Identification mission on Antimicrobial resistance in Indonesia

This report contains the findings and recommendations on antimicrobial use (AMU) and antimicrobial resistance (AMR) practice and policies in Indonesia.
The observations were made by a team of Dutch and Indonesian experts during an identification mission in August 2015. The mission did address AMU/AMR in both human and veterinary health.
It was found that the use of antimicrobials in Indonesia was widespread and uncontrolled on both the human and the veterinary side. This situation was recognised by the Indonesian public and private stakeholders. The awareness on AMR is low within the general public but also within a large part of the professional stakeholders.
There are only limited data available on antimicrobial usage in the human and veterinary sector or on the development of antimicrobial resistance. Research in this area is fragmented and poorly coordinated and reporting lines are not clear.
Several initiatives have been taken on both the human and veterinary side to reduce the use of antibiotics, through regulation and increasing awareness of public and professionals. However, from the interviews it appeared that the actual use is not being reduced.
The Ministry of Health has drafted a road map on the implementation of existing regulations and guidelines. However, human and financial resources are lacking to support the implementation of this roadmap and to measure the effect of the implementation.
The Ministry of Agriculture has recently approved a regulation to ban the use of antibiotics as growth promotor. However, no plan has been made to implement this regulation or to enforce this regulation. On the veterinary side a road map to support the reduction of antibiotic use in the livestock sector is not available.
Recommendations are given in this report to support the reduction of AMU/AMR on both the human and veterinary side.
On the veterinary side the development of a road map describing a feasible strategy should be the first priority.
Second priority should be to establish an intersectoral coordinating mechanism for AMU/AMR involving both human and veterinary stakeholders.
The development of monitoring and surveillance programmes for AMU/AMR and capacity building is important to support the policy and intervention programmes and is a logical third step.