In collaboration with the World Health Organization (WHO), the Republic of Palau Ministry of Health (MOH) hosted an Antimicrobial Resistance (AMR) National Action Plan (NAP) Workshop from Thursday, May 11, 2017 to Friday, May 12, 2017. The workshop was an opportunity for local partners to collaborate in the development of a national action plan for combating antimicrobial resistance in Palau. Participants included local agencies & businesses from the government as well as private sectors involved with the regulation, usage, and distribution of medications that contain antimicrobials.

Basically, antimicrobials are drugs that kill or inhibit the growth of microbes (microorganisms)—namely bacteria, virus, fungi, and some parasites. Antimicrobials are used in treating infections caused by these microbes. There are various types of antimicrobials and the kind of antimicrobial medication used identifies the type of microbe it is treating. For example, antibiotics inhibit or kill bacteria, antiviral do the same to viruses, antifungal on fungi, and antiparasitics on parasites.
Antimicrobial resistance is a quality of the microbe that enables it to reduce or eliminate the effectiveness of an antimicrobial by building defenses against its treatment. This quality is acquired through a change in the microbe’s genetic makeup causing it to continue to grow and cause infection, even in the presence of the antimicrobial medication. This is when the microbe is said to be resistant to the medication.
Microorganisms are rapidly forming resistance against medications, most commonly to antibiotics. The effectiveness of such medications to combat infections is failing. This has resulted in a decline of treatment options for common infections. Standard treatments become ineffective and infections persist & may spread to others.
Antimicrobials are strong, efficient, and precious health resources. However, they are diminishing in efficacy due to irresponsible use, misuse, and overuse. Examples of irresponsible use of antimicrobials include not completing a course of antibiotics or saving a part of it for future use; sharing antibiotics with others who are not prescribed antibiotics; exerting pressure on health workers to get antibiotics for an infection that does not require antibiotics; and prescribing or dispensing antibiotics with insufficient sensitivity justification.
The continual use of antimicrobials without proper prescription from a doctor results in antimicrobial resistance as they are, in most cases, being used for the wrong types of infection. For example, antibiotics are being used to treat viral infections like the common cold, cough, and most sore throats. This inappropriate use of antibiotics provides an opportunity for the naturally occurring and other bacteria to develop resistance against antibiotics.
May 24, 2017
At the same time, it unnecessarily exposes the patient to the side effects of the medications. In addition, the duration of treatment by antimicrobials as determined by your doctor must be completed even when you are feeling much better. This ensures that the infection is completely treated. When medications are not completed, it creates an opportune environment for the microbes to develop defenses against the antimicrobial and resist its effect.
In 2014, the World Health Organization declared antimicrobial resistance as a global threat. The Republic of Palau, along with other member states at the 2014 World Health Assembly, pledged its commitment to developing a national plan on antimicrobial resistance. The National Action Plan of each nation will follow the four main principles of the global action plan: 1) Whole-of-Society Engagement through a ‘ONE HEALTH’ Approach, 2) Prevention First, 3) Access to Effective Treatment, and 4) Sustainability.
Facilitator for the AMR NAP Workshop in Palau was Dr. Sarah Paulin. She is the Technical Officer for Antimicrobial Resistance from the WHO Western Pacific Regional Office (WPRO) in Manila, Philippines. During her presentation, Dr. Paulin explained the significant and global impact of antimicrobial resistance. She also identified factors fueling antimicrobials and the WHO response in combating its resistance. In addition, representatives from local agencies were given an opportunity to present about the use of antibiotics in Palau. Topics discussed included the use of antibiotics in Palau’s fishing industry, the management of medical wastes at the Belau National Hospital, an antibiogram & sensitivity pattern analysis by the Laboratory Department of the Belau National Hospital, an explanation of how the Pharmacy Department of the Belau National Hospital procures & distributes as well as monitors the usage of antimicrobials, and how the Infection Prevention & Control Unit of the Ministry of Health has implemented preventive measures in the community setting of Palau.
Representatives from the following local agencies, businesses, and offices participated in the AMR NAP Workshop: The Senate of the Tenth Olbiil Era Kelulau (10th OEK); the Bureau of Agriculture; the Ministry of Education; the Bureau of Immigration; the Bureau of Customs & Taxation; the Bureau of Marine Resources; the Belau Medical Clinic (BMC); the Pacific Family & Medical Supply (PFMS) Clinic; Family Surgical Clinic (FSC); the Koror State Animal Shelter; the Ministry of Community & Cultural affairs; the Environmental Quality Protection Board (EQPB); community partners, specifically the Civic Action Team (CAT); and the Ministry of Health.
Thank you all for contributing to Palau’s efforts in promoting local awareness about antimicrobial resistance. Recognition is also given to Dr. Paulin for providing technical assistance with identifying gaps in Palau’s awareness of antimicrobial resistance as well as direction in the development of Palau’s National Action Plan.
The Ministry of Health would like to stress on the importance of not sharing medication, especially antibiotics. Help maintain Palau’s ability to resist common infections by making the proper requests for medications through a medical examination and a doctor’s prescription. [/restrict]