Antimicrobial resistance and over the counter use of drugs in Nepal

The risk and burden of AMR in Asia are disproportionately higher than any other continents because of high population growth triggering antimicrobial demand together with the unregulated antimicrobial use in both humans and animals, and the wide circulation of counterfeit and sub-standard medicines [4]. Asia is the most populous continent of the planet earth with the population of 4.5 billion and constitutes 60% of the world’s population with China and India together constituting more than two-third of the Asia’s population [5]. Together with the population density, current transition in economy, migration, high burden of infectious diseases and tropical diseases and the consequent demands and use of antimicrobials has made Asia a hub for the antimicrobial resistance [6]. The emerging resistance of antimicrobials in South Asia is intertwined with epidemiological, social, cultural and political characteristics of the nations. In this article, we will discuss the social, cultural and regulatory factors contributing to AMR and potential solutions by focusing on the context of Nepal.