Fleming Fund Phase II in Bhutan: Advancing AMR Surveillance and Capacity Building
The Fleming Fund, a UK aid initiative, supports low- and middle-income countries in addressing
antimicrobial resistance (AMR). In Bhutan, the program has progressed from Fleming Fund
Phase I (FF I)—which focused on infrastructure development, capacity building, and AMR
surveillance—to Fleming Fund Phase II (FF II), which prioritizes sustainability, with a primary
focus on AMR surveillance and capacity building under the One Health approach.
Key Focus Areas in the Animal Health Sector
Under FF II, the National Centre for Animal Health (NCAH) has been identified as the
beneficiary institution, responsible for leading AMR surveillance and antimicrobial use (AMU)
monitoring in the animal health sector.
AMR Surveillance in Animal Health
Phase I: Surveillance Plan for AMR in Commercial Broiler and Layer Chicken
Population in Bhutan was conducted to establish a baseline for antimicrobial resistance in
poultry.
Phase II: Clinical Surveillance for Antimicrobial Resistance in Mastitis Cattle in Bhutan
is being implemented, focusing on bacterial pathogens and resistance patterns in dairy
cattle.
Surveillance Laboratories
National Veterinary Laboratory, NCAH, Serbithang
Regional Veterinary Hospital and Epidemiology Centre, Phuentsholing
Regional Livestock Development Centre (RLDC), Kanglung
Antimicrobial Stewardship Program
The National Veterinary Hospital will take the lead in initiating antimicrobial
stewardship (AMS) activities, promoting responsible antibiotic use in veterinary
practices.
Funding and Implementation Timeline
The total grant allocated for Bhutan under FF II is Nu. 134,866,834 (£1.5 million), of which Nu.
18,008,334 is designated for AMR and AMU surveillance in animal health.
Inception Phase: Completed in July 2024
Implementation Phase: The Detailed Technical Implementation Plan (DTiP) for AH
commenced in October 2024
Project Duration: The grant is expected to be fully implemented by December 2025
Technical Support and Sustainability Measures
To support some of the activities under the detailed implementation of the Country Grant (CG),
the Regional Grant, Antimicrobial Resistance and One Health (AMROH), Massey University,
New Zealand, has been identified as a technical partner.
Additionally, three Fleming Fellows (Cohort 4)—specializing in Policy, AMR Surveillance, and
AMU Surveillance—are being professionally trained under Peter Doherty Institute to ensure the
long-term sustainability of Bhutan’s AMR program.
Conclusion
Fleming Fund Phase II marks a critical step in strengthening Bhutan’s AMR surveillance and
laboratory capacity in the animal health sector. By shifting from infrastructure development to
surveillance, capacity building, and antimicrobial stewardship, the initiative aligns with Bhutan’s
National Action Plan on AMR and the One Health approach, ensuring a sustainable, evidence-based response to AMR challenges.
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