banned in 2021.

These antimicrobials are Erythromycin, Enrofloxacin, Tylosin, Ceftiofur, Tetracycline and Fosfomycin. Malaysia has also developed a three-year roadmap (2023-2025) to guide the phase-out of 23 more medically important antimicrobials as growth promoters and prophylactics in animal feed.

AMR awareness:

Public awareness campaigns related to the prudent use of antimicrobial agents can reduce the misuse of antimicrobials in food production animals. 

The department of veterinary Services, Malaysia (DVS) supports and conducts a series of activities to enhance and strengthen the awareness of AMR among — pharmaceutical wholesalers, veterinary practitioners, animal feed producers, students, health care workers, environmentalists and others.

DVS is also very committed to organising World Antimicrobial Awareness Week every year.

Read more: Antimicrobial resistance: Here are some practices to ensure safe poultry

We have developed an Antimicrobial Resistance Awareness Toolkit (ARAT) for the training and education of extension workers, health workers and technical staff in the field in a targeted and effective way.

ARAT’s objective is to ensure they receive sufficient education and training to become good trainers in their roles.

Vaccines:

Vaccines are considered among the most cost-effective ways to prevent morbidity and mortality from infectious diseases. The Malaysian government, through DVS, has funded the procurement of vaccines for diseases such as FMD and Brucellosis.

In addition, DVS also aims to ensure the availability of vaccines for endemic and newly emerging diseases in the country.

Farm biosecurity:

Farmers can avoid antimicrobial misuse by improving farm’s biosecurity. DVS has introduced certification schemes such as MyGAP, Veterinary Health Mark (VHM and Good Veterinary Hygiene Practice (GVHP)to promote the same.

Challenges:

• Awareness of AMR and prudent use of antimicrobials is still not satisfactory.
• The knowledge of the farmers concerning antibiotics, withdrawal periods, prescription and dosages was found to be low.
• Lack of funds to strengthen AMR surveillance, laboratories and research.
• Lack of farmers’ cooperation in reporting the use of antimicrobials.
• Antimicrobials are widely available online. It is difficult to be controlled by the authorities.

Misuse and overuse of antimicrobials in animals contribute to the increasing threat of antimicrobial resistance. Vaccines, good husbandry practices, probiotics, herbal products, essential oils and antioxidants can prevent possible infections and help limit the use of antibiotics.

Dr Rohaya Mohd Ali is the senior director of the Veterinary Public Health Division, Department of Veterinary Services, Malaysia.

Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth

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