Antimicrobial resistance (AMR) is a global problem to animal and public health. It has drawn the attention of public health experts, stakeholders, and medical science due to the substantial economic loss that it causes to individuals and nation as a whole. Various cross-sectional studies and some national surveys in developing countries have shown increase in the burden of antimicrobial resistance. Nepal is one of the major contributors to the growing burden of AMR due to widespread irrational use of antibiotics along with poor health care systems poor infection control and prevention measures. This review was conducted to summarize the situation of AMR in Nepal, determinants of AMR, current government intervention strategies and the way forward to reduce the AMR burden in Nepal. Available cross sectional reports warn that bacterial pathogens are becoming highly resistant to most first- and some second-line antibiotics. The irrational and injudicious use of high doses of antibiotics for therapy and sub-optimal doses as growth promoters are leading causes of AMR in Nepal. Establishment of a surveillance programme and a national plan for containment of AMR, following the National Antibiotics Treatment Guideline 2014 and generation of awareness among veterinarians, technicians, and medical physicians on prudent use of antimicrobial drugs in Nepal could reduce the burden of AMR. In addition, there is a need to develop a national laboratory strategic plan to provide guidance and governance to national laboratories.

More than 75% of emerging infectious diseases and 60% of known human infectious diseases are transmitted from animals. Among these zoonoses, rabies is of utmost public health significance due to its lethality. The multi-faceted nature of zoonotic disease complicates control and prevention and thus, a multi-sectoral One Health Approach could be a better strategy to cope with rabies. Up until now, rabies prevention and control programs are conducted utilizing mass vaccination of domestic and community dogs and cats, and mass awareness programs. However, the burden of rabies has not been reduced as these approaches have failed to include all stakeholders (human, animal, and environmental health sectors) in disease management programs. The aim of this review is to highlight why and how One Health Approach would be the most effective way to control rabies in low- and middle-income countries (LMICs) like Nepal.

Research and development (R&D) offer promising clues to address a wide range of socioeconomic problems through the development of new products and services or often by improving the existing ones. High-income countries (HICs) have realized the worth of R&D and invested tremendously in that sector; however, resource-poor low-income countries (LICs) are still far behind in realizing the potential benefit that R&D could offer for economic growth and national development. Even if some LICs have a positive outlook towards the R&D sector, the trend of emulating works from HICs to solve local or regional issues have most often yielded counterproductive results. LICs are suggested primarily to focus on applied research by incorporating their socioeconomic and cultural aspects to solve their everyday problems whose investigation is often ignored in research-intensive nations. Moreover, applied research in LICs offers the potential to provide low-cost and innovative solutions to local and regional problems with global implications.

Rabies is a vaccine-preventable viral disease present in more than 150 countries around the world. Globally, almost 60,000 people die each year from rabies, of which more than 58% are in Asia and around 45% in South Asia with especially high incidence in India, Pakistan and Bangladesh. Vaccination coverage of both people and stray dogs is low in the region and in general people are not given enough protection and information about pre- and post-exposure prophylaxis. Engagement of multiple sectors and One Health collaboration including community education, awareness programmes and vaccination campaigns are critical to control and elimination of rabies.