Madhya Pradesh State Action Plan for Containment of Antimicrobial Resistance (MP-SAPCAR)

2.2. Knowledge Knowledge and and evidence evidence 3. 3. Infection Infection prevention prevention and and control control

4.4. Optimizing Optimizing use use of of antibiotics antibiotics 5. Research 5. Research and and innovations innovations 6. 6. Collaborations Collaborations strategic priorities  DWͲ^WZʹϲƐƚƌĂƚĞŐŝĐƉƌŝŽƌŝƚŝĞƐ MP-SAPCAR — 6 dŚĞDĂĚŚLJĂWƌĂĚĞƐŚ^ƚĂƚĞĐƚŝŽŶWůĂŶĨŽƌŽŶƚĂŝŶŵĞŶƚŽĨŶƚŝŵŝĐƌŽďŝĂůZĞƐŝƐƚĂŶĐĞ The Madhya Pradesh State Action Plan for Containment of Antimicrobial Resistance ;DWͲ^WZͿŚĂƐƚŚĞĨŽůůŽǁŝŶŐϭϰĨŽĐƵƐĂƌĞĂƐ͗ (MP-SAPCAR) has the following 14 focus areas: ϭ͘ 1. /ŵƉƌŽǀĞ awareness Improve ĂǁĂƌĞŶĞƐƐ and ĂŶĚ understanding ƵŶĚĞƌƐƚĂŶĚŝŶŐ of ŽĨ AMR DZ ƚŚƌŽƵŐŚ effective _ through ĞĨĨĞĐƚŝǀĞ ĐŽŵŵƵŶŝĐĂƚŝŽŶ͕ĞĚƵĐĂƚŝŽŶĂŶĚƚƌĂŝŶŝŶŐ communication, education and training ex &ŽĐƵƐĂƌĞĂϭ͗/ŶĨŽƌŵĂƚŝŽŶĂŶĚĐŽŵŵƵŶŝĐĂƚŝŽŶ Focus area 1: Information and communication ex &ŽĐƵƐĂƌĞĂϮ͗ĚƵĐĂƚŝŽŶĂŶĚƚƌĂŝŶŝŶŐ Focus area 2: Education and training Ϯ͘ 2. ^ƚƌĞŶŐƚŚĞŶŬŶŽǁůĞĚŐĞĂŶĚĞǀŝĚĞŶĐĞƚŚƌŽƵŐŚƐƵƌǀĞŝůůĂŶĐĞ Strengthen knowledge and evidence through surveillance xe &ŽĐƵƐĂƌĞĂϯ͗>ĂďŽƌĂƚŽƌŝĞƐ Focus area 3: Laboratories ex &ŽĐƵƐĂƌĞĂϰ͗^ƵƌǀĞŝůůĂŶĐĞ Focus area 4: Surveillance ϯ͘ 3. ZĞĚƵĐĞƚŚĞŝŶĐŝĚĞŶĐĞŽĨŝŶĨĞĐƚŝŽŶƚŚƌŽƵŐŚĞĨĨĞĐƚŝǀĞŝŶĨĞĐƚŝŽŶƉƌĞǀĞŶƚŝŽŶĂŶĚ Reduce the incidence of infection through effective infection prevention and ĐŽŶƚƌŽů;/WͿ control (IPC) ϮϮ xe &ŽĐƵƐĂƌĞĂϱ͗/WŝŶŚƵŵĂŶŚĞĂůƚŚ Focus area 5: IPC in human health ex &ŽĐƵƐ area Focus ĂƌĞĂ 6:ϲ͗ IPC /W inŝŶ animal ĂŶŝŵĂů sector/farms, ƐĞĐƚŽƌͬĨĂƌŵƐ͕ community ĐŽŵŵƵŶŝƚLJ and ĂŶĚ ĞŶǀŝƌŽŶŵĞŶƚ environment ϰ͘ 4. KƉƚŝŵŝnjĞƚŚĞƵƐĞŽĨĂŶƚŝŵŝĐƌŽďŝĂůĂŐĞŶƚƐŝŶŚĞĂůƚŚ͕ĂŶŝŵĂůƐĂŶĚĨŽŽĚ Optimize the use of antimicrobial agents in health, animals and food ex &ŽĐƵƐĂƌĞĂϳ͗ZĞŐƵůĂƚŝŽŶƐ Focus area 7: Regulations ex &ŽĐƵƐĂƌĞĂϴ͗,ŽƐƉŝƚĂůƐ Focus area 8: Hospitals xe &ŽĐƵƐĂƌĞĂϵ͗ŶŝŵĂůƐĂŶĚĨŽŽĚ Focus area 9: Animals and food ϱ͘ 5. WƌŽŵŽƚĞŝŶǀĞƐƚŵĞŶƚƐĨŽƌDZĂĐƚŝǀŝƚŝĞƐ͕ƌĞƐĞĂƌĐŚĂŶĚŝŶŶŽǀĂƚŝŽŶƐĨŽƌDZ Promote investments for AMR activities, research and innovations for AMR ĐŽŶƚĂŝŶŵĞŶƚ containment ex &ŽĐƵƐĂƌĞĂϭϬ͗ZĞƐĞĂƌĐŚŽŶDZ Focus area 10: Research on AMR ex &ŽĐƵƐĂƌĞĂϭϭ͗/ŶŶŽǀĂƚŝŽŶƐ Focus area 11: Innovations ϲ͘ 6. ^ƚƌĞŶŐƚŚĞŶDĂĚŚLJĂWƌĂĚĞƐŚ͛ƐĐŽŵŵŝƚŵĞŶƚĂŶĚĐŽůůĂďŽƌĂƚŝŽŶƐŽŶDZ Strengthen Madhya Pradesh’s commitment and collaborations on AMR ex &ŽĐƵƐĂƌĞĂϭϮ͗'ŽǀĞƌŶĂŶĐĞŵĞĐŚĂŶŝƐŵƐ Focus area 12: Governance mechanisms ex &ŽĐƵƐĂƌĞĂϭϯ͗^ƚĂƚĞĐŽůůĂďŽƌĂƚŝŽŶƐ Focus area 13: State collaborations ex &ŽĐƵƐĂƌĞĂϭϰ͗/ŶƚĞƌƐĞĐƚŽƌĂůŵĞĐŚĂŶŝƐŵƐ Focus area 14: Intersectoral mechanisms iF 1. ya 2. Ry3. af 4. Ae 5. i)6. Awareness § Knowledge Awareness Knowledge Infection Infection Optimise Optimise Research & Research Collaborations Collaborations ro& & evidence evidence #/ prevention prevention use of use of Innovations Innovations mel understanding && control control PT aTe Leyes) antibiotics Information Information IPC inin IPC Regulations Regulations Governance Governance && Laboratories Laboratories human human Research Research Communication Communication health health Hospitals Hospitals State State collaborations collaborations IPC inin animal IPC animal Education Education sector/farms, sector/farms, Surveillance Surveillance Innovation Innovationss && Training Training community & community Animals && Animals Intersectoral Intersectoral environment environment Food Food collaborations collaborations DWͲ^WZʹϭϰĨŽĐƵƐĂƌĞĂƐ MP-SAPCAR — 14 focus areas ŵŽŶŝƚŽƌŝŶŐĂŶĚĞǀĂůƵĂƚŝŽŶĨƌĂŵĞǁŽƌŬŝƐĂŶŝŶƚĞŐƌĂůƉĂƌƚŽĨDWͲ^WZĂŶĚƐŚĂůů A monitoring and evaluation framework is an integral part of MP-SAPCAR and shall ĞŶƐƵƌĞŵŽŶŝƚŽƌŝŶŐĂŶĚŝŵƉůĞŵĞŶƚĂƚŝŽŶŽĨDWͲ^WZ͘ ensure monitoring and implementation of MP-SAPCAR. Ϯϯ Strategic priority Strategic priority 1:1: Improve Improve awareness awareness and and understanding understanding of of AMR AMR through through effective communication, effective communication, and and education education and and training training Awareness & Understanding Awareness Understanding Information and Information and communication communication Education and Education Wraining and training Focus area Focus area 1: Information DQGFommunication 1: Information and communication KďũĞĐƚŝǀĞ͗dŽŝŶĐƌĞĂƐĞĂǁĂƌĞŶĞƐƐĂŶĚƵŶĚĞƌƐƚĂŶĚŝŶŐƌĞŐĂƌĚŝŶŐDZ͕ĞƐƉĞĐŝĂůůLJ ĂŵŽŶŐƚŚĞƐƚƵĚĞŶƚƐĂŶĚƉƵďůŝĐ͕ŝŶDĂĚŚLJĂWƌĂĚĞƐŚ ϭ͘ϭ͘

1.1. EŽŶͲƉƌŽĨĞƐƐŝŽŶĂůĞĚƵĐĂƚŝŽŶĨŽƌƐĐŚŽŽůĂŶĚĐŽůůĞŐĞƐƚƵĚĞŶƚƐƚŚƌŽƵŐŚƌŽůĞ Non-professional education for school and college students through role ƉůĂLJƐ͕ƐŽĐŝĂůŵĞĚŝĂ͕ĂĚǀĞƌƚŝƐĞŵĞŶƚƐĂŶĚ&DƌĂĚŝŽ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ŝŐŚĞƌ plays, social media, advertisements and FM radio (Directorate of Higher ĚƵĐĂƚŝŽŶ͕ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ^ĞƌǀŝĐĞƐͿ Education, Directorate of Health Services) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϭ͘Ϯ͘

1.2. EŽŶͲƉƌŽĨĞƐƐŝŽŶĂů Non-professional ĞĚƵĐĂƚŝŽŶ education ĨŽƌ for ƉƵďůŝĐ public ďLJ by ƌŽůĞ role ƉůĂLJƐ͕ plays, ƐŽĐŝĂů social ŵĞĚŝĂ͕ media, ĂĚǀĞƌƚŝƐĞŵĞŶƚƐ and advertisements ĂŶĚ FM &D radio ƌĂĚŝŽ (Directorate ;ŝƌĞĐƚŽƌĂƚĞ of ŽĨ Higher ,ŝŐŚĞƌ Education, ĚƵĐĂƚŝŽŶ͕ ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ^ĞƌǀŝĐĞƐ͕ŝƌĞĐƚŽƌĂƚĞŽĨDĞĚŝĐĂůĚƵĐĂƚŝŽŶͿ Directorate of Health Services, Directorate of Medical Education) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϭ͘ϯ͘ 1.3. ŽŶĚƵĐƚ focus Conduct ĨŽĐƵƐ group ŐƌŽƵƉ discussions ĚŝƐĐƵƐƐŝŽŶƐ (Medical ,ĞĂůƚŚ Officers ;DĞĚŝĐĂů Health KĨĨŝĐĞƌƐ of ŽĨ districts, ĚŝƐƚƌŝĐƚƐ͕ //D^ŚŽƉĂů͕'DΘŽƚŚĞƌDĞĚŝĐĂůŽůůĞŐĞƐ͕WŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚͿ AIIMS Bhopal, GMC & other Medical Colleges, Pollution Control Board) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϭ͘ϰ͘ 1.4. hƚŝůŝnjĞƐŽĐŝĂůŵĞĚŝĂĨŽƌĂǁĂƌĞŶĞƐƐŐĞŶĞƌĂƚŝŽŶ;DĞĚŝĐĂů,ĞĂůƚŚKĨĨŝĐĞƌƐŽĨ Utilize social media for awareness generation (Medical Health Officers of ĚŝƐƚƌŝĐƚƐ͕//D^ŚŽƉĂůΘŽƚŚĞƌDĞĚŝĐĂůŽůůĞŐĞƐ͕WŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚͿ districts, AIIMS Bhopal & other Medical Colleges, Pollution Contro! Board) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year Ϯϰ KďũĞĐƚŝǀĞ͗dŽŝŶĐƌĞĂƐĞĂǁĂƌĞŶĞƐƐĂŶĚŝŵƉƌŽǀĞĐŽŵŵƵŶŝĐĂƚŝŽŶƌĞŐĂƌĚŝŶŐDZŝŶ ĂŶŝŵĂůƐĞĐƚŽƌ;ǀĞƚĞƌŝŶĂƌLJ͕ĂŶŝŵĂůŚƵƐďĂŶĚƌLJĂŶĚĨŝƐŚĞƌŝĞƐͿŝŶDW ϭ͘ϱ͘ 1.5. ŽŶƐŽůŝĚĂƚĞĞdžŝƐƚŝŶŐŝŶĨŽƌŵĂƚŝŽŶĂŶĚĐŽŶĚƵĐƚŝŽŶŽĨŬŶŽǁůĞĚŐĞ͕ĂƚƚŝƚƵĚĞ Consolidate existing information and conduction of knowledge, attitude ĂŶĚ and ƉƌĂĐƚŝĐĞ practice ;<WͿ (KAP) ĂŶĚ and ďĞŚĂǀŝŽƵƌĂů behavioural ƐƚƵĚŝĞƐ studies ĂĐƌŽƐƐ across ŐĞŶĞƌĂů general ƉŽƉƵůĂƚŝŽŶ͕ population, ĨĂƌŵĞƌƐ͕ƉƌŽĨĞƐƐŝŽŶĂůƐ;ŚĞĂůƚŚĐĂƌĞ͕zh^,͕ǀĞƚĞƌŝŶĂƌLJ͕ĞŶǀŝƌŽŶŵĞŶƚͿĂŶĚ farmers, professionals (healthcare, AYUSH, veterinary, environment) and ŝŶĚƵƐƚƌLJ;ĨŽŽĚƉƌŽĐĞƐƐŝŶŐ͕ƉŚĂƌŵĂĐĞƵƚŝĐĂůͿ industry (food processing, pharmaceutical) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϭ͘ϲ͘ 1.6. ŽŶĚƵĐƚƚĞĂĐŚŝŶŐƉƌŽŐƌĂŵŵĞƐ͕ƐĞŵŝŶĂƌƐ͕ǁŽƌŬƐŚŽƉƐ͖ĂƵĚŝŽͲǀŝƐƵĂůĂŝĚƐ Conduct teaching programmes, seminars, workshops; audio-visual aids ĨŽƌĨĂĐŝůŝƚĂƚŝŽŶ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ͕ŝƌĞĐƚŽƌĂƚĞŽĨDĞĚŝĐĂůĚƵĐĂƚŝŽŶ͕ for facilitation (Directorate of Health, Directorate of Medical Education, 'DĂŶĚŽƚŚĞƌŵĞĚŝĐĂůĐŽůůĞŐĞƐͿ GMC and other medical colleges) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϭ͘ϳ͘ 1.7. ŽŶĚƵĐƚĨŽĐƵƐŐƌŽƵƉĚŝƐĐƵƐƐŝŽŶƐ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ͕ŝƌĞĐƚŽƌĂƚĞŽĨ Conduct focus group discussions (Directorate of Health, Directorate of DĞĚŝĐĂůĚƵĐĂƚŝŽŶ͕'DĂŶĚŽƚŚĞƌŵĞĚŝĐĂůĐŽůůĞŐĞƐ͕E'KƐͿ Medical Education, GMC and other medical colleges, NGOs) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϭ͘ϴ͘ 1.8. hƚŝůŝnjĞƐŽĐŝĂůŵĞĚŝĂĨŽƌĂǁĂƌĞŶĞƐƐŐĞŶĞƌĂƚŝŽŶ;ŽůůĞŐĞƐʹŵĞĚŝĐĂůĂŶĚ Utilize social media for awareness generation (Colleges — medical and ǀĞƚĞƌŝŶĂƌLJ͕WŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚͿ veterinary, Pollution Control Board) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year KďũĞĐƚŝǀĞ͗dŽŝŶĐƌĞĂƐĞĂǁĂƌĞŶĞƐƐĂŶĚŝŵƉƌŽǀĞĐŽŵŵƵŶŝĐĂƚŝŽŶƌĞŐĂƌĚŝŶŐDZŝŶ ƉŚĂƌŵĂĐĞƵƚŝĐĂů ƐĞĐƚŽƌ ;ŝŶĐůƵĚŝŶŐ ƉŚĂƌŵĂĐĞƵƚŝĐĂů ĐŽŵƉĂŶŝĞƐ͕ ŵĞĚŝĐĂů ƐƚŽƌĞƐͿ ŝŶ DĂĚŚLJĂWƌĂĚĞƐŚĂŶĚĂƚůĞǀĞůŽĨDWWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚ ϭ͘ϵ͘ 1.9. ǁĂƌĞŶĞƐƐ and Awareness ĂŶĚ instructions ŝŶƐƚƌƵĐƚŝŽŶƐ for ĨŽƌ implementation ŝŵƉůĞŵĞŶƚĂƚŝŽŶ of ŽĨ Drug ƌƵŐ and ĂŶĚ Cosmetic ŽƐŵĞƚŝĐ Đƚ;ƌƵŐŽŶƚƌŽůůĞƌ͕WŚĂƌŵĂĐLJŽƵŶĐŝů͕ŚŝĞĨDĞĚŝĐĂůΘ,ĞĂůƚŚKĨĨŝĐĞƌƐ Act (Drug Controller, Pharmacy Council, Chief Medical & Health Officers ŽĨĚŝƐƚƌŝĐƚƐ͕DWWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚͿ of districts, MP Pollution Control Board) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϭ͘ϭϬ͘ 1.10. ŽŶĚƵĐƚ seminars Conduct ƐĞŵŝŶĂƌƐ and ĂŶĚ workshops ǁŽƌŬƐŚŽƉƐ (MP WŽůůƵƚŝŽŶ Control ;DW Pollution ŽŶƚƌŽů Board, ŽĂƌĚ͕ ŚĞĂůƚŚĐĂƌĞƉƌŽǀŝĚĞƌƐ͕ƌĞŐŝƐƚĞƌĞĚŵĞĚŝĐĂůďŽĚŝĞƐůŝŬĞ/D͕/W͕&K'^/ĂŶĚ healthcare providers, registered medical bodies like IMA, IAP, FOGSI and EƵƌƐŝŶŐ,ŽŵĞƐƐŽĐŝĂƚŝŽŶͿ Nursing Home Association) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years Ϯϱ Focus area Focus area 2: 2: Education and Wraining Education and training KďũĞĐƚŝǀĞ͗ĂƉĂĐŝƚLJďƵŝůĚŝŶŐŽĨŬĞLJƐƚĂŬĞŚŽůĚĞƌƐƌĞŐĂƌĚŝŶŐDZŝŶDĂĚŚLJĂWƌĂĚĞƐŚ ϭ͘ϭϭ͘ 1.11. ĚƵĐĂƚŝŽŶ programmes Education ƉƌŽŐƌĂŵŵĞƐ for ĨŽƌ nodal ŶŽĚĂů officers ŽĨĨŝĐĞƌƐ at Ăƚ state ƐƚĂƚĞ and ĂŶĚ district ĚŝƐƚƌŝĐƚ level ůĞǀĞů ;ŝƌĞĐƚŽƌĂƚĞ of (Directorate ŽĨ Medical DĞĚŝĐĂů Education, ĚƵĐĂƚŝŽŶ͕ Department ĞƉĂƌƚŵĞŶƚ of ŽĨ Animal ŶŝŵĂů Husbandry, ,ƵƐďĂŶĚƌLJ͕ ŝƌĞĐƚŽƌEƵƌƐŝŶŐ͕DĞĚŝĐĂůŽƵŶĐŝů͕ĞŶƚĂůŽƵŶĐŝůͿ Director Nursing, Medical Council, Dental Council) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϭ͘ϭϮ͘ 1.12. ŽŶĚƵĐƚƚĞĂĐŚŝŶŐƉƌŽŐƌĂŵŵĞƐ͕ƐĞŵŝŶĂƌƐ͕ǁŽƌŬƐŚŽƉƐ͖ĂƵĚŝŽͲǀŝƐƵĂůĂŝĚƐ Conduct teaching programmes, seminars, workshops; audio-visual aids ĨŽƌĨĂĐŝůŝƚĂƚŝŽŶŽĨƚƌĂŝŶŝŶŐŽŶDZ;ŚŝĞĨDĞĚŝĐĂůĂŶĚ,ĞĂůƚŚKĨĨŝĐĞƌƐŽĨ for facilitation of training on AMR (Chief Medical and Health Officers of ĚŝƐƚƌŝĐƚƐ͘//D^ŚŽƉĂů͕'DΘDĞĚŝĐĂůŽůůĞŐĞƐ͕WŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚͿ districts. AIIMS Bhopal, GMC & Medical Colleges, Pollution Control Board) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϭ͘ϭϯ͘

1.13. WƌŽĨĞƐƐŝŽŶĂůĞĚƵĐĂƚŝŽŶƉƌŽŐƌĂŵŵĞƐĨŽƌĚŽĐƚŽƌƐĂŶĚŶƵƌƐĞƐ;ŝƌĞĐƚŽƌĂƚĞ Professional education programmes for doctors and nurses (Directorate ŽĨDĞĚŝĐĂůĚƵĐĂƚŝŽŶ͕ŝƌĞĐƚŽƌEƵƌƐŝŶŐ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJ͕ of Medical Education, Director Nursing, Department of Animal Husbandry, DĞĚŝĐĂů Council Medical ŽƵŶĐŝů of ŽĨ India, /ŶĚŝĂ͕ Dental ĞŶƚĂů Council ŽƵŶĐŝů of ŽĨ India, /ŶĚŝĂ͕ registered ƌĞŐŝƐƚĞƌĞĚ medical ŵĞĚŝĐĂů ďŽĚŝĞƐůŝŬĞ/D͕/W͕&K'^/ĂŶĚEƵƌƐŝŶŐ,ŽŵĞƐƐŽĐŝĂƚŝŽŶͿ bodies like IMA, IAP, FOGSI and Nursing Home Association) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϭ͘ϭϰ͘

1.14. WƌŽĨĞƐƐŝŽŶĂůĞĚƵĐĂƚŝŽŶƉƌŽŐƌĂŵŵĞƐĨŽƌƉŚĂƌŵĂĐŝƐƚƐ;ŝƌĞĐƚŽƌĂƚĞŽĨ Professional education programmes for pharmacists (Directorate of DĞĚŝĐĂůĚƵĐĂƚŝŽŶ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJ͕WŚĂƌŵĂĐLJŽƵŶĐŝů͕ Medical Education, Department of Animal Husbandry, Pharmacy Council, DWDĞĚŝĐĂůŽƵŶĐŝů͕DW^ƚĂƚĞĞŶƚĂůŽƵŶĐŝůͿ MP Medical Council, MP State Dental Council) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϭ͘ϭϱ͘ 1.15. dĂƌŐĞƚĞĚ education Targeted ĞĚƵĐĂƚŝŽŶ and ĂŶĚ training ƚƌĂŝŶŝŶŐ on ŽŶ AMR DZ for ĨŽƌ veterinary ǀĞƚĞƌŝŶĂƌLJ and ĂŶĚ food ĨŽŽĚ ƉƌŽĨĞƐƐŝŽŶĂůƐ professionals ĂŶĚ and ĂǁĂƌĞŶĞƐƐ awareness ƉƌŽŐƌĂŵŵĞ programme ĨŽƌ for ĨĂƌŵĞƌƐ (Department ŽĨ farmers ;ĞƉĂƌƚŵĞŶƚ of ŶŝŵĂů,ƵƐďĂŶĚƌLJ͕ĞƉĂƌƚŵĞŶƚŽĨŐƌŝĐƵůƚƵƌĞͿ Animal Husbandry, Department of Agriculture) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϭ͘ϭϲ͘ 1.16. dĂƌŐĞƚĞĚ education Targeted ĞĚƵĐĂƚŝŽŶ on ŽŶ AMR DZĂŶĚ ƚƌĂŝŶŝŶŐƉƌŽŐƌĂŵŵĞĨŽƌĞŶǀŝƌŽŶŵĞŶƚ and training programme for environment ƌĞŐƵůĂƚŽƌƐ;ĞƉĂƌƚŵĞŶƚŽĨŶǀŝƌŽŶŵĞŶƚ͕WŽůůƵƚŝŽŶĐŽŶƚƌŽůďŽĂƌĚͿ regulators (Department of Environment, Pollution control board) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years Ϯϲ Strategic priority Strategic priority 2:2: Strengthen Strengthen knowledge knowledge and and evidence evidence through through surveillance surveillance Knowledge && Evidence Knowledge Evidence Laboratories Laboratories Surveillance Surveillance Focus area Focus area 3:3: Laboratories Laboratories KďũĞĐƚŝǀĞ͗ dŽ ƐƚƌĞŶŐƚŚĞŶ ůĂďŽƌĂƚŽƌLJ ĐĂƉĂĐŝƚLJ ĂŶĚ ĞƐƚĂďůŝƐŚ ƋƵĂůŝƚLJ ƐLJƐƚĞŵƐ ĨŽƌ ĐƵůƚƵƌĞĂŶĚĂŶƚŝďŝŽƚŝĐƐĞŶƐŝƚŝǀŝƚLJƚĞƐƚŝŶŐŝŶDĂĚŚLJĂWƌĂĚĞƐŚ͕ǁŚŝĐŚĐĂƚĞƌƚŽŶĞĞĚƐŽĨ ŚĞĂůƚŚ͕ ĂŶŝŵĂů ŚƵƐďĂŶĚƌLJ͕ ĨŽŽĚ ĂŶĚ ĞŶǀŝƌŽŶŵĞŶƚ ƐĞĐƚŽƌƐ͖ ƚŽ ĞŶƐƵƌĞ ƵŶŝĨŽƌŵ ŝŵƉůĞŵĞŶƚĂƚŝŽŶŽĨƋƵĂůŝƚLJƐƚĂŶĚĂƌĚƐďLJĐŽŶĚƵĐƚŝŶŐƌĞŐƵůĂƌƚƌĂŝŶŝŶŐĂŶĚŵŽŶŝƚŽƌŝŶŐ ĂĐƚŝǀŝƚŝĞƐƚŚƌŽƵŐŚŽƵƚDĂĚŚLJĂWƌĂĚĞƐŚ Ϯ͘ϭ͘ 2.1. ^ƚƌĞŶŐƚŚĞŶĂŶĚƐƚĂŶĚĂƌĚŝnjĞŵŝĐƌŽďŝŽůŽŐLJůĂďŽƌĂƚŽƌŝĞƐŝŶŚĞĂůƚŚ͕ĂŶŝŵĂů Strengthen and standardize microbiology laboratories in health, animal ŚƵƐďĂŶĚƌLJ͕ĨŝƐŚĞƌŝĞƐ͕ĨŽŽĚĂŶĚĞŶǀŝƌŽŶŵĞŶƚƐĞĐƚŽƌƐ;^ƚĂƚĞĞƉĂƌƚŵĞŶƚƐ husbandry, fisheries, food and environment sectors (State Departments ŽĨ,ĞĂůƚŚ͕ŶŝŵĂů,ƵƐďĂŶĚƌLJ͕&ŝƐŚĞƌŝĞƐ͕DWWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚͿ of Health, Animal Husbandry, Fisheries, MP Pollution Control Board) dŝŵĞůŝŶĞ͗ϭLJĞĂƌ Timeline: 1 year Ϯ͘Ϯ͘ 2.2. ĞǀĞůŽƉ^KWƐĨŽƌůĂďŽƌĂƚŽƌLJĂĐƚŝǀŝƚŝĞƐ;DĞĚŝĐĂůΘǀĞƚĞƌŝŶĂƌLJůĂďŽƌĂƚŽƌŝĞƐͿ Develop SOPs for laboratory activities (Medical & veterinary laboratories) dŝŵĞůŝŶĞ͗ϲŵŽŶƚŚƐ Timeline: 6 months Ϯ͘ϯ͘

2.3. WƌŽŵŽƚĞ NABH Promote E, and ĂŶĚ NABL E> accreditation ĂĐĐƌĞĚŝƚĂƚŝŽŶ among ĂŵŽŶŐ health ŚĞĂůƚŚ care ĐĂƌĞ providers, ƉƌŽǀŝĚĞƌƐ͕ ǁŝƚŚ at with Ăƚ least ůĞĂƐƚ microbiology ŵŝĐƌŽďŝŽůŽŐLJ lab ůĂď at Ăƚ 1ϭ medical ŵĞĚŝĐĂů college ĐŽůůĞŐĞ and ĂŶĚ 1ϭ district ĚŝƐƚƌŝĐƚ HQ ,Y ŚŽƐƉŝƚĂů inŝŶ each hospital ĞĂĐŚ district ĚŝƐƚƌŝĐƚ accredited ĂĐĐƌĞĚŝƚĞĚ as ĂƐ aĂ pilot ƉŝůŽƚ project ƉƌŽũĞĐƚ (Departments ;ĞƉĂƌƚŵĞŶƚƐ of ŽĨ Health ^ĞƌǀŝĐĞƐ ,ĞĂůƚŚ Services ĂŶĚ and DĞĚŝĐĂů Medical ĚƵĐĂƚŝŽŶ͕ Education, ƌĞŐŝƐƚĞƌĞĚ registered ŵĞĚŝĐĂů medical ďŽĚŝĞƐ bodies ůŝŬĞ like /D͕/W͕&K'^/ĂŶĚEƵƌƐŝŶŐ,ŽŵĞƐƐŽĐŝĂƚŝŽŶͿ IMA, IAP, FOGSI and Nursing Home Association) dŝŵĞůŝŶĞ͗ϯLJĞĂƌƐ Timeline: 3 years Ϯ͘ϰ͘

2.4. WƌŽĐƵƌĞŵĞŶƚŽĨĞƋƵŝƉŵĞŶƚĂƐƉĞƌŶĞĞĚŽĨ^KWƐ;DĂĚŚLJĂWƌĂĚĞƐŚWƵďůŝĐ Procurement of equipment as per need of SOPs (Madhya Pradesh Public ,ĞĂůƚŚ^ĞƌǀŝĐĞƐŽƌƉŽƌĂƚŝŽŶ>ŝŵŝƚĞĚʹDWWW,^>͕ĂƵƚŽŶŽŵŽƵƐďŽĚŝĞƐͿ Health Services Corporation Limited - MPPPHSCL, autonomous bodies) dŝŵĞůŝŶĞ͗ϲŵŽŶƚŚƐʹϭLJĞĂƌ Timeline: 6 months — 1 year Ϯϳ Ϯ͘ϱ͘ 2.5. ĞǀĞůŽƉŵĞŶƚŽĨƐLJƐƚĞŵƐĨŽƌƉƌŽƉĞƌƚƌĞĂƚŵĞŶƚĂŶĚĚŝƐƉŽƐĂůŽĨůĂďŽƌĂƚŽƌLJ Development of systems for proper treatment and disposal of laboratory ǁĂƐƚĞ waste ;ZĞƐƉĞĐƚŝǀĞ (Respective ŝŶƐƚŝƚƵƚĞƐ͕ State institutes, ^ƚĂƚĞ WŽůůƵƚŝŽŶ Pollution ŽŶƚƌŽů Control ŽĂƌĚͿ Board) dŝŵĞůŝŶĞ͗ϮŵŽŶƚŚƐĂĨƚĞƌƌĞĐĞŝƉƚŽĨĨƵŶĚƐ Timeline: 2 months after receipt of funds Ϯ͘ϲ͘ Ensuring uninterrupted supply 2.6. ŶƐƵƌŝŶŐƵŶŝŶƚĞƌƌƵƉƚĞĚƐƵƉƉůLJŽĨĐŽŶƐƵŵĂďůĞƐ;DWWW,^>Ϳ of consumables (MPPPHSCL) dŝŵĞůŝŶĞ͗ϯŵŽŶƚŚƐ Timeline: 3 months Ϯ͘ϳ͘

2.7. WĂƌƚŝĐŝƉĂƚŝŽŶŝŶdžƚĞƌŶĂůYƵĂůŝƚLJƐƐĞƐƐŵĞŶƚ^ĐŚĞŵĞ;Y^ͿĂŶĚŝŶƚĞƌ Participation in External Quality Assessment Scheme (EQAS) and inter ůĂďŽƌĂƚŽƌLJĐŽŵƉĂƌŝƐŽŶƉƌŽŐƌĂŵŵĞƐ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ^ĞƌǀŝĐĞƐ͕ laboratory comparison programmes (Directorate of Health Services, ĐĐƌĞĚŝƚĞĚY^ƉƌŽǀŝĚĞƌͿ Accredited EQAS provider) dŝŵĞůŝŶĞ͗ϮLJĞĂƌƐ Timeline: 2 years Ϯ͘ϴ͘

2.8. ZĞĐƌƵŝƚŵĞŶƚ Recruitment ŽĨ of ĂĚĞƋƵĂƚĞ adequate ŵĂŶƉŽǁĞƌ manpower Ăƚ at Ăůů all ůĞǀĞůƐ levels ĐŽŶƐŝƐƚĞŶƚ consistent ǁŝƚŚ with ĞdžƉĞĐƚĞĚ sample expected ƐĂŵƉůĞ load ůŽĂĚ of ŽĨ laboratory ůĂďŽƌĂƚŽƌLJ (State ;^ƚĂƚĞ Health ,ĞĂůƚŚ Department, ĞƉĂƌƚŵĞŶƚ͕ ŝƌĞĐƚŽƌĂƚĞŽĨDĞĚŝĐĂůĚƵĐĂƚŝŽŶͿ Directorate of Medical Education) dŝŵĞůŝŶĞ͗ƚƚŚĞĞĂƌůŝĞƐƚ͖ĨƵŶĚƐ͗ĂƚŐŽǀĞƌŶŵĞŶƚůĞǀĞů Timeline: At the earliest; funds: at government level Ϯ͘ϵ͘

2.9. ZĞŐƵůĂƌƚƌĂŝŶŝŶŐĂŶĚŵŽŶŝƚŽƌŝŶŐŽĨƉĞƌĨŽƌŵĂŶĐĞŽĨƌĞĐƌƵŝƚĞĚŵĂŶƉŽǁĞƌ Regular training and monitoring of performance of recruited manpower ĨŽƌĐŽŵƉůŝĂŶĐĞƚŽ^KWƐ;dĞĂĐŚŝŶŐŝŶƐƚŝƚƵƚĞƐʹŵĞĚŝĐĂůĂŶĚǀĞƚĞƌŝŶĂƌLJͿ for compliance to SOPs (Teaching institutes — medical and veterinary) dŝŵĞůŝŶĞ͗ǀĞƌLJϲŵŽŶƚŚƐ Timeline: Every 6 months  Focus area Focus area 4:4: Surveillance Surveillance KďũĞĐƚŝǀĞ͗ƐƚĂďůŝƐŚƐƚĂƚĞůĞǀĞůDZƐƵƌǀĞŝůůĂŶĐĞĂĐƌŽƐƐĂůůƐĞĐƚŽƌƐ͕ďĂƐĞĚŽŶt,K ƉƌŝŽƌŝƚLJůŝƐƚŽĨƉĂƚŚŽŐĞŶƐ Ϯ͘ϭϬ͘ 2.10. ĚĂƉƚ national Adapt ŶĂƚŝŽŶĂů AMR DZ surveillance ƐƵƌǀĞŝůůĂŶĐĞ standards/SOPs ƐƚĂŶĚĂƌĚƐͬ^KWƐ for ĨŽƌ Madhya DĂĚŚLJĂ Pradesh WƌĂĚĞƐŚ ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ͕ŝƌĞĐƚŽƌĂƚĞŽĨDĞĚŝĐĂůĚƵĐĂƚŝŽŶͿ (Directorate of Health, Directorate of Medical Education) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year Ϯ͘ϭϭ͘ 2.11. ƐƚĂďůŝƐŚ aĂ network Establish ŶĞƚǁŽƌŬ of ŽĨ AMR DZ laboratories ůĂďŽƌĂƚŽƌŝĞƐ for ĨŽƌ AMR DZ surveillance ƐƵƌǀĞŝůůĂŶĐĞ using ƵƐŝŶŐ t,KEd͕ƐƚĂƌƚŝŶŐǁŝƚŚE,ĂŶĚE>ĂĐĐƌĞĚŝƚĞĚĨĂĐŝůŝƚŝĞƐ;ŝƌĞĐƚŽƌĂƚĞ WHONET, starting with NABH and NABL accredited facilities (Directorate ŽĨ,ĞĂůƚŚ͕ŝƌĞĐƚŽƌĂƚĞŽĨDĞĚŝĐĂůĚƵĐĂƚŝŽŶͿ of Health, Directorate of Medical Education) dŝŵĞůŝŶĞ͗ϲŵŽŶƚŚƐ Timeline: 6 months Ϯ͘ϭϮ͘ 2.12. ŶƐƵƌĞŐĞŶĞƌĂƚŝŽŶŽĨĂŶƚŝďŝŽŐƌĂŵƐĨƌŽŵǀĂƌŝŽƵƐůĞǀĞůƐŽĨŚŽƐƉŝƚĂůƐ Ensure generation of antibiograms from various levels of hospitals dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year Ϯϴ Ϯ͘ϭϯ͘ 2.13. ^ŚĂƌŝŶŐŽĨDZĚĂƚĂǁŝƚŚŝŶƚŚĞŶĞƚǁŽƌŬ Sharing of AMR data within the network dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 —3 years Ϯ͘ϭϰ͘ 2.14. ŽŵƉŝůĂƚŝŽŶŽĨĚĂƚĂͬŝŶĨŽƌŵĂƚŝŽŶĂŶĚĂŶĂůLJƐĞƚŚĞƚƌĞŶĚƐ Compilation of data/information and analyse the trends dŝŵĞůŝŶĞ͗ϮLJĞĂƌƐ Timeline: 2 years Ϯ͘ϭϱ͘ 2.15. ŝƐƐĞŵŝŶĂƚŝŽŶƚŽĂůůƐƚĂŬĞŚŽůĚĞƌƐ͕ƚŽĨĂĐŝůŝƚĂƚĞũƵĚŝĐŝŽƵƐƵƐĞŽĨĂŶƚŝďŝŽƚŝĐƐ Dissemination to all stakeholders, to facilitate judicious use of antibiotics ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ͕ŝƌĞĐƚŽƌĂƚĞŽĨDĞĚŝĐĂůĚƵĐĂƚŝŽŶͿ (Directorate of Health, Directorate of Medical Education) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years Ϯ͘ϭϲ͘ 2.16. ƐƚĂďůŝƐŚ surveillance Establish ƐƵƌǀĞŝůůĂŶĐĞ of ŽĨ AMR DZ inŝŶ animals ĂŶŝŵĂůƐ and ĂŶĚ animal ĂŶŝŵĂů products ƉƌŽĚƵĐƚƐ such ƐƵĐŚ as ĂƐ ƉŽƵůƚƌLJ͕ĚĂŝƌLJ͕ĨŝƐŚ;ĞƉƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJ͕ĞƉƚ͘ŽĨ&ŝƐŚĞƌŝĞƐͿ poultry, dairy, fish (Dept of Animal Husbandry, Dept. of Fisheries) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year Ϯ͘ϭϳ͘ 2.17. ^ƵƌǀĞŝůůĂŶĐĞ of Surveillance ŽĨ antimicrobial ĂŶƚŝŵŝĐƌŽďŝĂů residues ƌĞƐŝĚƵĞƐ inŝŶ retail ƌĞƚĂŝů food ĨŽŽĚ (Food ;&ŽŽĚ &Θ Drug ƌƵŐ ĚŵŝŶŝƐƚƌĂƚŝŽŶͿ Administration) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year Ϯ͘ϭϴ͘ 2.18. ^ƵƌǀĞŝůůĂŶĐĞŽĨDZĂŶĚĂŶƚŝŵŝĐƌŽďŝĂůƌĞƐŝĚƵĞƐŝŶǁĂƐƚĞĨƌŽŵĨĂƌŵƐ͕ǁĞƚ Surveillance of AMR and antimicrobial residues in waste from farms, wet ŵĂƌŬĞƚƐ͕ markets, ƐůĂƵŐŚƚĞƌ slaughter ŚŽƵƐĞƐ͕ houses, ĨŽŽĚ food ƉƌŽĐĞƐƐŝŶŐ processing ƵŶŝƚƐ͕ units, ƐĞǁĂŐĞͬĐŽŵŵŽŶ sewage/common ĞĨĨůƵĞŶƚ treatment effluent ƚƌĞĂƚŵĞŶƚ plants, ƉůĂŶƚƐ͕ veterinary ǀĞƚĞƌŝŶĂƌLJ or Žƌ healthcare, ŚĞĂůƚŚĐĂƌĞ͕ pharmaceutical ƉŚĂƌŵĂĐĞƵƚŝĐĂů ƐĞƚƚŝŶŐƐ;^ƚĂƚĞWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚͿ settings (State Pollution Control Board) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year Ϯ͘ϭϵ͘ 2.19. ^ƵƌǀĞŝůůĂŶĐĞ of Surveillance ŽĨ antibiotic ĂŶƚŝďŝŽƚŝĐ use ƵƐĞ at Ăƚ producer, ƉƌŽĚƵĐĞƌ͕ seller ƐĞůůĞƌ and ĂŶĚ user ƵƐĞƌ level ůĞǀĞů (Drug ;ƌƵŐ ŽŶƚƌŽůĞƉĂƌƚŵĞŶƚ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJ͕ĞƉĂƌƚŵĞŶƚŽĨ Control Department, Department of Animal Husbandry, Department of &ŝƐŚĞƌŝĞƐͿ Fisheries) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year Ϯ͘ϮϬ͘ 2.20. ^ƵƌǀĞŝůůĂŶĐĞ of Surveillance ŽĨ antibiotic ĂŶƚŝďŝŽƚŝĐ use ƵƐĞ and ĂŶĚ AMR DZ inŝŶ crops ĐƌŽƉƐ (Department ;ĞƉĂƌƚŵĞŶƚ of ŽĨ ŐƌŝĐƵůƚƵƌĞͿ Agriculture) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year Ϯϵ Strategic priority Strategic priority 3:3: Reduce Reduce the the incidence incidence of of infection infection through through effective effective infection prevention infection prevention and and control control (IPC) (IPC) Infection Prevention Infection Prevention & Control Control Human health Human health Animal sector/farms, Animal sector/farms, community community & environment environment   Focus area Focus area 5:5: IPC inin human human health health KďũĞĐƚŝǀĞ͗dŽĐŽŶƚƌŽůŝŶĨĞĐƚŝŽŶŝŶŚĞĂůƚŚĐĂƌĞ͕ƚŚƌŽƵŐŚ/WĂĐƚŝǀŝƚŝĞƐ Objective: To control infection in healthcare, through IPC activities ϯ͘ϭ͘ 3.1. &ŽƌŵĂƚŝŽŶŽĨƵŶŝĨŝĞĚ/WĐŽŵŵŝƚƚĞĞƐŝŶĂůůŚŽƐƉŝƚĂůƐ͕ĂƐƉĞƌĚŝƌĞĐƚŝǀĞŽĨ Formation of unified IPC committees in all hospitals, as per directive of 'Žǀƚ͘ of Govt. ŽĨ India/ICMR /ŶĚŝĂͬ/DZ (Hospital ;,ŽƐƉŝƚĂů Infection /ŶĨĞĐƚŝŽŶ Control ŽŶƚƌŽů Committees, ŽŵŵŝƚƚĞĞƐ͕ Hospital ,ŽƐƉŝƚĂů DĞĚŝĐĂů Superintendents, Medical ^ƵƉĞƌŝŶƚĞŶĚĞŶƚƐ͕ Directorate ŝƌĞĐƚŽƌĂƚĞ of ŽĨ Medical DĞĚŝĐĂů Education ĚƵĐĂƚŝŽŶ and ĂŶĚ ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚͿ Directorate of Health) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϯ͘Ϯ͘ 3.2. ƐƐŝŐŶ/ŶĨĞĐƚŝŽŶŽŶƚƌŽůEƵƌƐĞƐŝŶĂůůŚŽƐƉŝƚĂůƐĨƌŽŵƚŚĞĂǀĂŝůĂďůĞŶƵƌƐĞƐ Assign Infection Control Nurses in all hospitals from the available nurses ĂŶĚ strengthen and ƐƚƌĞŶŐƚŚĞŶ their ƚŚĞŝƌ capacity ĐĂƉĂĐŝƚLJ for ĨŽƌ implementation ŝŵƉůĞŵĞŶƚĂƚŝŽŶ of ŽĨ IPC /W measures ŵĞĂƐƵƌĞƐ ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚͿ (Directorate of Health) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϯ͘ϯ͘ 3.3. ^ƚƌĞŶŐƚŚĞŶĐĂƉĂĐŝƚLJĨŽƌĚŝĂŐŶŽƐƚŝĐƐƚĞǁĂƌĚƐŚŝƉĨŽƌďĞƚƚĞƌƵƚŝůŝnjĂƚŝŽŶŽĨ Strengthen capacity for diagnostic stewardship for better utilization of ŵŝĐƌŽďŝŽůŽŐLJ laboratories microbiology ůĂďŽƌĂƚŽƌŝĞƐ (Directorate ;ŝƌĞĐƚŽƌĂƚĞ of ŽĨ Health ,ĞĂůƚŚ and ĂŶĚ Directorate ŝƌĞĐƚŽƌĂƚĞ of ŽĨ DĞĚŝĐĂůĚƵĐĂƚŝŽŶͿ Medical Education) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϯLJĞĂƌƐ Timeline: within 3 years  Focus area Focus area 6:6: IPC IPC inin animal animal sector/farms, sector/farms, community community and and environment environment KďũĞĐƚŝǀĞ͗ To Objective: dŽ control ĐŽŶƚƌŽů spread ƐƉƌĞĂĚ of ŽĨ antimicrobial ĂŶƚŝŵŝĐƌŽďŝĂů resistance ƌĞƐŝƐƚĂŶĐĞ inŝŶ animal ĂŶŝŵĂů sector/farms, ƐĞĐƚŽƌͬĨĂƌŵƐ͕ ĐŽŵŵƵŶŝƚLJĂŶĚĞŶǀŝƌŽŶŵĞŶƚ͕ďLJĐŽŶĚƵĐƚŝŶŐĂǁĂƌĞŶĞƐƐƐĞƐƐŝŽŶƐŽŶ/WƉƌĂĐƚŝĐĞƐ community and environment, by conducting awareness sessions on IPC practices ϯϬ 30 ϯ͘ϰ͘ 3.4. &ŽƌŵƵůĂƚŝŽŶ of Formulation ŽĨ stringent ƐƚƌŝŶŐĞŶƚ regulations ƌĞŐƵůĂƚŝŽŶƐ and ĂŶĚ their ƚŚĞŝƌ implementation ŝŵƉůĞŵĞŶƚĂƚŝŽŶ across ĂĐƌŽƐƐ ĂŶŝŵĂůͬĨĂƌŵƐ (Central animal/farms ;ĞŶƚƌĂů Drug ƌƵŐ Control ŽŶƚƌŽů Department, ĞƉĂƌƚŵĞŶƚ͕ State ^ƚĂƚĞ Drug ƌƵŐ Control ŽŶƚƌŽů ĞƉĂƌƚŵĞŶƚ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ Department, Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϯ͘ϱ͘

3.5. KƌŐĂŶŝƐĞ activities Organise ĂĐƚŝǀŝƚŝĞƐ to ƚŽ generate ŐĞŶĞƌĂƚĞ awareness ĂǁĂƌĞŶĞƐƐ about ĂďŽƵƚ IPC /W amongst ĂŵŽŶŐƐƚ farmers ĨĂƌŵĞƌƐ ĂŶĚ communityand and ĐŽŵŵƵŶŝƚLJĂŶĚ strengthen ƐƚƌĞŶŐƚŚĞŶ IPC /W inŝŶ animal ĂŶŝŵĂů and ĂŶĚ food ĨŽŽĚ sectors ƐĞĐƚŽƌƐ ;ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ (Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϯ͘ϲ͘ 3.6. ĞǀĞůŽƉͬĂĚŽƉƚ policy Develop/adopt ƉŽůŝĐLJ on ŽŶ registration/licensing ƌĞŐŝƐƚƌĂƚŝŽŶͬůŝĐĞŶƐŝŶŐ of ŽĨ food ĨŽŽĚ animal ĂŶŝŵĂů farms, ĨĂƌŵƐ͕ ƐůĂƵŐŚƚĞƌ slaughter ŚŽƵƐĞƐ͕ houses, ĨŝƐŚͬŵĞĂƚͬĚĂŝƌLJ fish/meat/dairy ƉƌŽĐĞƐƐŝŶŐ processing ƵŶŝƚƐ͕ units, ĂŶŝŵĂů animal ĨĞĞĚ feed ŵĂŶƵĨĂĐƚƵƌŝŶŐ units, manufacturing ƵŶŝƚƐ͕ health ŚĞĂůƚŚ and ĂŶĚ veterinary ǀĞƚĞƌŝŶĂƌLJ care ĐĂƌĞ units ƵŶŝƚƐ (Department ;ĞƉĂƌƚŵĞŶƚ of ŽĨ ŶŝŵĂů,ƵƐďĂŶĚƌLJͿ Animal Husbandry) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϯLJĞĂƌƐ Timeline: within 3 years ϯ͘ϳ͘ 3.7. ĞǀĞůŽƉͬĂĚŽƉƚĂƉƉƌŽƉƌŝĂƚĞďŝŽƐĞĐƵƌŝƚLJŐƵŝĚĞůŝŶĞƐ͕ƐŝƚŝŶŐŐƵŝĚĞůŝŶĞƐĂŶĚ Develop/adopt appropriate biosecurity guidelines, siting guidelines and ^ƚĂŶĚĂƌĚKƉĞƌĂƚŝŶŐWƌŽĐĞĚƵƌĞƐ;^KWƐͿŽŶǁĂƐƚĞŵĂŶĂŐĞŵĞŶƚĨŽƌĨĂƌŵƐ͕ Standard Operating Procedures (SOPs) on waste management for farms, ĨĞĞĚŵĂŶƵĨĂĐƚƵƌĞƌƐ͕ƐůĂƵŐŚƚĞƌŚŽƵƐĞƐ͕ƉƌŽĐĞƐƐŝŶŐƵŶŝƚƐ͕ŚĞĂůƚŚĂŶĚǀĞƚͲ feed manufacturers, slaughter houses, processing units, health and vet- ĐĂƌĞ care ĨĂĐŝůŝƚŝĞƐ͕ facilities, ƐĞǁĂŐĞ sewage ƚƌĞĂƚŵĞŶƚ treatment ƉůĂŶƚƐ plants ĂŶĚ and ŐŽŽĚ good ŵĂŶƵĨĂĐƚƵƌŝŶŐ manufacturing ƉƌĂĐƚŝĐĞƐ (GMPs) practices ;'DWƐͿ for ĨŽƌ fish/meat/dairy ĨŝƐŚͬŵĞĂƚͬĚĂŝƌLJ processing ƉƌŽĐĞƐƐŝŶŐ units ƵŶŝƚƐ (Department ŽĨ ;ĞƉĂƌƚŵĞŶƚ of ŶŝŵĂů,ƵƐďĂŶĚƌLJͿ Animal Husbandry) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϯLJĞĂƌƐ Timeline: within 3 years ϯ͘ϴ͘ 3.8. >ĞƐƐ risky Less ƌŝƐŬLJ litter/manure ůŝƚƚĞƌͬŵĂŶƵƌĞ management ŵĂŶĂŐĞŵĞŶƚ approaches ĂƉƉƌŽĂĐŚĞƐ such ƐƵĐŚ as ĂƐ biogas ďŝŽŐĂƐ ŐĞŶĞƌĂƚŝŽŶ generation ;ŝŶͲŚŽƵƐĞ (in-house Žƌ or ĐŽŵŵŽŶ common ƉůĂŶƚƐͿ plants) ƚŽ to ďĞ be ƉƌĞĨĞƌƌĞĚ preferred ŽǀĞƌ over ůĂŶĚ land ĂƉƉůŝĐĂƚŝŽŶ of application ŽĨ manure. ŵĂŶƵƌĞ͘ Proper WƌŽƉĞƌ composting ĐŽŵƉŽƐƚŝŶŐ for ĨŽƌ treatment ƚƌĞĂƚŵĞŶƚ of ŽĨ ůŝƚƚĞƌͬŵĂŶƵƌĞ should litter/manure ƐŚŽƵůĚ be ďĞ encouraged ĞŶĐŽƵƌĂŐĞĚ only ŽŶůLJ under ƵŶĚĞƌ very ǀĞƌLJ high ŚŝŐŚ level ůĞǀĞů of ŽĨ ƐƵƉĞƌǀŝƐŝŽŶ along supervision ĂůŽŶŐ with ǁŝƚŚ use ƵƐĞ of ŽĨ more ŵŽƌĞ bio-manure/ ďŝŽͲŵĂŶƵƌĞͬ decreased ĚĞĐƌĞĂƐĞĚ use ƵƐĞ of ŽĨ ĂŶƚŝďŝŽƚŝĐƐ along antibiotics ĂůŽŶŐ with ǁŝƚŚ pesticides ƉĞƐƚŝĐŝĚĞƐ inŝŶ fruit ĨƌƵŝƚ and ĂŶĚ vegetable ǀĞŐĞƚĂďůĞ garden ŐĂƌĚĞŶ ;ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJ͕ĞƉĂƌƚŵĞŶƚŽĨŐƌŝĐƵůƚƵƌĞͿ (Department of Animal Husbandry, Department of Agriculture) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϯLJĞĂƌƐ Timeline: within 3 years ϯϭ Strategic priority Strategic priority 4:4: Optimize Optimize the the use use of of antimicrobial antimicrobial agents agents inin health, health, animals and animals and food food Optimise the Optimise the use use of of antimicrobials antimicrobials Regulations Regulations Hospitals Hospitals Animals & food Animals food Focus area Focus area 7:7: Regulations Regulations KďũĞĐƚŝǀĞ͗ZĞŐƵůĂƚĞĂĐĐĞƐƐƚŽŚŝŐŚƋƵĂůŝƚLJĂŶƚŝŵŝĐƌŽďŝĂůƐ ϰ͘ϭ͘ 4.1, ^ƚƌŝĐƚ implementation Strict ŝŵƉůĞŵĞŶƚĂƚŝŽŶ of ŽĨ regulations ƌĞŐƵůĂƚŝŽŶƐ to ƚŽ stop ƐƚŽƉ OTC Kd sale ƐĂůĞ of ŽĨ drugs ĚƌƵŐƐ for ĨŽƌ ŚƵŵĂŶͬĂŶŝŵĂůƵƐĞ;&ŽŽĚĂŶĚƌƵŐƐĚŵŝŶŝƐƚƌĂƚŝŽŶ͕ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚͿ human/animal use (Food and Drugs Administration, Directorate of Health) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϰ͘Ϯ͘ 4.2. ĂŶ Ban ƐƵďͲƐƚĂŶĚĂƌĚ sub-standard ĂŶĚ and ƐƉƵƌŝŽƵƐ spurious ĚƌƵŐƐ drugs ŝŶ in ƚŚĞ the ƐƚĂƚĞ (Food ĂŶĚ state ;&ŽŽĚ and ƌƵŐƐ Drugs ĚŵŝŶŝƐƚƌĂƚŝŽŶͿ Administration) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϰ͘ϯ͘ 4.3. ƉƉ for App ĨŽƌ H1 ,ϭ drugs ĚƌƵŐƐ made ŵĂĚĞ by ďLJ food ĨŽŽĚ and ĂŶĚ drug ĚƌƵŐ department ĚĞƉĂƌƚŵĞŶƚ for ĨŽƌ TB d drugs ĚƌƵŐƐ to ƚŽ be ďĞ ĞdžƉĂŶĚĞĚ for expanded ĨŽƌ all Ăůů H1 ,ϭ drugs ĚƌƵŐƐ including ŝŶĐůƵĚŝŶŐ antibiotics ĂŶƚŝďŝŽƚŝĐƐ (Food ;&ŽŽĚ and ĂŶĚ Drugs ƌƵŐƐ ĚŵŝŶŝƐƚƌĂƚŝŽŶͿ Administration) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϰ͘ϰ͘ 4.4. ĂŶKdƐĂůĞŽĨĂŶƚŝďŝŽƚŝĐƐ;&ŽŽĚĂŶĚƌƵŐƐĚŵŝŶŝƐƚƌĂƚŝŽŶͿ Ban OTC sale of antibiotics (Food and Drugs Administration) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϰ͘ϱ͘

4.5. EŽ antibiotics No ĂŶƚŝďŝŽƚŝĐƐ to ƚŽ be ďĞ sold ƐŽůĚ without ǁŝƚŚŽƵƚ aĂ valid ǀĂůŝĚ prescription/stop ƉƌĞƐĐƌŝƉƚŝŽŶͬƐƚŽƉ OTC Kd sale ƐĂůĞ of ŽĨ ĂŶƚŝďŝŽƚŝĐƐ;WŚĂƌŵĂĐŝƐƚƐĂƐƐŽĐŝĂƚŝŽŶƐ͕^ƚĂƚĞƌƵŐŽŶƚƌŽůůĞƌͿ antibiotics (Pharmacists associations, State Drug Controller) dŝŵĞůŝŶĞ͗ϲŵŽŶƚŚƐʹϭLJĞĂƌ Timeline: 6 months — 1 year ϰ͘ϲ͘

4.6. ZĞǀŝĞǁĂŶĚŝŵƉůĞŵĞŶƚƌĞŐƵůĂƚŝŽŶƐƌĞŐĂƌĚŝŶŐƵƐĞŽĨĂŶƚŝŵŝĐƌŽďŝĂůƐŝŶĨŽŽĚ Review and implement regulations regarding use of antimicrobials in food ĂŶŝŵĂůƐ;ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ animals (Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϯϮ Focus area Focus area 8: 8: Hospitals Hospitals KďũĞĐƚŝǀĞ͗ĞǀĞůŽƉŵĞŶƚŽĨŶƚŝďŝŽƚŝĐ^ƚĞǁĂƌĚƐŚŝƉWƌŽŐƌĂŵŵĞŝŶŚĞĂůƚŚĐĂƌĞ ϰ͘ϳ͘ 4.7. ĞǀĞůŽƉ^ƚĂƚĞĂŶĚŝŶƐƚŝƚƵƚŝŽŶĂůĂŶƚŝďŝŽƚŝĐƉŽůŝĐŝĞƐĂŶĚŚĂŶĚŬƐĨŽƌƌĂƚŝŽŶĂů Develop State and institutional antibiotic policies and handbooks for rational ĞŵƉŝƌŝĐĂů antibiotic empirical ĂŶƚŝďŝŽƚŝĐ use ƵƐĞ (Chief ;ŚŝĞĨ Medical DĞĚŝĐĂů and ĂŶĚ Health ,ĞĂůƚŚ Officer, KĨĨŝĐĞƌ͕ AIIMS //D^ Bhopal, ŚŽƉĂů͕ ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ^ĞƌǀŝĐĞƐ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ Directorate of Health Services, Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϰ͘ϴ͘ 4.8. ůŝŐŶ Align ƐƚĂƚĞ state ŐŽǀĞƌŶŵĞŶƚ government ƉŚĂƌŵĂĐLJ pharmacy ŝŶǀĞŶƚŽƌŝĞƐ inventories ĂĐĐŽƌĚŝŶŐ according ƚŽ to DW MP ĂŶƚŝďŝŽƚŝĐ antibiotic ƉŽůŝĐLJ;ŚŝĞĨDĞĚŝĐĂůĂŶĚ,ĞĂůƚŚKĨĨŝĐĞƌ͕//D^ŚŽƉĂů͕ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚͿ policy (Chief Medical and Health Officer, AIIMS Bhopal, Directorate of Health) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϰ͘ϵ͘ 4.9. ĂĐŚƐƚĂƚĞĂŶĚĐĞŶƚƌĂůŐŽǀĞƌŶŵĞŶƚŚĞĂůƚŚƐĞĐƚŽƌƚŽŵĞŶƚŽƌϮͲϯƉƌŝǀĂƚĞƐĞƚͲ Each state and central government health sector to mentor 2-3 private set- ƵƉƐ;ŚŝĞĨDĞĚŝĐĂůĂŶĚ,ĞĂůƚŚKĨĨŝĐĞƌ͕//D^ŚŽƉĂů͕ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ͕ ups (Chief Medical and Health Officer, AIIMS Bhopal, Directorate of Health, ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϰ͘ϭϬ͘

4.10. ZĞŐƵůĂƚŝŽŶ Regulation ͬ / ǀĂůŝĚĂƚŝŽŶ validation ĐŚĞĐŬƐ checks ŵĞĐŚĂŶŝƐŵƐ mechanisms ƐŚĂůů shall ďĞ be ĞƐƚĂďůŝƐŚĞĚ established ĨŽƌ for ƉƌĞƐĐƌŝďŝŶŐŚŝŐŚĞƌĂŶƚŝďŝŽƚŝĐƐďLJǀĂƌŝŽƵƐĐĂĚƌĞƐŽĨĚŽĐƚŽƌƐ;ŚŝĞĨDĞĚŝĐĂůĂŶĚ prescribing higher antibiotics by various cadres of doctors (Chief Medical and ,ĞĂůƚŚKĨĨŝĐĞƌ͕//D^ŚŽƉĂů͕ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ^ĞƌǀŝĐĞƐͿ Health Officer, AIIMS Bhopal, Directorate of Health Services) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϰ͘ϭϭ͘

4.11. WƌĞƐĐƌŝƉƚŝŽŶĂƵĚŝƚƐŽĨƐƚĂƚĞŐŽǀĞƌŶŵĞŶƚŚŽƐƉŝƚĂůƐĂŶĚŶƵƌƐŝŶŐŚŽŵĞƐ;ŚŝĞĨ Prescription audits of state government hospitals and nursing homes (Chief DĞĚŝĐĂůĂŶĚ,ĞĂůƚŚKĨĨŝĐĞƌ͕ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ^ĞƌǀŝĐĞƐͿ Medical and Health Officer, Directorate of Health Services) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year Focus area Focus area 9:9: Animals Animals and Iood and food KďũĞĐƚŝǀĞ͗KƉƚŝŵŝnjĞƚŚĞƵƐĞŽĨĂŶƚŝŵŝĐƌŽďŝĂůƐŝŶǀĞƚĞƌŝŶĂƌLJĂŶĚĂƋƵĂĐƵůƚƵƌĞ ϰ͘ϭϮ͘ 4.12. ŽůůĞĐƚĚĂƚĂŽŶĂŶƚŝŵŝĐƌŽďŝĂůƐŝŶĂŶŝŵĂůĨĞĞĚ;ŝŶĐůƵĚŝŶŐƋƵĂŶƚŝƚĂƚŝŽŶͿ Collect data on antimicrobials in animal feed (including quantitation) dŝŵĞůŝŶĞ͗ϭLJĞĂƌ Timeline: 1 year ϰ͘ϭϯ͘ 4.13. ƐƚĂďůŝƐŚĂƐƚĂƚĞƐƵƌǀĞŝůůĂŶĐĞƐLJƐƚĞŵďLJĐŽůůĞĐƚŝŶŐĚĂƚĂŽŶƵƐĞ;ĂŶĚƉƌĞƐĞŶĐĞͿ Establish a state surveillance system by collecting data on use (and presence) ŽĨĂŶƚŝŵŝĐƌŽďŝĂůƐŝŶĂŶŝŵĂůĨŽŽĚ;ŵŝůŬ͕ŵŝůŬƉƌŽĚƵĐƚƐ͕ƉŽƵůƚƌLJĂŶĚĨŝƐŚͿ of antimicrobials in animal food (milk, milk products, poultry and fish) dŝŵĞůŝŶĞ͗ǁŝƚŚŝŶϭLJĞĂƌ Timeline: within 1 year ϯϯ ϰ͘ϭϰ͘ 4.14. ^ƚĞƉƐƚŽďĞƚĂŬĞŶƚŽƉƌĞǀĞŶƚƵƐĞŽĨ͞ĂŶƚŝďŝŽƚŝĐƐĨŽƌŚƵŵĂŶƵƐĞ͟ĂƐ͞ĂŶƚŝďŝŽƚŝĐƐ Steps to be taken to prevent use of “antibiotics for human use” as “antibiotics ĨŽƌŐƌŽǁƚŚƉƌŽŵŽƚŝŽŶŝŶǀĞƚĞƌŝŶĂƌLJĂŶĚĂƋƵĂĐƵůƚƵƌĞ͟ for growth promotion in veterinary and aquaculture” dŝŵĞůŝŶĞ͗ϭLJĞĂƌ Timeline: 1 year ϰ͘ϭϱ͘ 4.15. /ŵƉƌŽǀĞ appropriate Improve ĂƉƉƌŽƉƌŝĂƚĞ use ƵƐĞ of ŽĨ antimicrobials ĂŶƚŝŵŝĐƌŽďŝĂůƐ inŝŶ animals ĂŶŝŵĂůƐ and ĂŶĚ agriculture ĂŐƌŝĐƵůƚƵƌĞ —ʹ ƚƌĞĂƚŵĞŶƚĂŶĚƉƌŽƉŚLJůĂdžŝƐ͖ĂŶĚŝŶĨŽĚĚĞƌ;ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ treatment and prophylaxis; and in fodder (Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϰ͘ϭϲ͘ 4.16. ĂŶͬƌĞƐƚƌŝĐƚƵƐĞŽĨĐƌŝƚŝĐĂůůLJŝŵƉŽƌƚĂŶƚĂŶƚŝŵŝĐƌŽďŝĂůƐĨŽƌŚƵŵĂŶŵĞĚŝĐŝŶĞ͕ŝŶ Ban/restrict use of critically important antimicrobials for human medicine, in ĂŶŝŵĂůƐĂŶĚĨŝƐŚĞƌŝĞƐ;ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ animals and fisheries (Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϰ͘ϭϳ͘ 4.17. ĂŶͬŐƌĂĚƵĂůůLJ Ban/gradually ƉŚĂƐĞ phase ŽĨĨ off ƚŚĞ the ƵƐĞ use ŽĨ of ŚŝŐŚ high ƉƌŝŽƌŝƚLJ priority ĐƌŝƚŝĐĂůůLJ critically ŝŵƉŽƌƚĂŶƚ important ĂŶƚŝŵŝĐƌŽďŝĂůƐĨŽƌƵƐĞŝŶĂŶŝŵĂůƐ;ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ antimicrobials for use in animals (Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϰ͘ϭϴ͘ 4.18. ĂŶƚŚĞƵƐĞŽĨĂŶƚŝďŝŽƚŝĐƐĂƐŐƌŽǁƚŚƉƌŽŵŽƚĞƌƐŝŶĂŶŝŵĂůƐ;ĞƉĂƌƚŵĞŶƚŽĨ Ban the use of antibiotics as growth promoters in animals (Department of ŶŝŵĂů,ƵƐďĂŶĚƌLJͿ Animal Husbandry) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϰ͘ϭϵ͘ 4.19. ĂŶͬŐƌĂĚƵĂůůLJƉŚĂƐĞŽĨĨƚŚĞƵƐĞŽĨĂŶƚŝďŝŽƚŝĐƐĨŽƌŶŽŶͲƚŚĞƌĂƉĞƵƚŝĐƵƐĞƐƵĐŚ Ban/gradually phase off the use of antibiotics for non-therapeutic use such ĂƐĚŝƐĞĂƐĞƉƌĞǀĞŶƚŝŽŶ;ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ as disease prevention (Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϰ͘ϮϬ͘ 4.20. ĞǀĞůŽƉͬĂĚŽƉƚ Develop/adopt ƉŽůŝĐLJ policy ŽŶ on_ ƌĞŐŝƐƚƌĂƚŝŽŶͬůŝĐĞŶƐŝŶŐ registration/licensing ŽĨ of ŵĂŶƵĨĂĐƚƵƌĞƌƐ͕ manufacturers, ĚŝƐƚƌŝďƵƚŽƌƐ͕ sellers distributors, ƐĞůůĞƌƐ of ŽĨ antibiotics, ĂŶƚŝďŝŽƚŝĐƐ͕ feed ĨĞĞĚ and ĂŶĚ feed ĨĞĞĚ premixes ƉƌĞŵŝdžĞƐ (Department ŽĨ ;ĞƉĂƌƚŵĞŶƚ of ŶŝŵĂů,ƵƐďĂŶĚƌLJͿ Animal Husbandry) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϰ͘Ϯϭ͘ 4.21. ĞǀĞůŽƉͬĂĚŽƉƚ regulations Develop/adopt ƌĞŐƵůĂƚŝŽŶƐ to ƚŽ monitor ŵŽŶŝƚŽƌ antibiotic ĂŶƚŝďŝŽƚŝĐ use ƵƐĞ inŝŶ animals ĂŶŝŵĂůƐ and ĂŶĚ ĂŶƚŝďŝŽƚŝĐƐ used antibiotics ƵƐĞĚ inŝŶ feed/feed ĨĞĞĚͬĨĞĞĚ premix ƉƌĞŵŝdž including ŝŶĐůƵĚŝŶŐ their ƚŚĞŝƌ sale, ƐĂůĞ͕ labelling, ůĂďĞůůŝŶŐ͕ ƌĞŐŝƐƚƌĂƚŝŽŶ͕ prescription, registration, ƉƌĞƐĐƌŝƉƚŝŽŶ͕ import, ŝŵƉŽƌƚ͕ online ŽŶůŝŶĞ sale ƐĂůĞ (Department ŽĨ Animal ;ĞƉĂƌƚŵĞŶƚ of ŶŝŵĂů ,ƵƐďĂŶĚƌLJ͕^ƚĂƚĞƌƵŐŽŶƚƌŽůůĞƌͿ Husbandry, State Drug Controller) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϰ͘ϮϮ͘ 4.22. ĞǀĞůŽƉ and Develop ĂŶĚ implement ŝŵƉůĞŵĞŶƚ drug/antibiotic ĚƌƵŐͬĂŶƚŝďŝŽƚŝĐ take ƚĂŬĞ back ďĂĐŬ programmes ƉƌŽŐƌĂŵŵĞƐ across ĂĐƌŽƐƐ the ƚŚĞ ǀĂůƵĞĐŚĂŝŶ;ĂŶƚŝďŝŽƚŝĐƉƌŽĚƵĐƚŝŽŶƚŽƐĂůĞĂŶĚĨƵƌƚŚĞƌƵƐĞͿ value chain (antibiotic production to sale and further use) 1 — 3 years  dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: ϯϰ Strategic priority Strategic priority 5:5: Promote Promote investments investments for for AMR AMR activities, activities, research research and and innovations for innovations for AMR AMR containment containment Research & Innovations Research Innovations Research Research Innovations Innovations Focus area Focus area 10: 10: Research Research on on AMR AMR KďũĞĐƚŝǀĞ͗ dŽ ĞƐƚĂďůŝƐŚ ďĂƐĞůŝŶĞ ĚĂƚĂ ŽŶ ƐƚĂƚƵƐ ŽĨ ĐƵƌƌĞŶƚ ƌĞƐĞĂƌĐŚ ŽŶ DZ ŝŶ DĂĚŚLJĂWƌĂĚĞƐŚ͖ƉƌŽŵŽƚĞŝŶǀĞƐƚŵĞŶƚƐĨŽƌƌĞƐĞĂƌĐŚŽŶDZ ϱ͘ϭ͘

5.1. ZĞǀŝĞǁŽĨůŝƚĞƌĂƚƵƌĞĂŶĚĐŽŵƉŝůĂƚŝŽŶŽĨƌĞƐĞĂƌĐŚĂĐƚŝǀŝƚŝĞƐŽŶDZŝŶDĂĚŚLJĂ Review of literature and compilation of research activities on AMR in Madhya WƌĂĚĞƐŚ to Pradesh ƚŽ develop ĚĞǀĞůŽƉ knowledge ŬŶŽǁůĞĚŐĞ base ďĂƐĞ (Directorate ;ŝƌĞĐƚŽƌĂƚĞ of ŽĨ Health, ,ĞĂůƚŚ͕ AIIMS //D^ Bhopal, ŚŽƉĂů͕ 'DŚŽƉĂů͕EĂŶĂũŝĞƐŚŵƵŬŚsĞƚĞƌŝŶĂƌLJ^ĐŝĞŶĐĞhŶŝǀĞƌƐŝƚLJ:ĂďĂůƉƵƌͿ GMC Bhopal, Nanaji Deshmukh Veterinary Science University Jabalpur) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϱ͘Ϯ͘ 5.2. ŽŵƉŝůĞ Compile ůŝƐƚ list ŽĨ of DZ AMR ƐƚĂŬĞŚŽůĚĞƌƐ͕ stakeholders, ŝŶĐůƵĚŝŶŐ including ŝŶƐƚŝƚƵƚĞƐ institutes ĂŶĚ and ƌĞůĞǀĂŶƚ relevant ŝŶǀĞƐƚŝŐĂƚŽƌƐ͕ working investigators, ǁŽƌŬŝŶŐ on ŽŶ AMR DZ inŝŶ Madhya DĂĚŚLJĂ Pradesh WƌĂĚĞƐŚ (Directorate ŽĨ Health, ;ŝƌĞĐƚŽƌĂƚĞ of ,ĞĂůƚŚ͕ //D^ŚŽƉĂůͿ AIIMS Bhopal) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϱ͘ϯ͘ 5.3. ĞǀĞůŽƉĂŶŽŶůŝŶĞƌĞƉŽƐŝƚŽƌLJŽĨDZĐŽŶƚĂŝŶŵĞŶƚŝŶDĂĚŚLJĂWƌĂĚĞƐŚ͖ƐŚĂƌĞ Develop an online repository of AMR containment in Madhya Pradesh; share ŬŶŽǁůĞĚŐĞ resources knowledge ƌĞƐŽƵƌĐĞƐ (online ;ŽŶůŝŶĞ and ĂŶĚ offline) ŽĨĨůŝŶĞͿ for ĨŽƌ knowledge ŬŶŽǁůĞĚŐĞ management ŵĂŶĂŐĞŵĞŶƚ to ƚŽ ĐƌĞĂƚĞDZŽŵŵƵŶŝƚLJŽĨWƌĂĐƚŝĐĞ create AMR Community of Practice dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϱ͘ϰ͘

5.4. DĞƚŚŽĚŽůŽŐLJ and Methodology ĂŶĚ search ƐĞĂƌĐŚ engine ĞŶŐŝŶĞ optimization ŽƉƚŝŵŝnjĂƚŝŽŶ to ƚŽ be ďĞ established ĞƐƚĂďůŝƐŚĞĚ to ƚŽ guide ŐƵŝĚĞ ĨƵƚƵƌĞƐĞĂƌĐŚĞƐ;^ƚĂƚĞĞƉĂƌƚŵĞŶƚƐŽĨŚĞĂůƚŚ͕ĂŶŝŵĂůŚƵƐďĂŶĚƌLJ͕ĨŝƐŚĞƌŝĞƐ͕ future searches (State Departments of health, animal husbandry, fisheries, ĂŐƌŝĐƵůƚƵƌĞ͕ĞŶǀŝƌŽŶŵĞŶƚͿ agriculture, environment) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϱ͘ϱ͘ 5.5. /ĚĞŶƚŝĨLJĐƌŝƚŝĐĂůŐĂƉƐŝŶĞdžŝƐƚŝŶŐƌĞƐĞĂƌĐŚƐƚƌĂƚĞŐŝĞƐŽŶDZĐŽŶƚĂŝŶŵĞŶƚŝŶ Identify critical gaps in existing research strategies on AMR containment in DĂĚŚLJĂ Pradesh Madhya WƌĂĚĞƐŚ —ʹacross ĂĐƌŽƐƐ all Ăůů sectors ƐĞĐƚŽƌƐ —ʹ human, ŚƵŵĂŶ͕ animal, ĂŶŝŵĂů͕ food, ĨŽŽĚ͕ environment ĞŶǀŝƌŽŶŵĞŶƚ ϯϱ ;^ƚĂƚĞ Departments (State ĞƉĂƌƚŵĞŶƚƐ of ŽĨ health, ŚĞĂůƚŚ͕ animal ĂŶŝŵĂů husbandry, ŚƵƐďĂŶĚƌLJ͕ fisheries, ĨŝƐŚĞƌŝĞƐ͕ agriculture, ĂŐƌŝĐƵůƚƵƌĞ͕ ĞŶǀŝƌŽŶŵĞŶƚͿ environment) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years ϱ͘ϲ͘

5.6. WƌŽŵŽƚĞƌĞƐĞĂƌĐŚƚŽĚĞǀĞůŽƉŶĞǁĂŶƚŝŵŝĐƌŽďŝĂůƐ͕ĚŝĂŐŶŽƐƚŝĐƐ͕ǀĂĐĐŝŶĞƐĂŶĚ Promote research to develop new antimicrobials, diagnostics, vaccines and ĂůƚĞƌŶĂƚŝǀĞƐ;ĞƉĂƌƚŵĞŶƚŽĨ,ĞĂůƚŚ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJͿ alternatives (Department of Health, Department of Animal Husbandry) dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϱ͘ϳ͘ 5.7. ŽŶĚƵĐƚƌĞƐĞĂƌĐŚŽŶnjŽŽŶŽƚŝĐďĂĐƚĞƌŝĂ Conduct research on zoonotic bacteria dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϱ͘ϴ͘ 5.8. hƚŝůŝnjĞƐŚĂƌĞĚƌĞƐŽƵƌĐĞƐĂŶĚůĂďŽƌĂƚŽƌŝĞƐĨŽƌƌĞƐĞĂƌĐŚ;^ƚĂƚĞĞƉĂƌƚŵĞŶƚƐŽĨ Utilize shared resources and laboratories for research (State Departments of ŚĞĂůƚŚ͕ĂŶŝŵĂůŚƵƐďĂŶĚƌLJ͕ĨŝƐŚĞƌŝĞƐ͕ĂŐƌŝĐƵůƚƵƌĞ͕ĞŶǀŝƌŽŶŵĞŶƚͿ health, animal husbandry, fisheries, agriculture, environment) dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1-3 years ϱ͘ϵ͘ 5.9. ƐƚŝŵĂƚĞ requirements Estimate ƌĞƋƵŝƌĞŵĞŶƚƐ for ĨŽƌ funds ĨƵŶĚƐ and ĂŶĚ human ŚƵŵĂŶ resources ƌĞƐŽƵƌĐĞƐ and ĂŶĚ_ allocate ĂůůŽĐĂƚĞ ƌĞƐŽƵƌĐĞƐ resources dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϱ͘ϭϬ͘ 5.10. &ĂĐŝůŝƚĂƚĞĞǀŝĚĞŶĐĞͲďĂƐĞĚƉŽůŝĐLJĨŽƌŵƵůĂƚŝŽŶ Facilitate evidence-based policy formulation dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years Focus area Focus area 11: 11: Innovations Innovations KďũĞĐƚŝǀĞ͗ WƌŽŵŽƚĞ ŝŶǀĞƐƚŵĞŶƚƐ ĨŽƌ ĚĞǀĞůŽƉŵĞŶƚ ŽĨ ĂůƚĞƌŶĂƚĞ ƐƚƌĂƚĞŐŝĞƐ ĨŽƌ ĐŽŵďĂƚŝŶŐDZ ϱ͘ϭϭ͘ 5.11. 'ĞŶĞƌĂƚĞ investments Generate ŝŶǀĞƐƚŵĞŶƚƐ to ƚŽ fund ĨƵŶĚ research ƌĞƐĞĂƌĐŚ on ŽŶ rapid ƌĂƉŝĚ diagnostic ĚŝĂŐŶŽƐƚŝĐ kits ŬŝƚƐ dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϱ͘ϭϮ͘

5.12. ZĂŝƐĞ Raise ƌĞƐŽƵƌĐĞƐ resources ĂŶĚ and ŝŶǀĞƐƚŵĞŶƚƐ investments ƚŽ to ĨƵŶĚ fund ƌĞƐĞĂƌĐŚ research Θ & ĚĞǀĞůŽƉŵĞŶƚ development ŽŶ on ďŝŽĨŝůŵƐ͕ŚĞƌďĂůĞdžƚƌĂĐƚƐĂŶĚƉŚLJƚŽĐŚĞŵŝĐĂůƉƌŽĚƵĐƚƐ biofilms, herbal extracts and phytochemical products dŝŵĞůŝŶĞ͗ƵƉƚŽϯLJĞĂƌƐ Timeline: upto 3 years ϱ͘ϭϯ͘ 5.13. ĞǀĞůŽƉ an Develop ĂŶ app ĂƉƉ for ĨŽƌ mobile ŵŽďŝůĞ phones ƉŚŽŶĞƐ to ƚŽ ensure ĞŶƐƵƌĞ easy ĞĂƐLJ access ĂĐĐĞƐƐ to ƚŽ treatment ƚƌĞĂƚŵĞŶƚ ŐƵŝĚĞůŝŶĞƐĨŽƌĚŽĐƚŽƌƐ͕ƚŽŽƉƚŝŵŝƐĞĂŶƚŝŵŝĐƌŽďŝĂůƵƐĞ;ŝƌĞĐƚŽƌĂƚĞŽĨ,ĞĂůƚŚ guidelines for doctors, to optimise antimicrobial use (Directorate of Health ^ĞƌǀŝĐĞƐ͕ŚŝĞĨDĞĚŝĐĂůĂŶĚ,ĞĂůƚŚKĨĨŝĐĞƌ͕//D^ŚŽƉĂůͿ Services, Chief Medical and Health Officer, AIIMS Bhopal) dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϯϲ Strategic priority Strategic priority 6:6: Strengthen Strengthen MPs MPs commitment commitment and and collaborations collaborations on on AMR AMR Commitment & collaborations Commitment collaborations Governance Governance State collaborations State collaborations Intersectoral collaborations Intersectoral collaborations Focus area Focus area 12: 12: Governance Governance mechanisms mechanisms KďũĞĐƚŝǀĞ͗dŽƐƚƌĞŶŐƚŚĞŶŐŽǀĞƌŶĂŶĐĞŵĞĐŚĂŶŝƐŵƐŽŶDZĐŽŶƚĂŝŶŵĞŶƚ ϲ͘ϭ 6.1 ƐƚĂďůŝƐŚ state Establish ƐƚĂƚĞ level ůĞǀĞů governance ŐŽǀĞƌŶĂŶĐĞ mechanisms ŵĞĐŚĂŶŝƐŵƐ on ŽŶ AMR DZ_ containment, ĐŽŶƚĂŝŶŵĞŶƚ͕ ĐŽŵƉƌŝƐŝŶŐ of comprising ŽĨ Advisory ĚǀŝƐŽƌLJ Committee; ŽŵŵŝƚƚĞĞ͖ Technical dĞĐŚŶŝĐĂů Committee ŽŵŵŝƚƚĞĞ and ĂŶĚ Core ŽƌĞ AMR DZ dĞĂŵ Team dŝŵĞůŝŶĞ͗ƵƉƚŽϲŵŽŶƚŚƐ Timeline: upto 6 months ϲ͘Ϯ 6.2 ƐƚĂďůŝƐŚƐƚĂƚĞĐŽŵŵŝƚƚĞĞĨŽƌŶƚŝŵŝĐƌŽďŝĂů^ƚĞǁĂƌĚƐŚŝƉ;D^Ϳ Establish state committee for Antimicrobial Stewardship (AMS) dŝŵĞůŝŶĞ͗ƵƉƚŽϲŵŽŶƚŚƐ Timeline: upto 6 months Focus area Focus area 13: 13: State State collaborations collaborations KďũĞĐƚŝǀĞ͗dŽƐƚƌĞŶŐƚŚĞŶƐƚĂƚĞĐŽůůĂďŽƌĂƚŝŽŶƐŽŶDZĐŽŶƚĂŝŶŵĞŶƚǁŝƚŚĨŽĐƵƐŽŶ ĐŽŶǀĞƌŐĞŶĐĞŽĨĂĐƚŝǀŝƚŝĞƐĂŶĚĞƐƚĂďůŝƐŚDZĂƐĂƐƚĂƚĞůĞǀĞůƉƌŝŽƌŝƚLJ ϲ͘ϯ 6.3 ^ŚĂƌĞŬŶŽǁůĞĚŐĞĂŶĚƌĞƐŽƵƌĐĞƐĂŵŽŶŐƐƚĚŝĨĨĞƌĞŶƚůĞǀĞůƐ;ĚŝƐƚƌŝĐƚƐ͕ĚŝǀŝƐŝŽŶƐ Share knowledge and resources amongst different levels (districts, divisions ĂŶĚĐĞŶƚƌĂůůĞǀĞůͿ͕ĨŽƌŵĂŶĂŐĞŵĞŶƚĨŽƌDZĐŽŶƚĂŝŶŵĞŶƚ and central level), for management for AMR containment dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϲ͘ϰ 6.4 ŶƐƵƌĞ fund Ensure ĨƵŶĚ allocation ĂůůŽĐĂƚŝŽŶ for ĨŽƌ various ǀĂƌŝŽƵƐ AMR DZ activities, ĂĐƚŝǀŝƚŝĞƐ͕ without ǁŝƚŚŽƵƚ duplication ĚƵƉůŝĐĂƚŝŽŶ dŝŵĞůŝŶĞ͗ƵƉƚŽϲŵŽŶƚŚƐ Timeline: upto 6 months ϲ͘ϱ 6.5 ^ŚĂƌĞďĞƐƚƉƌĂĐƚŝĐĞƐĂĐƌŽƐƐĚŝĨĨĞƌĞŶƚůĞǀĞůƐ Share best practices across different levels dŝŵĞůŝŶĞ͗ϭʹϮLJĞĂƌƐ Timeline: 1 — 2 years ϯϳ ϲ͘ϲ 6.6 ŽůůĂďŽƌĂƚĞǁŝƚŚŽƚŚĞƌƐƚĂƚĞƐƚŽĐŽŵďĂƚDZ Collaborate with other states to combat AMR dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϲ͘ϳ 6.7 ^ƚƌĞŶŐƚŚĞŶDZĂĐƚŝǀŝƚŝĞƐŝŶ,/sͬ^d/͕d͕ŵĂůĂƌŝĂ͕ůĞƉƌŽƐLJΘEdƐ Strengthen AMR activities in HIV/STI, TB, malaria, leprosy & NTDs dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϲ͘ϴ 6.8 ^ƚƌĞŶŐƚŚĞŶĞŶŐĂŐĞŵĞŶƚŽĨ/^WŝŶDZĂĐƚŝǀŝƚŝĞƐ Strengthen engagement of IDSP in AMR activities dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year  Focus area Focus area 14: 14: Intersectoral Intersectoral mechanisms mechanisms and and private private sector sector engagement engagement KďũĞĐƚŝǀĞ͗dŽƐƚƌĞŶŐƚŚĞŶŝŶƚĞƌƐĞĐƚŽƌĂůŵĞĐŚĂŶŝƐŵƐĂŶĚƉƌŝǀĂƚĞƐĞĐƚŽƌĞŶŐĂŐĞŵĞŶƚ ĨŽƌDZĐŽŶƚĂŝŶŵĞŶƚŝŶDĂĚŚLJĂWƌĂĚĞƐŚ ϲ͘ϵ 6.9 ƐƚĂďůŝƐŚůŝŶŬĂŐĞƐĂŶĚŝŶĨŽƌŵĂƚŝŽŶƐŚĂƌŝŶŐ;ŝŶĐůƵĚŝŶŐďĞƐƚƉƌĂĐƚŝĐĞƐͿĂŵŽŶŐƐƚ Establish linkages and information sharing (including best practices) amongst ĚŝƐĞĂƐĞ control disease ĐŽŶƚƌŽů programmes ƉƌŽŐƌĂŵŵĞƐ inŝŶ Madhya DĂĚŚLJĂ Pradesh WƌĂĚĞƐŚ (RNTCP, ;ZEdW͕ NACP, EW͕ NVBDCP EsW ĞƚĐ͘ͿĂŶĚ^ƚĂƚĞDZƉƌŽŐƌĂŵŵĞ etc.) and State AMR programme dŝŵĞůŝŶĞ͗ƵƉƚŽϭLJĞĂƌ Timeline: upto 1 year ϲ͘ϭϬ 6.10 ŶŐĂŐĞƚŚĞƉƌŝǀĂƚĞƐĞĐƚŽƌŝŶŚĞĂůƚŚĐĂƌĞ͕ĂŶŝŵĂůŚƵƐďĂŶĚƌLJ͕ĚŝĂŐŶŽƐƚŝĐƐĂŶĚ Engage the private sector in healthcare, animal husbandry, diagnostics and ƉŚĂƌŵĂĐĞƵƚŝĐĂůƐ for pharmaceuticals ĨŽƌ AMR DZ containment ĐŽŶƚĂŝŶŵĞŶƚ through ƚŚƌŽƵŐŚ surveillance ƐƵƌǀĞŝůůĂŶĐĞ of ŽĨ AMR, DZ͕ IPC /W ĂĐƚŝǀŝƚŝĞƐ͕ surveillance activities, ƐƵƌǀĞŝůůĂŶĐĞ of ŽĨ antimicrobial ĂŶƚŝŵŝĐƌŽďŝĂů consumption, ĐŽŶƐƵŵƉƚŝŽŶ͕ surveillance ƐƵƌǀĞŝůůĂŶĐĞ of ŽĨ ŚĞĂůƚŚĐĂƌĞĂƐƐŽĐŝĂƚĞĚŝŶĨĞĐƚŝŽŶƐĂŶĚĂŶƚŝŵŝĐƌŽďŝĂůƐƚĞǁĂƌĚƐŚŝƉ;ĞƉĂƌƚŵĞŶƚ healthcare associated infections and antimicrobial stewardship (Department ŽĨ,ĞĂůƚŚ͕ of ĞƉĂƌƚŵĞŶƚ of Health, Department ŽĨ Animal ŶŝŵĂů Husbandry, ,ƵƐďĂŶĚƌLJ͕ State ^ƚĂƚĞ Drug ƌƵŐŽŶƚƌŽůůĞƌ͕ /ŶĚŝĂŶ Controller, Indian Association)  DĞĚŝĐĂůƐƐŽĐŝĂƚŝŽŶͿ Medical dŝŵĞůŝŶĞ͗ϭʹϯLJĞĂƌƐ Timeline: 1 — 3 years   ϯϴ 0RQLWRULQJDQG(YDOXDWLRQ)UDPHZRUN Monitoring and Monitoring and Evaluation Framework Evaluation Framework MP-SAPCAR sya MP-SAPCAROr Input (basic Input Input (basic (basic Process Process Process Outputs (results at Outputs (results Outputs (results at at at (results at Outcomes (results Outcomes Outcomes (results at Priority Priority Priority resources) resources) resources) (activities) ELTA) (activities) programme programme level) level) programme level) population population level) level) population level) 1. 1.1. Awareness and Awareness and MP State MP State AMR awareness AMR awareness Number ofof print Number print articles articles AMR awareness AMR awareness levels levels inin Awareness and MP State AMR awareness Number of print articles AMR awareness levels in Understanding Understanding Antibiotic Policy Antibiotic Antibiotic Policy Policy campaign among campaign among covering AMR covering AMR AMR target populations, target populations, e.g. e.g. %% ofof % of Understanding campaign among covering target populations, e.g. students, students, public, public, population who population who know who know that that ititit know that students, public, population NHM and NHM and media, govtgovt and and Total number number ofof is inappropriate inappropriate toto use use NHM and media, media, govt and Total Total number of isis inappropriate to use AIIMS Bhopal AIIMS Bhopal private health private health care care minutes ofof audio-visual minutes audio-visual antibiotics for antibiotics for viral viral infections infections AIIMS Bhopal private health care minutes of audio-visual antibiotics for viral infections collaboration collaboration for providers for at at various clips aired collaboration for providers providers at various various clips aired clips aired containment ofof level (district level (district &sub- Knowledge, attitudes Knowledge, attitudes and and containment containment of level (district &&sub- sub- Knowledge, attitudes and AMR AMR district level), district level), practices ofof health practices health workers workers AMR district level), practices of health workers pharmacists, vets pharmacists, vets and vets and vets on on AMR AMR and and its its pharmacists, vets and vets on AMR and its IIMAR activities IIMAR activities activities and others and others implications implications for for antimicrobial antimicrobial IIMAR and others implications for antimicrobial coordinated by coordinated by use and use and misuse misuse (via(via online online coordinated by use and misuse (via online RDGMC, Ujjain RDGMC, Ujjain survey) survey) RDGMC, Ujjain survey) 2.2. 2. Knowledge and and Resource Number ofof Number Surveillance systems systems Reducing trends Reducing trends of MDR MDR E.E. Knowledge Knowledge and Resource Resource Number of Surveillance Surveillance systems Reducing trends ofof MDR E. Evidence Evidence Centre ofof Centre microbiology microbiology established for established for AMR AMR inin coli, coli,, Klebsiella spp., Evidence Centre of microbiology established for AMR in coli Klebsiella spp., Klebsiella spp., Tropical and Tropical and laboratories laboratories human, animals, human, animals, food food Pseudomonas aeruginosa, Pseudomonas aeruginosa, Tropical and laboratories human, animals, food Pseudomonas aeruginosa, Infectious Infectious participating inin participating Salmonella, Acinetobacter Salmonella, Acinetobacter Infectious participating in Salmonella , Acinetobacter Diseases Diseases quality assurance quality assurance spp., MRSA spp., MRSA and and Diseases quality assurance spp., MRSA and (RCTID) (RCTID) programme programme Enterococcus Enterococcus spp. spp. (RCTID) programme Enterococcus spp. established atat established established at AIIMS Bhopal AIIMS Bhopal SOPs established SOPs established AIIMS Bhopal SOPs established for AMR for AMR for AMR surveillance inin surveillance surveillance in animals, animals, animals, aquaculture and aquaculture and aquaculture and environment environment environment 3.3. 3. Infection Active QA team % hospitals with Hib/rotavirus/typhoid, Average hand hygiene Infection Infection Active QA Active QA team % hospitals % hospitals with with Hib/rotavirus/typhoid, Hib/rotavirus/typhoid, Average hand Average hand hygiene hygiene Prevention && Prevention at NHM at NHM NHM functioning functioning PCV vaccine PCV PCV vaccine coverage coverage compliance rates compliance rates in hospitals hospitals rates inin hospitals Prevention & at functioning vaccine coverage compliance Control Control IPC/HICC IPC/HICC across MP across MP and PHCs and PHCs Control IPC/HICC across MP and PHCs Tropical and Tropical and committee committee Tropical and committee infectious infectious infectious Proportion ofof acute Proportion Proportion acute of acute %%% HAI HAI ratesin HAI ratesin health facilities rates in health health facilities disease Help disease Help %% hospitals hospitals with hospitals with health care health care facilities facilities under Kayakalp under Kayakalp disease Help % with health care facilities facilities under Kayakalp Centre (THC) Centre adequate IPC (THC) atat adequate IPC with IPC with IPC programme programme inin Centre (THC) at adequate IPC with IPC programme in AIIMS Bhopal nurses nurses place (including Number of of hospitals with AIIMS Bhopal AIIMS Bhopal nurses place (including place (including Number Number of hospitals with hospitals with monitoring ofof hand monitoring hand effective BMW effective BMW management management monitoring of hand effective BMW management AMR issues AMR issues hygiene) hygiene) AMR issues hygiene) incorporated inin incorporated Number ofof pharmaceutical Number pharmaceutical incorporated in Number of pharmaceutical biosecurity biosecurity Number ofof health Number health companies manufacturing companies manufacturing biosecurity Number of health companies manufacturing guidance for guidance for farms farms facilities with facilities with WASH WASH antibiotics with antibiotics with effluent effluent guidance for farms facilities with WASH antibiotics with effluent and and facilities facilities treatment plants treatment plants and facilities treatment plants slaughterhouses slaughterhouses slaughterhouses Number ofof commercial Number commercial Number ofof licenses Number licenses Number of commercial Number of licenses farms compliant farms compliant with with applied/received -MP applied/received –MP farms compliant with applied/received – MP IPC guidelines and PollutionControl Board Board IPC guidelines IPC guidelines and and PollutionControl Pollution Control Board good practices good practices good practices ϯϵ MP-SAPCAR sya MP-SAPCAROr Input (basic Input Input (basic (basic Process Process Process Outputs (results at Outputs (results Outputs (results at at at (results at Outcomes (results Outcomes Outcomes (results at Priority Priority Priority resources) resources) resources) (activities) ELTA) (activities) programme level) programme programme level) level) population level) population population level) level) 4. 4. 4. Optimizing Use Optimizing Optimizing Number of Number Number of of Treatment Treatment Treatment Numbers of Numbers Numbers hospitals ofof hospitals hospitals Monitoring of Monitoring Monitoring amount of total amount ofof total total amount ofof Useof Useof of Antibiotics notices issued notices notices issued issued guidelines reviewed guidelines reviewed guidelines reviewed updated AB with updated with with updated AB AB antibiotics consumed antibiotics antibiotics consumed (state consumed (state (state Antibiotics Antibiotics by Food by by Food and Food and and and updated and and updated as updated per as per as per based on guidelines based guidelines guidelines based on on level) level) level) Drugs Drugs Drugs MP Antibiotic MP MP Antibiotic Policy Antibiotic Policy Policy local AMR local local AMR pattern AMR pattern pattern Administration Administration Administration for human for for human health human health health % of % % ofof antibiotics antibiotics tested antibiotics tested by tested by by for OTC for for OTC sale OTC sale of of sale of Percentage Percentage Percentage of of medical of medical medical State State Drug State Drug Controller with Controller Drug Controller with with antibiotics antibiotics antibiotics colleges/hospitals with colleges/hospitals colleges/hospitals with with acceptable quality. acceptable acceptable quality. quality. Antimicrobial Antimicrobial Antimicrobial Online system Online Online system system stewardship stewardship stewardship Banning incorporation Banning Banning incorporation of incorporation ofof for distribution for for distributionof distributionof programme programme programme antibiotics ininin animal antibiotics antibiotics animal food animal food food drugs drugs of drugstoto to Govt. Govt. hospitals hospitals Govt. hospitals Implementation of Implementation Implementation ofof Involvement of Involvement Involvement of veterinarians of ban/restrictions on ban/restrictions ban/restrictions on on inveterinariansin veterinariansin implementation of MP- AMSP network AMSP AMSP network network antibiotic premixed antibiotic antibiotic premixed food premixed implementation ofof MP- food SAPCAR food implementation MP- established established established ininin animal animal husbandry animal husbandry husbandry SAPCAR SAPCAR and aquaculture and and aquaculture aquaculture 5.5. 5. Research Research and Research and and AMR research AMR AMR research research MP State MP MP State AMR State AMR AMR be to be sources to Financial sources Financial Financial sources to be % of fund used for service for service used for fund used of fund %% of service Innovations Innovations Innovations network network network research agenda research research agenda agenda identified identified identified delivery, teaching, delivery, delivery, teaching, training teaching, training training established established established established established established and research and and research research %% major % major hospitals major hospitals and hospitals and and labs reporting labs labs reporting to to reporting to government government government 6. 6. 6. Collaborations Collaborations Collaborations Annual Annual Annual AMR Steering AMR AMR Steering Steering Intersectoral Intersectoral Intersectoral Number of Number Number ofof meetings meetings held meetings held of held ofof stakeholder stakeholder stakeholder Committee and Committee Committee and and coordination meetings coordination coordination meetings meetings AMR governance AMR AMR governance governance meeting during meeting meeting during during AMR Technical AMR AMR Technical Technical organized to organized organized to share to share share mechanisms mechanisms mechanisms WAAW WAAW WAAW Committee Committee Committee results from results results from each from each each established established established sector sector sector % of %% ofof points points implemented points implemented by implemented by by next meeting next next meeting meeting Data/information from Data/information Data/information from MP- from MP- MP- SAPCAR reported SAPCAR SAPCAR reported to reported to State to State State and Central and and Central Government Central Government 666 Government monthly monthly monthly   ϰϬ $FNQRZOHGJHPHQWV Acknowledgements ŽŶƚƌŝďƵƚŝŽŶƐŽĨƚŚĞĨŽůůŽǁŝŶŐƐƚĂŬĞŚŽůĚĞƌƐĂƌĞŐƌĂƚĞĨƵůůLJĂĐŬŶŽǁůĞĚŐĞĚ͗ Contributions of the following stakeholders are gratefully acknowledged: ex Dr Pallavi Jain Govil, IAS — Principal Secretary, ƌWĂůůĂǀŝ:ĂŝŶ'Žǀŝů͕/^ʹWƌŝŶĐŝƉĂů^ĞĐƌĞƚĂƌLJ͕,ĞĂůƚŚΘ&ĂŵŝůLJtĞůĨĂƌĞ͕'Žǀƚ͘ŽĨDW Health & Family Welfare, Govt. of MP ex Nitesh Vyas, IAS - Commissioner EŝƚĞƐŚsLJĂƐ͕/^ʹŽŵŵŝƐƐŝŽŶĞƌ,ĞĂůƚŚΘ&ĂŵŝůLJtĞůĨĂƌĞ͕'Žǀƚ͘ŽĨDW Health & Family Welfare, Govt. of MP x e EŝƐŚĂŶƚtĂƌǁĂĚĞ͕/^ʹŽŵŵŝƐƐŝŽŶĞƌ͕DĞĚŝĐĂůĚƵĐĂƚŝŽŶ'Žǀƚ͘ŽĨDW Nishant Warwade, IAS — Commissioner, Medical Education Govt. of MP ex = Chhavi Bhardwaj, IAS— Mission Director, ŚŚĂǀŝŚĂƌĚǁĂũ͕/^ʹDŝƐƐŝŽŶŝƌĞĐƚŽƌ͕EĂƚŝŽŶĂů,ĞĂůƚŚDŝƐƐŝŽŶ͕'Žǀƚ͘ŽĨDW National Health Mission, Govt. of MP ex Prof Dr Sarman Singh — WƌŽĨƌ^ĂƌŵĂŶ^ŝŶŐŚʹŝƌĞĐƚŽƌΘK͕//D^ŚŽƉĂů Director & CEO, AIIMS Bhopal ex Smt Usha Parmar, IAS — Additional ^ŵƚhƐŚĂWĂƌŵĂƌ͕/^ʹĚĚŝƚŝŽŶĂůDŝƐƐŝŽŶŝƌĞĐƚŽƌ͕E,D'ŽǀƚŽĨDW Mission Director, NHM Govt of MP ex Dr Sujeet Singh, Director, National ƌ^ƵũĞĞƚ^ŝŶŐŚ͕ŝƌĞĐƚŽƌ͕EĂƚŝŽŶĂůĞŶƚƌĞĨŽƌŝƐĞĂƐĞŽŶƚƌŽů͕EĞǁĞůŚŝ Centre for Disease Control, New Delhi x e ƌsW^ŝŶŐŚʹŝƌĞĐƚŽƌ͕/ZͲE/,^͕ŚŽƉĂů Dr VP Singh — Director, ICAR-NIHSAD, Bhopal ex Mr OP Saxena — DƌKW^ĂdžĞŶĂʹŝƌĞĐƚŽƌ&ŝƐŚĞƌŝĞƐ Director Fisheries ex Dr Prabha Desikan — ƌWƌĂďŚĂĞƐŝŬĂŶʹŝƌĞĐƚŽƌ͕D,^Z͕ŚŽƉĂů Director, BMHSRC, Bhopal ex Dr PK Behera — Regional ƌW<ĞŚĞƌĂʹZĞŐŝŽŶĂůŝƌĞĐƚŽƌ͕WͲŚŽƉĂů Director, CPCB-Bhopal ex Mr Rakesh Munshi — Joint Director, DƌZĂŬĞƐŚDƵŶƐŚŝʹ:ŽŝŶƚŝƌĞĐƚŽƌ͕,^͕'Žǀƚ͘ŽĨDĂĚŚLJĂWƌĂĚĞƐŚ DHS, Govt. of Madhya Pradesh x Dƌŵŝƚ<ŚƵƌĂŶĂʹĞŶƚƌĞĨŽƌ^ĐŝĞŶĐĞĂŶĚŶǀŝƌŽŶŵĞŶƚ͕ĞůŚŝ e Mr Amit Khurana — Centre for Science and Environment, Delhi x e ƌZĂũĞƐǁĂƌŝ^ŝŶŚĂʹĞŶƚƌĞŽĨ^ĐŝĞŶĐĞĂŶĚŶǀŝƌŽŶŵĞŶƚ͕ĞůŚŝ Dr Rajeswari Sinha — Centre of Science and Environment, Delhi ex Mr KL Manjhi—CGM, Dƌ<>DĂŶũŚŝʹ'D͕&ŝƐŚ&ĞĚĞƌĂƚŝŽŶŚŽƉĂů Fish Federation Bhopal ex DrT Karuna -—Site Pl, ICMR ƌd<ĂƌƵŶĂʹ^ŝƚĞW/͕/DZDZEĞƚǁŽƌŬ͕//D^ŚŽƉĂů AMR Network, AIIMS Bhopal ex Dr Debashish Biswas — Professor, ƌĞďĂƐŚŝƐŚŝƐǁĂƐʹWƌŽĨĞƐƐŽƌ͕DŝĐƌŽďŝŽůŽŐLJ͕//D^ŚŽƉĂů Microbiology, AIMS Bhopal ex Dr Shashank ƌ^ŚĂƐŚĂŶŬWƵƌǁĂƌʹĚĚŝƚŝŽŶĂůWƌŽĨĞƐƐŽƌ͕DŝĐƌŽďŝŽůŽŐLJ͕//D^ŚŽƉĂů Purwar — Additional Professor, Microbiology, AIIMS Bhopal x e ƌĞĞƉƚŝŚĂƵƌĂƐŝĂʹWƌŽĨĞƐƐŽƌ͕DŝĐƌŽďŝŽůŽŐLJ͕'D Dr Deepti Chaurasia — Professor, Microbiology, GMC ex Dr RK Mehiya — Joint ƌZ<DĞŚŝLJĂʹ:ŽŝŶƚŝƌĞĐƚŽƌŶŝŵĂů,ƵƐďĂŶĚƌLJ Director Animal Husbandry ex Dr DK Pal — Prof. & Head, ƌ<WĂůʹWƌŽĨ͘Θ,ĞĂĚ͕ŽŵŵƵŶŝƚLJDĞĚŝĐŝŶĞ Community Medicine ex Dr Himanshu Jaiswar— Deputy ƌ,ŝŵĂŶƐŚƵ:ĂŝƐǁĂƌʹĞƉƵƚLJŝƌĞĐƚŽƌsW͕,^͕ŚŽƉĂů Director VBDCP, DHS, Bhopal ex Dr SK Sakalle — Deputy ƌ^<^ĂŬĂůůĞʹĞƉƵƚLJŝƌĞĐƚŽƌ^,͕E,DŚŽƉĂů Director ASHA, NHM Bhopal x e ƌWƌĂŵŽĚ'ŽĞůʹĞƉƵƚLJŝƌĞĐƚŽƌ͕/^W,^͕ŚŽƉĂů Dr Pramod Goel — Deputy Director, IDSP DHS, Bhopal ex Dr TWakhande — Addl. Deputy ƌdtĂŬŚĂŶĚĞʹĚĚů͘ĞƉƵƚLJŝƌĞĐƚŽƌ^/>͕ŚŽƉĂů Director SADIL, Bhopal ex Dr Ajay Ramtake — Deputy Director ƌũĂLJZĂŵƚĂŬĞʹĞƉƵƚLJŝƌĞĐƚŽƌŶŝŵĂů,ƵƐďĂŶĚƌLJ͕ŚŽƉĂů Animal Husbandry, Bhopal ex DrJTapase — ƌ:dĂƉĂƐĞʹĞƉƵƚLJŝƌĞĐƚŽƌ Deputy Director ex Dr Anoop ƌŶŽŽƉŚĂƚƵƌǀĞĚŝʹWͲŚŽƉĂů Chaturvedi — CPCB-Bhopal ex Mr Bharat Singh — Deputy DƌŚĂƌĂƚ^ŝŶŐŚʹĞƉƵƚLJŝƌĞĐƚŽƌ͕&ŝƐŚĞƌŝĞƐͲŚŽƉĂů Director, Fisheries-Bhopal x e ƌĂůũĞĞƚ<ĂƵƌŚŚĂďƌĂʹWƌŽĨ͘Θ/ŶĐŚĂƌŐĞDŝĐƌŽďŝŽůŽŐLJ͕sĞƚ͘ŽůůĞŐĞ͕DŚŽǁ Dr Daljeet Kaur Chhabra — Prof. & In charge Microbiology, Vet. College, Mhow ex Dr Vipin Kumar Gupta — Assistant ƌsŝƉŝŶ<ƵŵĂƌ'ƵƉƚĂʹƐƐŝƐƚĂŶƚWƌŽĨ͘ĞƉƚ͘ŽĨsĞƚ͘WƵďůŝĐ,ĞĂůƚŚ Prof. Dept. of Vet. Public Health ex Mr Shobhit Jain — Deputy Dƌ^ŚŽďŚŝƚ:ĂŝŶʹĞƉƵƚLJŝƌĞĐƚŽƌ͕&DW Director, FDA MP ex Dr Narendra Singh — Secretary.MP ƌEĂƌĞŶĚƌĂ^ŝŶŐŚʹ^ĞĐƌĞƚĂƌLJ͘DWEƵƌƐŝŶŐ,ŽŵĞƐƐŽĐŝĂƚŝŽŶŚŽƉĂů Nursing Home Association Bhopal ex Dr Anoop Hajela — Adviser, MP ƌŶŽŽƉ,ĂũĞůĂʹĚǀŝƐĞƌ͕DWEƵƌƐŝŶŐ,ŽŵĞƐƐŽĐŝĂƚŝŽŶŚŽƉĂů Nursing Home Association Bhopal x e Dƌ>Ăůŝƚ:ĂŝŶʹWƌĞƐŝĚĞŶƚ͕DĞĚŝĐĂůWŚĂƌŵĂĐLJĂƐƐŽĐŝĂƚŝŽŶŚŽƉĂů Mr Lalit Jain — President, Medical Pharmacy association Bhopal ex Dr Vivek Mishra — Consultant QA, ƌsŝǀĞŬDŝƐŚƌĂʹŽŶƐƵůƚĂŶƚY͕WƵďůŝĐ,ĞĂůƚŚ͕E,DͲŚŽƉĂů Public Health, NHM-Bhopal ex Juhi Jaiswar— State Consultant :ƵŚŝ:ĂŝƐǁĂƌʹ^ƚĂƚĞŽŶƐƵůƚĂŶƚYƵĂůŝƚLJƐƐƵƌĂŶĐĞ͕E,DŚŽƉĂů Quality Assurance, NHM Bhopal ex Rahul Jain — ZĂŚƵů:ĂŝŶʹŽŶƐƵůƚĂŶƚ/d͕ŚŽƉĂů Consultant IT, Bhopal ϰϭ DĞŵďĞƌƐŽĨƚŚĞǁƌŝƚŝŶŐƚĞĂŵƚŚĂƚĐŽŵƉŝůĞĚĂŶĚĐŽůůĂƚĞĚDWͲ^WZ͗ Members of the writing team that compiled and collated MP-SAPCAR: x e ƌŶƵũ^ŚĂƌŵĂʹdĞĐŚŶŝĐĂůKĨĨŝĐĞƌʹDZ͖>ĂďƐ͕t,K/ŶĚŝĂ Dr Anuj Sharma — Technical Officer — AMR; Labs, WHO India ex Dr Pankaj Shukla — Joint Director, ƌWĂŶŬĂũ^ŚƵŬůĂʹ:ŽŝŶƚŝƌĞĐƚŽƌ͕YƵĂůŝƚLJƐƐƵƌĂŶĐĞE,D͕'Žǀƚ͘ŽĨDW Quality Assurance NHM, Govt. of MP ex Dr Sagar Khadanga — Site PI, ƌ^ĂŐĂƌ<ŚĂĚĂŶŐĂʹ^ŝƚĞW/͕/DZͲD^WEĞƚǁŽƌŬ͕//D^ŚŽƉĂů ICMR-AMSP Network, AIIMS Bhopal  WĂƌƚŝĐŝƉĂŶƚƐĂƚDW^ƚĂƚĞtŽƌŬƐŚŽƉŽŶŶƚŝŵŝĐƌŽďŝĂůZĞƐŝƐƚĂŶĐĞ;EŽǀĞŵďĞƌϮϬϭϳͿ͗ Participants at MP State Workshop on Antimicrobial Resistance (November 2017): ex Dr Manohar Agnani, Joint Secretary, IAS, ƌDĂŶŽŚĂƌŐŶĂŶŝ͕:ŽŝŶƚ^ĞĐƌĞƚĂƌLJ͕/^͕DŝŶŝƐƚƌLJŽĨ,ĞĂůƚŚΘ&ĂŵŝůLJtĞůĨĂƌĞ Ministry of Health & Family Welfare ex Mrs Gauri Singh, Principal Secretary, DƌƐ'ĂƵƌŝ^ŝŶŐŚ͕WƌŝŶĐŝƉĂů^ĞĐƌĞƚĂƌLJ͕/^͕WƵďůŝĐ,ĞĂůƚŚDĂĚŚLJĂWƌĂĚĞƐŚ IAS, Public Health Madhya Pradesh ex Dr Pallavi Jain Govil, Commissioner, ƌWĂůůĂǀŝ:ĂŝŶ'Žǀŝů͕ŽŵŵŝƐƐŝŽŶĞƌ͕/^͕WƵďůŝĐ,ĞĂůƚŚDĂĚŚLJĂWƌĂĚĞƐŚ IAS, Public Health Madhya Pradesh ex Shri S. Viswanathan, Mission ^Śƌŝ^͘sŝƐǁĂŶĂƚŚĂŶ͕DŝƐƐŝŽŶŝƌĞĐƚŽƌ͕/^͕E,DDĂĚŚLJĂWƌĂĚĞƐŚ Director, IAS, NHM Madhya Pradesh x ƌ<>^ĂŚƵ͕ŝƌĞĐƚŽƌWƵďůŝĐ,ĞĂůƚŚDĂĚŚLJĂWƌĂĚĞƐŚ e Dr KL Sahu, Director Public Health Madhya Pradesh ex Dr BN Chouhan, Director ƌEŚŽƵŚĂŶ͕ŝƌĞĐƚŽƌE,DDĂĚŚLJĂWƌĂĚĞƐŚ NHM Madhya Pradesh ex Dr kK Thassu, Director, Hospital ƌ<<dŚĂƐƐƵ͕ŝƌĞĐƚŽƌ͕,ŽƐƉŝƚĂůĚŵŝŶŝƐƚƌĂƚŝŽŶŝƌĞĐƚŽƌĂƚĞ͕DĂĚŚLJĂWƌĂĚĞƐŚ Administration Directorate, Madhya Pradesh ex Shri Rakesh Munshi, ^ŚƌŝZĂŬĞƐŚDƵŶƐŚŝ͕:ŽŝŶƚŝƌĞĐƚŽƌ/^W Joint Director IDSP ex Dr Sheela Meena; ƌ^ŚĞĞůĂDĞĞŶĂ͖ĞƉƵƚLJŝƌĞĐƚŽƌ/^W Deputy Director IDSP x ƌ^ƵŶŝů'ƵƉƚĂ͕ĚĚů͘ŝƌĞĐƚŽƌ͕ĞƉƚ͘ŽĨDŝĐƌŽďŝŽůŽŐLJ͕EĞůŚŝ e Dr Sunil Gupta, Addl. Director, Dept. of Microbiology, NCDC Delhi ex Dr Sandhya Kabra, Addl. Director, ƌ^ĂŶĚŚLJĂ<ĂďƌĂ͕ĚĚů͘ŝƌĞĐƚŽƌ͕ĞƉƚ͘ŽĨDŝĐƌŽďŝŽůŽŐLJ͕EĞůŚŝ Dept. of Microbiology, NCDC Delhi ex Dr Arti Bahl, Joint Director, Dept. ƌƌƚŝĂŚů͕:ŽŝŶƚŝƌĞĐƚŽƌ͕ĞƉƚ͘ŽĨƉŝĚĞŵŝŽůŽŐLJ͕EĞůŚŝ of Epidemiology, NCDC Delhi ex Dr Anuj Sharma, Technical Officer ƌŶƵũ^ŚĂƌŵĂ͕dĞĐŚŶŝĐĂůKĨĨŝĐĞƌʹDZΘ,ĞĂůƚŚ>ĂďŽƌĂƚŽƌŝĞƐ͕t,K/ŶĚŝĂ —- AMR & Health Laboratories, WHO India ex Dr Suraj Kumar, ƌ^ƵƌĂũ<ƵŵĂƌ͕EĞĞƚŝ&ŽƵŶĚĂƚŝŽŶ Neeti Foundation x e ƌ'ĞĞƚĂŶũĂůŝ<ĂƉŽŽƌ͕^ŚŽƌƚdĞƌŵŽŶƐƵůƚĂŶƚ͕t,K/ŶĚŝĂ Dr Geetanjali Kapoor, Short Term Consultant, WHO India x e ƌ^ŚĂŝůĞƐŚ<ƵŵĂƌ^ŚĂŬůůĞ͕sĞƚĞƌŝŶĂƌŝĂŶ Dr Shailesh Kumar Shaklle, Veterinarian ex Dr VD Yadav, Joint ƌszĂĚĂǀ͕:ŽŝŶƚŝƌĞĐƚŽƌ/^͕DW Director AIDS, MP ex Dr Himasu Jaiswar, Deputy ƌ,ŝŵĂƐƵ:ĂŝƐǁĂƌ͕ĞƉƵƚLJŝƌĞĐƚŽƌsW͕DW Director VBDCP, MP ex Dr Kumar, Deputy ƌ<ƵŵĂƌ͕ĞƉƵƚLJŝƌĞĐƚŽƌ>ĞƉƌŽƐLJ Director Leprosy   ex Dr Shivshankar Bhushan, ƌ^ŚŝǀƐŚĂŶŬĂƌŚƵƐŚĂŶ͕LJŝƌĞĐƚŽƌ͕d Dy Director, TB  x e ^Śƌŝ^Śŝǀ^ŚĞŬŚĂƌ^ŚƵŬůĂ͕/^͕ŽŵŵŝƐƐŝŽŶĞƌ͕DĞĚŝĐĂůĚƵĐĂƚŝŽŶ Shri Shiv Shekhar Shukla, IAS, Commissioner, Medical Education ex Dr Ulka Shrivastava, Director Medical ƌhůŬĂ^ŚƌŝǀĂƐƚĂǀĂ͕ŝƌĞĐƚŽƌDĞĚŝĐĂůĚƵĐĂƚŝŽŶDĂĚŚLJĂWƌĂĚĞƐŚ Education Madhya Pradesh ex Dr Dipti Chaurasia, Prof. of ƌŝƉƚŝŚĂƵƌĂƐŝĂ͕WƌŽĨ͘ŽĨDŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞŚŽƉĂů Microbiology, Medical College Bhopal   ex Dr Jaya Lalwani, Reader, ƌ:ĂLJĂ>ĂůǁĂŶŝ͕ZĞĂĚĞƌ͕DĞĚŝĐĂůŽůůĞŐĞŚŽƉĂů Medical College Bhopal   ex Dr Garima, Lecturer, ƌ'ĂƌŝŵĂ͕>ĞĐƚƵƌĞƌ͕DĞĚŝĐĂůŽůůĞŐĞŚŽƉĂů Medical College Bhopal   x ƌZĞĞŶŝDĂůŝŬ͕WƌŽĨ͘WĂƚŚŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞŚŽƉĂů e Dr Reeni Malik, Prof. Pathology, Medical College Bhopal   ex Dr RK Nigam, Prof. Pathology, ƌZ<EŝŐĂŵ͕WƌŽĨ͘WĂƚŚŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞŚŽƉĂů Medical College Bhopal   ex Dr Thora, Dean, MGM ƌdŚŽƌĂ͕ĞĂŶ͕D'DDĞĚŝĐĂůŽůůĞŐĞ͕/ŶĚŽƌĞ Medical College, Indore   ex Dr Anita Mutha, Prof. of Microbiology, ƌŶŝƚĂDƵƚŚĂ͕WƌŽĨ͘ŽĨDŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ/ŶĚŽƌĞ Medical College Indore   ex Dr Ashutosh Shrivastav, Assistant Prof. ƌƐŚƵƚŽƐŚ^ŚƌŝǀĂƐƚĂǀ͕ƐƐŝƐƚĂŶƚWƌŽĨ͘DŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ/ŶĚŽƌĞ Microbiology, Medical College Indore ex Dr Manish Purohit, Assistant Prof. ƌDĂŶŝƐŚWƵƌŽŚŝƚ͕ƐƐŝƐƚĂŶƚWƌŽĨ͘DŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ/ŶĚŽƌĞ Microbiology, Medical College Indore  x ƌszĂĚĂǀ͕ƐƐŝƐƚĂŶƚWƌŽĨ͘;WĂƚŚŽůŽŐLJͿ͕DĞĚŝĐĂůŽůůĞŐĞ/ŶĚŽƌĞ e Dr AV Yadav, Assistant Prof. (Pathology), Medical College Indore  ex DrM Mittal, Assistant Prof. ƌDDŝƚƚĂů͕ƐƐŝƐƚĂŶƚWƌŽĨ͘;WĂƚŚŽůŽŐLJͿ͕DĞĚŝĐĂůŽůůĞŐĞ/ŶĚŽƌĞ (Pathology), Medical College Indore   ex Dr Sabita Bharat Jain, Prof. of ƌ^ĂďŝƚĂŚĂƌĂƚ:ĂŝŶ͕WƌŽĨ͘ŽĨDŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ'ǁĂůŝŽƌ Microbiology, Medical College Gwalior ex Dr Vaibhav Mishra, Associate Professor ƌsĂŝďŚĂǀDŝƐŚƌĂ͕ƐƐŽĐŝĂƚĞWƌŽĨĞƐƐŽƌDŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ'ǁĂůŝŽƌ Microbiology, Medical College Gwalior ϰϮ x ƌ<ƵŵĂƌWƌĂďŚĂƚZĂŶũĂŶ͕ƐƐƚ͘WƌŽĨĞƐƐŽƌDŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ'ǁĂůŝŽƌ Dr Kumar Prabhat Ranjan, Asst. Professor Microbiology, Medical College Gwalior x Dr KS Mangal, Associate Professor ƌ<^DĂŶŐĂů͕ƐƐŽĐŝĂƚĞWƌŽĨĞƐƐŽƌ;WĂƚŚŽůŽŐLJͿ͕DĞĚŝĐĂůŽůůĞŐĞ'ǁĂůŝŽƌ (Pathology), Medical College Gwalior x Dr Rajlashmi Sharma, Associate Professor ƌZĂũůĂƐŚŵŝ^ŚĂƌŵĂ͕ƐƐŽĐŝĂƚĞWƌŽĨĞƐƐŽƌ;WĂƚŚŽůŽŐLJͿ͕DĞĚŝĐĂůŽůůĞŐĞ'ǁĂůŝŽƌ (Pathology), Medical College Gwalior x Dr Rajesh Kumar Jain, Prof. of ƌZĂũĞƐŚ<ƵŵĂƌ:ĂŝŶ͕WƌŽĨ͘ŽĨDŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ:ĂďĂůƉƵƌ Microbiology, Medical College Jabalpur x Dr Manish Nagendra, Assistant ƌDĂŶŝƐŚEĂŐĞŶĚƌĂ͕ƐƐŝƐƚĂŶƚWƌŽĨ͕͘DĞĚŝĐĂůŽůůĞŐĞ͕:ĂďĂůƉƵƌ Prof., Medical College, Jabalpur  x Dr DP Lokwani, Prof. Pathology, ƌW>ŽŬǁĂŶŝ͕WƌŽĨ͘WĂƚŚŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ:ĂďĂůƉƵƌ Medical College Jabalpur x ƌKWŚĂƌŐĂǀ͕ƐƐŝƐƚĂŶƚWƌŽĨ͕͘DĞĚŝĐĂůŽůůĞŐĞ:ĂďĂůƉƵƌ Dr OP Bhargav, Assistant Prof., Medical College Jabalpur x Dr Dipankar Patnaik, Assistant Prof. ƌŝƉĂŶŬĂƌWĂƚŶĂŝŬ͕ƐƐŝƐƚĂŶƚWƌŽĨ͘DŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞZĞǁĂ Microbiology, Medical College Rewa x Dr Neelu Jain, Assistant Prof. ƌEĞĞůƵ:ĂŝŶ͕ƐƐŝƐƚĂŶƚWƌŽĨ͘DŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞZĞǁĂ Microbiology, Medical College Rewa x Dr UR Singh, Associate Professor ƌhZ^ŝŶŐŚ͕ƐƐŽĐŝĂƚĞWƌŽĨĞƐƐŽƌ;WĂƚŚŽůŽŐLJͿ͕DĞĚŝĐĂůŽůůĞŐĞZĞǁĂ (Pathology), Medical College Rewa x Dr AS Rai, Prof. of Microbiology, ƌ^ZĂŝ͕WƌŽĨ͘ŽĨDŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ^ĂŐĂƌ Medical College Sagar x ƌ^Ƶŵŝƚ<ƵŵĂƌZĂǁĂƚ͕ƐƐŝƐƚĂŶƚWƌŽĨ͘DŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ^ĂŐĂƌ Dr Sumit Kumar Rawat, Assistant Prof. Microbiology, Medical College Sagar x Dr Shoab Akhtar Khan, Assistant Prof. ƌ^ŚŽĂďŬŚƚĂƌ<ŚĂŶ͕ƐƐŝƐƚĂŶƚWƌŽĨ͘DŝĐƌŽďŝŽůŽŐLJ͕DĞĚŝĐĂůŽůůĞŐĞ^ĂŐĂƌ Microbiology, Medical College Sagar x Dr OP Moorjhani, Associate Professor ƌKWDŽŽƌũŚĂŶŝ͕ƐƐŽĐŝĂƚĞWƌŽĨĞƐƐŽƌ;WĂƚŚŽůŽŐLJͿ͕DĞĚŝĐĂůŽůůĞŐĞ^ĂŐĂƌ (Pathology), Medical College Sagar x Dr BK Sharma, Associate Professor ƌ<^ŚĂƌŵĂ͕ƐƐŽĐŝĂƚĞWƌŽĨĞƐƐŽƌ;WĂƚŚŽůŽŐLJͿ͕DĞĚŝĐĂůŽůůĞŐĞ^ĂŐĂƌ (Pathology), Medical College Sagar x Dr Nitin Madhusudan Nagarkar, ƌEŝƚŝŶDĂĚŚƵƐƵĚĂŶEĂŐĂƌŬĂƌ͕ŝƌĞĐƚŽƌ͕//D^ŚŽƉĂů Director, AIIMS Bhopal  x ƌĞďĂƐŝƐŝƐǁĂƐ͕WƌŽĨΘ,KDŝĐƌŽďŝŽůŽŐLJ͕//D^ŚŽƉĂů Dr Debasis Biswas, Prof & HOD Microbiology, AIIMS Bhopal x ƌ^ŚĂƐŚĂŶŬWƵƌǁĂƌ͕ĚĚů͘WƌŽĨŽĨDŝĐƌŽďŝŽůŽŐŝƐƚ͕//D^ŚŽƉĂů Dr Shashank Purwar, Addl. Prof of Microbiologist, AIIMS Bhopal   x Dr Abhinav Singh, Prof & HOD ƌďŚŝŶĂǀ^ŝŶŐŚ͕WƌŽĨΘ,KĞŶƚĂů^ƵƌŐĞƌLJ͕//D^ŚŽƉĂů Dental Surgery, AIIMS Bhopal x Dr Prabha Desican, ƌWƌĂďŚĂĞƐŝĐĂŶ͕ŝƌĞĐƚŽƌ͕D,Z͕ŚŽƉĂů Director, BMHRC, Bhopal x Dr Angoori Singh, Registrar, Nursing ƌŶŐŽŽƌŝ^ŝŶŐŚ͕ZĞŐŝƐƚƌĂƌ͕EƵƌƐŝŶŐZĞŐŝƐƚƌĂƚŝŽŶŽƵŶĐŝůDĂĚŚLJĂWƌĂĚĞƐŚ Registration Council Madhya Pradesh x Shri Shobhit Koshta, Deputy Drug ^Śƌŝ^ŚŽďŚŝƚ<ŽƐŚƚĂ͕ĞƉƵƚLJƌƵŐŽŶƚƌŽůůĞƌ͕&ŽŽĚĂŶĚƌƵŐƐĚŵŝŶŝƐƚƌĂƚŝŽŶ Controller, Food and Drugs Administration x ^ŚƌŝƌǀŝŶĚWĂƚŚƌĂů͕^ĞŶŝŽƌ&ŽŽĚ^ĂĨĞƚLJKĨĨŝĐĞƌ͕&ŽŽĚĂŶĚƌƵŐƐĚŵŝŶŝƐƚƌĂƚŝŽŶ Shri Arvind Pathral, Senior Food Safety Officer, Food and Drugs Administration x Shri Rajnish Chaudhary, Assistant ^ŚƌŝZĂũŶŝƐŚŚĂƵĚŚĂƌLJ͕ƐƐŝƐƚĂŶƚ^>͕&ŽŽĚĂŶĚƌƵŐƐĚŵŝŶŝƐƚƌĂƚŝŽŶ SLA, Food and Drugs Administration x Smt Vandana Kosthi, Drug Inspector, ^ŵƚsĂŶĚĂŶĂ<ŽƐƚŚŝ͕ƌƵŐ/ŶƐƉĞĐƚŽƌ͕&ŽŽĚĂŶĚƌƵŐƐĚŵŝŶŝƐƚƌĂƚŝŽŶ Food and Drugs Administration x Shri Ajit Keshri, Principal secretary, ^Śƌŝũŝƚ<ĞƐŚƌŝ͕WƌŝŶĐŝƉĂůƐĞĐƌĞƚĂƌLJ͕/^͕ĞƉƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJ IAS, Dept of Animal Husbandry x Dr RK Rokade, Director, Animal Husbandry, ƌZ<ZŽŬĂĚĞ͕ŝƌĞĐƚŽƌ͕ŶŝŵĂů,ƵƐďĂŶĚƌLJ͕WƌĞƐŝĚĞŶƚʹ^ƚĂƚĞsĞƚĞƌŝŶĂƌLJŽƵŶĐŝů President — State Veterinary Council x ƌZ<DĂŚŝĂ͕:ŽŝŶƚŝƌĞĐƚŽƌ͕ŶŝŵĂů,ƵƐďĂŶĚƌLJŝƌĞĐƚŽƌĂƚĞ Dr RK Mahia, Joint Director, Animal Husbandry Directorate  x Dr Jayant Tapase, Addl. Dy. Director, ƌ:ĂLJĂŶƚdĂƉĂƐĞ͕ĚĚů͘LJ͘ŝƌĞĐƚŽƌ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJ Department of Animal Husbandry x Dr Ajay Ramteke, Dy Director, Department ƌũĂLJZĂŵƚĞŬĞ͕LJŝƌĞĐƚŽƌ͕ĞƉĂƌƚŵĞŶƚŽĨŶŝŵĂů,ƵƐďĂŶĚƌLJŝƌĞĐƚŽƌĂƚĞ of Animal Husbandry Directorate x Dr VP Singh, Director, ƌsW^ŝŶŐŚ͕ŝƌĞĐƚŽƌ͕E/,^͕ŚŽƉĂů NIHSAD, Bhopal x Dr Varsha Sharma, Prof & Head, ƌsĂƌƐŚĂ^ŚĂƌŵĂ͕WƌŽĨΘ,ĞĂĚ͕DŝĐƌŽďŝŽůŽŐLJ͕sĞƚĞƌŝŶĂƌLJŽůůĞŐĞ͕:ĂďĂůƉƵƌ Microbiology, Veterinary College, Jabalpur x Dr SK Purnam, Joint Director, Disease ƌ^<WƵƌŶĂŵ͕:ŽŝŶƚŝƌĞĐƚŽƌ͕ŝƐĞĂƐĞZĞƐĞĂƌĐŚ͕ŶŝŵĂů,ƵƐďĂŶĚƌLJĞƉĂƌƚŵĞŶƚ Research, Animal Husbandry Department x ƌdƵƐŚĂƌ>ŽŬŚĂŶĚĞ͕ĂĐƚĞƌŝŽůŽŐŝƐƚ͕^ƚĂƚĞŝƐĞĂƐĞ/ŶǀĞƐƚŝŐĂƚŝŽŶ>ĂďŽƌĂƚŽƌLJ Dr Tushar Lokhande, Bacteriologist, State Disease Investigation Laboratory x Dr HL Sahu, Dy Director, State ƌ,>^ĂŚƵ͕LJŝƌĞĐƚŽƌ͕^ƚĂƚĞsĞƚĞƌŝŶĂƌLJ,ŽƐƉŝƚĂůŚŽƉĂů Veterinary Hospital Bhopal x Dr Mukesh K Mehta, College of Veterinary ƌDƵŬĞƐŚ<DĞŚƚĂ͕ŽůůĞŐĞŽĨsĞƚĞƌŝŶĂƌLJ^ĐŝĞŶĐĞΘŶŝŵĂů,ƵƐďĂŶĚƌLJ͕DŚŽǁ Science & Animal Husbandry, Mhow x Shri Omprakash Saxena, Director, ^ŚƌŝKŵƉƌĂŬĂƐŚ^ĂdžĞŶĂ͕ŝƌĞĐƚŽƌ͕ŝƌĞĐƚŽƌĂƚĞŽĨ&ŝƐŚĞƌŝĞƐ Directorate of Fisheries x Shri Mahendra Singh Dhakad, MD, ^ŚƌŝDĂŚĞŶĚƌĂ^ŝŶŐŚŚĂŬĂĚ͕D͕&ŝƐŚĞƌŝĞƐtĞůĨĂƌĞĂŶĚĞǀĞůŽƉŵĞŶƚ Fisheries Welfare and Development x ^ŚƌŝZ>WĂŶĚĞLJ͕:ŽŝŶƚŝƌĞĐƚŽƌ͕&ŝƐŚĞƌŝĞƐĞƉĂƌƚŵĞŶƚ Shri RL Pandey, Joint Director, Fisheries Department  x Dr Somdutt, Principal Scientist, ƌ^ŽŵĚƵƚƚ͕WƌŝŶĐŝƉĂů^ĐŝĞŶƚŝƐƚ͕/&WŽǁĞƌŬŚĞĚĂ,ŽƐŚĂŶŐĂďĂĚ CIFE Powerkheda Hoshangabad x Dr Sunil Kumar Nayak, Scientist, ƌ^ƵŶŝů<ƵŵĂƌEĂLJĂŬ͕^ĐŝĞŶƚŝƐƚ͕/&WŽǁĞƌŬŚĞĚĂ,ŽƐŚĂŶŐĂďĂĚ CIFE Powerkheda Hoshangabad x Shri KL Manji, CGM, Fisheries Fed. ^Śƌŝ<>DĂŶũŝ͕'D͕&ŝƐŚĞƌŝĞƐ&ĞĚ͘&ŝƐŚĞƌŝĞƐ&ĞĚĞƌĂƚŝŽŶŚŽƉĂů Fisheries Federation Bhopal x Dr Shashikant Mahajan, In-charge ƌ^ŚĂƐŚŝŬĂŶƚDĂŚĂũĂŶ͕/ŶͲĐŚĂƌŐĞĞĂŶ͕Es^h:ĂďĂůƉƵƌ Dean, NDVSU Jabalpur x Dr Rajesh Rajora, IAS, Pri. Secretary, Farmer ƌZĂũĞƐŚZĂũŽƌĂ͕/^͕Wƌŝ͘^ĞĐƌĞƚĂƌLJ͕&ĂƌŵĞƌtĞůĨĂƌĞΘŐƌŝĐƵůƚƵƌĞĞǀĞůŽƉŵĞŶƚ Welfare & Agriculture Development ϰϯ x ^ŚƌŝDŽŚĂŶ>Ăů͕ŝƌĞĐƚŽƌ͕/^͕&ĂƌŵĞƌtĞůĨĂƌĞΘŐƌŝĐƵůƚƵƌĞ͕DĂĚŚLJĂWƌĂĚĞƐŚ Shri Mohan Lal, Director, IAS, Farmer Welfare & Agriculture, Madhya Pradesh x Dr SV Saiprasad, Head (Regional ƌ^s^ĂŝƉƌĂƐĂĚ͕,ĞĂĚ;ZĞŐŝŽŶĂů^ƚĂƚŝŽŶͿ/ŶĚŽƌĞ͕/Z//ŶĚŽƌĞ Station) Indore, IARI Indore x Shri ML Jain, Joint Director Farmer ^ŚƌŝD>:ĂŝŶ͕:ŽŝŶƚŝƌĞĐƚŽƌ&ĂƌŵĞƌtĞůĨĂƌĞĂŶĚŐƌŝĐƵůƚƵƌĞĞǀĞůŽƉŵĞŶƚ Welfare and Agriculture Development x Shri SN Mishra, Principal Secretary, ^Śƌŝ^EDŝƐŚƌĂ͕WƌŝŶĐŝƉĂů^ĞĐƌĞƚĂƌLJ͕,ŽƵƐŝŶŐĂŶĚŶǀŝƌŽŶŵĞŶƚĞƉĂƌƚŵĞŶƚ Housing and Environment Department x Dr Raj Narayan Tiwari, Director, NIREH, ƌZĂũEĂƌĂLJĂŶdŝǁĂƌŝ͕ŝƌĞĐƚŽƌ͕E/Z,͕'ĂŶĚŚŝDĞĚŝĐĂůŽůůĞŐĞĂŵƉƵƐŚŽƉĂů Gandhi Medical College Campus Bhopal x Shri AA Mishra, Member Secretary, ^ŚƌŝDŝƐŚƌĂ͕DĞŵďĞƌ^ĞĐƌĞƚĂƌLJ͕D͘WWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚ͕ŚŽƉĂů M.P Pollution Control Board, Bhopal x ƌWƵƐŚƉĞŶĚƌĂ^ŝŶŐŚƵŶĚĞůĂ͕ZĞŐŝŽŶĂůKĨĨŝĐĞƌ͕DWWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚ Dr Pushpendra Singh Bundela, Regional Officer, MP Pollution Control Board x Shri Rajendra Malviya, Chief Chemist, ^ŚƌŝZĂũĞŶĚƌĂDĂůǀŝLJĂ͕ŚŝĞĨŚĞŵŝƐƚ͕D͘WWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚ͕ŚŽƉĂů M.P Pollution Control Board, Bhopal x Dr PK Behera, Scientist & In-charge, ƌW<ĞŚĞƌĂ͕^ĐŝĞŶƚŝƐƚΘ/ŶͲĐŚĂƌŐĞ͕ŽŶĂůŽĨĨŝĐĞ͕W͕ŚŽƉĂů Zonal office, CPCB, Bhopal x Shri Anup Chautrvedi, SSA Zonal office, ^ŚƌŝŶƵƉŚĂƵƚƌǀĞĚŝ͕^^ŽŶĂůŽĨĨŝĐĞ͕ĞŶƚƌĂůWŽůůƵƚŝŽŶŽŶƚƌŽůŽĂƌĚŚŽƉĂů Central Pollution Control Board Bhopal x Dr Apoorva Das, Director, ƌƉŽŽƌǀĂĂƐ͕ŝƌĞĐƚŽƌ͕E/Zd,:ĂďĂůƉƵƌ NIRTH Jabalpur x Dr ƌ:LJŽƚŝŚĂƚ͕,ŽDŝĐƌŽďŝŽůŽŐLJ͕E/Zd,:ĂďĂůƉƵƌ Jyoti Bhat, HoD Microbiology, NIRTH Jabalpur x Dr Nikhilesh Chandra, Sr. Regional ƌEŝŬŚŝůĞƐŚŚĂŶĚƌĂ͕^ƌ͘ZĞŐŝŽŶĂůŝƌĞĐƚŽƌ͕ZĞŐŝŽŶĂůKĨĨŝĐĞĨŽƌ,&t Director, Regional Office for HFW x Dr MM Upadhyay, Principal Advisor, ƌDDhƉĂĚŚLJĂLJ͕WƌŝŶĐŝƉĂůĚǀŝƐŽƌ͕ƚĂůŝŚĂƌŝsĂũƉĂLJĞĞ''WW͕ŚŽƉĂů Atal Bihari Vajpayee CGGPP, Bhopal x Dr Hajela, Private Medical ƌ,ĂũĞůĂ͕WƌŝǀĂƚĞDĞĚŝĐĂůƐƐŽĐŝĂƚŝŽŶ͕ŚŽƉĂů Association, Bhopal   ϰϰ @) World Health WSs ISL Organization India Developed with support from WHO Country Office for India