 Okay, so maybe we can start actually because we are going to have in any case, I mean people joining along the way. So welcome to this knowledge dissemination dialogue today to all of you. As you know, this is an activity that we have started a few months ago and now we are having actually twice twice a month. It is a rich series of webinars in which we do invite people to share their experiences but also their research activities. Today, the presentation will be on providing one experience on the implementation of antimicrobial resistance and antimicrobial use monitoring in a small developing countries, which is actually team or less. And the presenter will be Dr. Shantin, which is from originally from Singapore and living in Australia. Then this series of webinars, it is organized by the FAO, EMR Working Group, together with the FAO Sustainable Livestock Technical Working Group. Giving some housekeeping rule as usual. Please keep your microphone on mute. Rename yourself with your organization and country and then follow by your name so we can also know where you're coming from. And then please note that the views of the presenter are those of the speakers and not that the Food and Agriculture Organization, the United Nations, refrain from advertising your services, your companies and any commercial product and brand. Please post the chat in the chat your question and we will aim to answer all questions during the discussion at the end of the presentation. Just to remind you that the meeting is being recorded. You should have already received like the message. And then both the video recording and the PowerPoint presentation will be posted in the YouTube FAO channel. And also shared with the participant list that we have gotten through the registration. Now, going to the presentation like as I said before we do, and I'm so sure you can start to have your slide share while I'm briefing you, giving some information about yourself so as I was saying that we do have the pleasure this, this time to have Dr. So he's a senior researcher fellow at the Menzies School of Health Research in Australia is currently lead the animal health aspect of the project into more or less focusing on enhancing the animal health system with a one health approach. And especially focusing on antimicrobial resistance, but also on zoonotic diseases more in general. He works closely and in a collaborative way with the local government and agencies, international organization, different academic institution, donor agencies and private stakeholders for the implementation of the project. Sean is also a member of the Australian and New Zealand College of Veterinary Scientists, more on the epidemiology side and completed this master of public health from the University of New South Wales. Previously, Sean was awarded the scholarship for the government veterinary services Singapore, and has had various position focusing on the port risk analysis and diseases or data. He has an international experience through the work that he has done with us. So, Sean, over to you for the presentation and then to remember to the participant that we will have like 20, 30 minutes presentation and then we will reply to the two different questions that you can put in the chat. Thank you very much and Sean over to you. Thank you Francesca, can you hear me. Yes, we can. Good evening from Darwin where it's 9pm in Australia, but also good morning and good afternoon to those from other time zones. Thank you to FAO colleagues for opportunity to share about the work on strengthening in mind and monitoring and team on this day. I also see a lot of colleagues who I know from previous roles in the group as well so hello to all of you and hello to those who I will meet today as well. So much of my work has been either in research or government focusing on that at the end that public health. And this work here is done alongside colleagues in Timor last day. Many who are like my people who have a vision of strengthening the health system there. It's a pleasure working alongside all of them. So this presentation focuses on building am I am you monitoring from ground zero in a low resource setting. This presentation will cover some of the findings, the learnings, but also the challenges. There are still aspects that need to be worked on and very happy to hear ideas from participants as many of you might have experienced from other more established systems. And also hope that this presentation could provide food for thought for countries that are just starting this journey and an opportunity for us to learn from more developed systems as well. I'd like to acknowledge our main collaborators from Ministry of Agriculture livestock fisheries and forestry's and Ministry of Health of Timor last day and offer gratitude to the funders planning fund for enabling this capacity building. This presentation will cover one health approaches and partnerships that increases the effectiveness of capacity building efforts, especially in a low resource setting. Antimicrobial use monitoring and antimicrobial resistance monitoring. The presentation you'll see will alternate between am I am you monitoring. But I think it gives us appreciation of how both monitoring systems are complementary to each other. But first, a introduction on Timor last day. It is a country in Southeast Asia. The closest neighbors are Indonesia and yellow here and Australia in orange. It is a newly sovereign country where independence was gained just 20 years ago. A zoomed in looked at Timor last day. The country is located on Timor Island. The yellow portions are Timor last, whereas the gray version by the gray areas are Indonesia. And the country shares a land border in red with Indonesia. And this is relevant when discussing entry of that drugs and animals into the country and the country as a population of 1.2 million people. Agriculture provides the largest proportion of employment to people in the country, more than half the men and women work in agriculture and up to 87.2% of households keep livestock. The diagram here on the left shows the proportion of households with livestock in different regions of the country with red being areas with a very high proportion. So what we can see here is most areas in Timor last day have a high proportion of households owning livestock, but most household practice subsistence farming using low input, low output systems. More about the government that service in Timor last day, the national direct trade of veterinary is the competent authority for animal health. When work was started in 2019, there was no established program for monitoring antimicrobial resistance or antimicrobial use. And there is a vet diagnostic laboratory which sits under the national direct trade on veterinary and my work was started there. There was only basic capacity for bacteriology, but no capacity for antibiotic sensitivity test. Strengthening am I am monitoring is the key objective, but it can be achieved more effectively and sustainably through a one health approach and through partnerships with other organizations. So I just want to mention these two points in this slide for one health approach and the next slide for partnerships. In this slide is the framework for one health approach that we are striving towards here, and there are six domains. This helps to maximize synergies within the existing government structure which has limited resources through information sharing resource sharing. For example, under the laboratory component, there is joint use of equipment to maximize resources. So instead of developing broad micro dilution capacity and multi top capacities in both the vet lab and health lab, which results in duplication. These platforms will develop only in the health lab because it has a higher throughput of samples. And the vet lab can request access to these facilities when required for testing. Examples of work in the other domains can be found if you scan the QR code that's supposed to presentation that you can find more information. This slide now is on partnerships. Menzi strives towards partnerships with other organizations and projects working in the animal health space to strengthen the system. And the picture in the middle here and on the right shows example of partnerships between different programs. To set the context, it is very manpower intensive to restrain cattle in Timor-Leste due to the lack of restraining facilities and also farmers need to bring in their free roaming cattle for the cattle to be restrained. Therefore, partnerships between different programs with different through partnerships with different programs, several outcomes can be achieved when a single cattle is restrained. So for example, here, we have a member of the Menzi team collecting blood from a cattle that's pulled there. And at the same time, a rectal swap can be collected for AMR monitoring and at the same time health services and treatment can be provided for cattle. With the necessary frameworks and approaches in place, the next step was to understand the antibiotic supply chain. This would give a more strategic approach to developing AMU and AMR monitoring and it could indicate where we should concentrate the limited resources that are available. So to develop the supply chain map visits were made to different actors involved in importing, distributing, selling and using antibiotics. These are pictures from some of the site visits which include agriculture shops, government vet services and farms. And now to elaborate on how the supply chain map was constructed. The first step was to divide the map into four phases, the import of antibiotics, distribution of antibiotics, who use the antibiotics and what species the antibiotics was used in. Manufacture was not included here because all that antibiotics were imported into the country. The actors involved in the import will be potential targets for collecting input data. The actors that are involved in distribution will be potential targets for collecting sales data. Actors involved in using the antibiotics will be potential targets for collecting individual animal or farm level use data. And they will also be targets for understanding any poor knowledge, attitudes and practices towards antibiotic use so that appropriate prudent use training can be provided. And animals which antibiotics are used in will be potential targets for AMR data collection. The next step was to fill in the key players in each phase based on the site visits. So for importers, we divided them into non-government and government importers for distributors that were vacuuming agriculture shop and municipal offices that are owned by the government. And for users, the three groups were private animal health practitioners such as vets, farmers or government technicians and vets. And the target animals for antibiotic use can be divided into companion animals, commercial farm animals or small-holder farm animals. The third step was to then join these together to show the supply chain. It was found that the government and non-government supply chain was quite separate. So on the right over here, the government imports their own antibiotics. It is distributed to municipal offices for use by government employed technicians in small-holder farms. And on the left, the private sector imports antibiotics through agriculture shops, vet clinics or commercial farms. And these are eventually used by either private animal health practitioners or farmers in commercial farm animals or companion animals. Based on this map, we pondered where to start the journey with AMR and AMU monitoring. It was hard to start AMR monitoring based on this information because there was limited information on what were the common antibiotics used, which made it hard to determine what resistance to test for. And there was also limited information on which animals received antibiotics and it made it hard to determine the target population for AMR monitoring. Therefore, it was wiser to start with AMU monitoring and this could be done by focusing on quantifying imports or quantifying antibiotic use in animals in this phase over here. And we decided the best way would be to start at the top here on quantifying imports because there were less actors involved in import compared to using antibiotics and that a single data point source was available through import approval documents at the office of the National Directorate of Veterinary. But we recognized that the trade-off of this would be the lack of accurate information on species of use, reasons of use, and also the root of administration. So the collection of import data was not simple when it was not routinely collected to begin with. Some of the challenges were poor ability to differentiate between antibiotics and other vet medicines and limited computer literacy. So we overcame this through training followed by ongoing side-by-side mentoring that is still ongoing now. And this model of capacity building was useful because it allowed the Menzies team to customize learning over time to be more effective and implement the recording of data in a way that is suited to the computer literacy level. We like to acknowledge the team at the National Office for working with us to establish this new system and practices. We enjoy the collaboration that benefits the country and we're happy that the country is now able to routinely submit data to OWA at reporting option 3. So what was found on quantifying antibiotic imports? This was based on published data between 2016 and 2019. The average quantity of antimicrobials imported was only 57.4 kilograms per year, and even after adjusting for biomass, it was only 0.55 milligrams per kilogram and more biomass per year, very low compared to the global and regional average. The most common antimicrobials imported into the country were tetracycline penicillin macrolites followed by aminoglycosides, consistent with global and regional patterns. The green and orange bars represent parenteral versus oral routes of administration based on the indication on the label at the time the drug was imported. And by importer, the government or math Ministry of Agriculture is the main importer. Followed by commercial poultry farms such as lay and broiler farms, and then agriculture shops. It was interesting that oral formulations, the one in orange bars were almost completely imported by commercial poultry farms here. And that the ones in green bars were almost completely imported by math the government and agriculture shops. More diagrams and information on this can be found at the published paper if you scan the QR code link. And this study was used to add information to the antibiotic supply chain map. So this study provided information on who were the actual non-government importers who were which were layer farms, broiler farms, agriculture shops and that clinics. Secondly, it provided information on how much each of them imported. So around 50% of antibiotics were imported by the government. And around another 50% of antibiotics by the private sector. It also provided information on the route of administration based on the label instructions. So commercial farms imported oral antibiotics. Whereas the others imported mainly parental antibiotics. And finally, based on the species indication on the label of the antibiotics that were imported, it was possible to guess the target species for the important antibiotics. So this updated supply chain map gives new information. It shows that half of the antibiotics in Timor-Leste is imported by the government, distributed through the municipal offices, used by government technicians via a parental route in animals such as cattle, buffalo, chicken, pigs and goats in small order farm settings. Whereas another 40% of antibiotics was imported and used directly by commercial poultry farms through oral administration. And about 7% of antibiotics were distributed through agriculture shops can be sold to anyone such as farmers and private animal health practitioners. And they are mainly administered parentially. And vet clinics imported a very small proportion of antibiotics and hence the use in containing animals is likely to be very low. So based on the supply chain map, the animal population at the highest risk of AMR is likely to be commercial layers and broilers. Because it shows that 40% of that antibiotics was concentrated only in two-layer farms in the countries and a dozen of broiler farms. And the route of administration was oral and this helped to prioritize the target animal population for AMR monitoring. So the AMR monitoring program was designed to focus on healthy chickens with four sub-populations. Layers and broilers were included because they were the highest risk of the AMR. And chickens are imported as Dao chicks from either Indonesia or Malaysia. Local chickens were included to provide a baseline for comparison and fighting cocks were included based on reports that they were routinely given antibiotics pre and post-fight and that human antibiotics were sometimes used. We decided to collect samples from broiler local chickens and fighting cocks from live but markets to reduce operational costs from visiting multiple farm locations. And these farm locations were also hard to find because there was no centralized list of where these farms were. Whereas on the other hand, layer farms were visited individually because there were only two farms and drag swaps were used. In the laboratory, the collected samples were tested for four priority bacteria, E.coli, Salmonella, Enterococcus and Campylobacter. Initially, we only focused on E.coli and Salmonella. And over the last year, it's expanded to Enterococcus and Campylobacter through laboratory capacity building, through our current lab scientist mentor, Hannah. And this diagram was designed by her, shows the process of the isolation and confirmation of the four priority bacteria. The design of the AMR monitoring program was adapted from FAO's regional AMR guidelines. So I put it here as a useful reference for implementing AMR surveillance for those who are interested. So in the next few slides, I'll share more about the objective method and then results in the next slide from AMR monitoring program in chickens. So the objective was about estimating the prevalence of AMR in E.coli isolated from healthy chickens in live bird markets and layer farms. It was a cross-sectional study. In live bird markets, cloacal swaps were collected from individual healthy chickens. We talked to local authorities in each municipality to develop a list of live bird markets and the largest live bird market within each municipality was visited. If time permitted, the next largest live bird markets were also visited. And within each live bird market, all vendors were approached with random selection of one chicken from every vendor. On a layer farms, boot swaps were collected only from houses with adult chickens with up to four boot swaps per house. The samples were sent to the vet lab for isolation of E.coli. This diffusion test was performed on all the isolates and the selection of antibiotic discs was based on the commonly imported antibiotics from the previous study. And this table here shows the six antibiotic discs that are being used, tagged to the commonly used imported antibiotic brands based on the import data. So the disc diameter was recorded, entered into UNEP and interpreted according to CLSI guidelines. Some isolates were also sent to the human health lab for broth micro dilution, but the MIC results will not be discussed today. So based on the results, 345 cloacal swaps, 87 boot swaps were collected. A decent E.coli isolation rate of about 85% and samples were collected from various parts of the country, quite well distributed. This slide shows the distribution results. The columns show the resistance across the four chicken sub-populations of local chickens, fighting cocks, layer farms and broiler chickens. The main point of this table is that across every antibiotic here, you will see that resistance is ascending from local chickens to fighting cocks to layer farms to broiler chickens. And if we look at it, there is generally lower resistance in non-commercial chickens and higher resistance in commercial chickens. And the commercial chicken resistance is similar to the AMR profiles reported in nearby countries like Indonesia, where the Dao chicks are imported from. The sample size for broilers is still quite small, so more samples are required. The AMR monitoring will pivot towards that in the future. It's been difficult to target this population because production cycle is short and there's only intermittent production on many farms. And this makes it hard to find broilers at like-but-markets or even at the farm. So happy to hear ideas on how to get a better sample from broiler chickens on this later during discussion or if you'd like to get in touch directly. Now let's talk about imports by the government on the right side over here. The government imports 50% of antibiotics, but it's only used by about 180 technicians employed by the government, but used in thousands of animals of different animal species throughout the country. So this means two things. If the 180 technicians were able to submit vet drug use records, it will be a good approximation of antibiotic use in each species of production animals in the country. And if the 180 technicians are able to practice prudent use, antibiotic use principles, then we will be confident that at least 50% of the antibiotics imported into the country are used appropriately. So a knowledge attitudes and practices survey was developed to identify poor knowledge and practices among technicians and future training on prudent use can focus on addressing this poor knowledge and practice areas. So moving on to first on collecting animal level AMU data. A data source was already available in the country in hard copy form. Technicians are obliged to fill up these hard copy forms when they use vet medicines, although it is not always done. Also collection of data on hard copy form means that analysis occurs many months later. It takes time to send these individual sheets throughout the country to the national office enter this data into a computer for further analysis. Therefore, we are working together to see if this process can be improved by entering usage data directly on a mobile app called EpiCollect. And the benefits of using such an app are it allows immediate entry upon use so people don't forget. It's also light. And so people are more likely to enter it compared to holding a thick stack of paper reduces data entry errors from poor handwriting and allows quicker analysis and reporting. But overall the idea is that the app helps to increase compliance with reporting usage by increasing the convenience of reporting it. But it has its challenges as well. So for example, for example, older technicians do not have smartphones. And so there's no 100% capture. Some technicians work in areas with poor internet connection and are unable to send information regularly. Sending data costs money and their calls to subsidize this. So this initiative has been fully implemented in one of the 13 municipalities and is gaining traction in another two. Changing lens now to determining poor knowledge and poor knowledge and practices among government technicians with respect to antibiotics. The objective of the study was to determine the knowledge attitudes and practices on antibiotics and antibiotic resistance among government technicians. It was a cross sectional study. The target population as expected was employees and volunteers that had access to antibiotics imported by the government. This in the next slide focuses on selected results only and the full results can be found in the published article by scanning the QR code if you like. So what was the knowledge of technicians on antibiotics? It was positive that 87.7% correctly identified that antibiotics kill or inhibit bacteria. However, about a third incorrectly identified that antibiotics kill or inhibit viruses. And more than 90% incorrectly identified that antibiotics directly reduce inflammation and fever. And some of these responses especially these two were poorer than compared to other low and middle income countries. It is also worrying that about a third, about three quarters, sorry, of participants believe that broad spectrum antibiotic was always a better choice than narrow spectrum antibiotics. This is likely due to technicians wanting to maximize the likelihood of antibiotics being effective against infection in the absence of diagnostic support, rather than considering the impact of broad spectrum antibiotic use on antibiotic resistance. On prescribing practices, it was good that use of antibiotics for growth promotion was rare at 3.7%. As antibiotics were given, it was often used empirically without a lab diagnosis. It was concerning that participants identified antibiotics as the primary treatment of choice for scabies and gastrointestinal worms. Further training for technicians should focus on addressing these issues. It was identified that the top three species that receive antibiotics from technicians were cattle, pig, and buffalo. And this corresponded with animal level AMU data, which showed that cattle followed by pigs received the highest amount of antibiotics. And finally, technicians reported using oxytetracycline the most, and this corresponds with data seen on AMU monitoring based on input data and the previous diagram on resistance as well. Tetracycline had the highest resistance compared to all the other antibiotics. And on the use of human antibiotics in animals, 15% reported ever using human antibiotics. One reason could be the lack of supply of vet medicines, which was also found in the study. And human antibiotics were often used in animal species such as chicken, pig, dog, cattle. The active ingredients were tetracycline, amoxicillin, ampicillin. And the source of these antibiotics were often from leftovers in hospital healthcare centers or purchased from kiosks or human pharmacies. Now going back to the supply chain map, so both the survey and the AMU data collection from technicians suggest that cattle receive the highest amount of antibiotics from government technicians. And therefore the AMR monitoring program has been expanded to cattle in addition to commercial poultry. And now rewinding back to the first study on quantifying antibiotic use inputs, we talked about that agriculture shops imported about 6.9% of antibiotics. But this was likely to be an underestimation and some reasons for that were that import applications were not being submitted by agriculture shops, the National Vet Office, and the data was not captured. There can be many reasons for this and a workshop was held to kind of address these reasons. This is a picture from the workshop with agriculture shops to improve compliance with submitting import applications. During the workshop, the rationale for obtaining import approval for vet medicines was provided together with clear guidance on how to follow the procedure to submit import applications, and also address queries from agriculture shop owners. Custom and border police officials those in uniforms were also invited to discuss preventing entry of unapproved medicines through the border. Another benefit of this workshop was achieving agreement with the government vet services was achieving agreement that the government vet services could do more to ensure prudent use of vet antibiotics sold from agriculture shops to the public. And so a list of vet technicians and their contact details and where they were working was provided to all agriculture shops in the country. This means that buyers of vet medicines at agriculture shops can discuss the use of vet medicines with technicians in their region at no cost before using antibiotics. This tries to reroute usage habits in Timor last day. So instead of agriculture shops selling directly to farmers and the drugs being used in small holder farm animals, they would first consult with a government technician before use which the green arrow shows. So to summarize the journey on implementing AMI and AMU monitoring in Timor last day. A one health framework was adopted and partnerships developed and this maximizes synergies and efficiencies to developing a monitoring system in a country that has limited resources. The next step was to understand the supply chain. This involved mapping the supply chain and quantifying import of antibiotics. This helped to prioritize resources for AMI and AMU monitoring. Using the information from mapping and quantifying imports, we move on to understanding antimicrobial resistance and it focused on commercial poetry because of high usage in this sector. And it has expanded the cattle based on input that this species received the highest amount of antibiotics from government technicians. Understanding animal level usage targeted government technicians because a small group was responsible for administering more than 50% of antibiotics in the country to food producing animals. And the data could be used to promote prudent use in animals in this group. And finally, better compliance was encouraged from agriculture shops when submitting import applications and farmers were encouraged to contact technicians about antibiotic usage. So let's end here today but first I'd like to take the opportunity to acknowledge our collaborators and partners. Personal thanks to my bosses, Josh and Jen for the support of animal health work and their guidance to Dr. Johnita, who is the chief at Dr. Felix, head of the lab for Intimal Estate for their positive collaboration to the animal health team at Menzies, Hannah, Paul, Amalia, Kristi Bella and Rogerville for their call to the work as well. So thank you all for listening. Thanks to FAO for the invitation to share about the work. Happy to answer questions. And here I need to suggest the ideas on improving MR and EMU monitoring Intimal Estate. Thank you very much Sean and then I cannot like agree more with what people have written in the chat very excellent presentation very clear and thank you really for sharing like I mean what the work has been done there. I think that the, I mean, you've got many different results and already changes in Intimal Estate so for the reporting. So, there is, there is one, one question in the chat and then, yeah, I have asked also that the colleague, if you can just write in the chat the question. So then I can pick up from there. And maybe just out of curiosity, what it is meant by government technician, what are these figures specifically and then what is the background maybe as I mean they're technically what is their, you know, for example, the university degrees or like what kind of training they receive. This is just for my curiosity and I will pass to the other to the question in the chat. No worries. Government technicians are typically trained in Timor-Leste in the national university. They are, I think it's a three or four year program. It's a diploma program. And so they're basically you call them I think in war terms para veterinarians. Thanks. And do you know how many veterinarians are available in the country. It is growing. I don't have a full count, but it is between 10 to 20. Okay, thanks. And there's more every year recently. And I think in this group here we have at least one from there that I saw before. Okay, thank you very much. So I pick up the question which is in the chat and then please colleague the other one. We do not allow other people to provide questions. So if you can just try it there, then I will pick up your question there. So, Sophie is asking, so did you consider collecting the sample for broiler from for a modest rotor house, instead of from the library chicken. Yeah, thank you for that suggestion. It's a good suggestion. We tried the easy answer or the short answer is that there's no broiler slaughterhouse. And so they go straight from the farm to the life but market, and they get sold to household so the slaughterhouse is in the household, or get sold to the restaurant and so the slaughterhouse is in the restaurant. That's indeed. So very strange I think that when we are used to have slaughterhouses like and especially when they're so also for the big commercial poultry farms, they do not. Or they have their own slaughterhouse. Yeah, exactly. And also to give a context these broiler farms are very small scale broiler farms. The maximum number will be maybe 5000 but so between 10 to 5000 birds per farm. So it's small scale instead of very large farms. Yeah. Okay, thanks. So then I was a bit like so you presented already like the resulted to receive from the laboratories. And then, well, so the selection of the antibiotic understood that you did only when after the result of the new data. So are there. I mean, we're further like this, because they were only six antibiotics. So we're also other like, you know, some interesting isolate where further analyze and then for what. Yeah, just trying to understand the question you're asking if we're going to add more antibiotics onto the antibiotics panel is that right. Yeah. So if you do consider because you were discussing on the fact that the some laboratory are more advanced than others or like isolate bacterial isolate and being collected and then they are like also put for further characterization, especially if you have. Yeah, multi resistance. Yeah. Yeah, that's great question. So what we've done is we've start easy. We've got the equal isolate. We buy a bank them or store them only to AST for the six antibiotics. Some of them have been sent for broth micro dilution using Phoenix BD Phoenix. So as a panel of about 20 something antibiotics that are relevant for human health those results were not presented today, but they were tested for a wider range of resistance using broth micro dilution. At this moment we haven't thought about further characterization yet because the idea is to provide more contextualized information for the vet services on the antibiotics that they're using so focusing our resources in that area instead of other things. Okay, thanks and then I think that maybe as a as a one health approach also considering like the result that you have like matching with the DMR from the human health side at least. So we do have other two questions in the chat so one it is from the community from war from pilot so take Kiri is asking if you have done a more surveillance in Qatar what sample did you use. Maybe you have already seen. Well before the picture. Yeah. Thank you, Tickery. Tickery was just there. I think one or two weeks ago in team also hello to Tickery. We collect sample samples, but recently we've been trilling fecal power samples. We are still looking at how effective it is because as you saw rectal swap samples require a lot of manpower so we're looking for a method of email data collection that requires less manpower that would benefit the country in the long term if they were to have a sustainable program. Thanks. So. Yeah, and then we can read the chat because the case reply for you. Then there is a question from a colleague from a file so this along so asking how strong is or what is the experience of team or in control in this indiscriminate distribution and use of antimicrobials. Yes, good question. I think. Tickery was there to address try to address some of these issues as well understanding from war. The easiest way to put it is that we encourage agriculture shops to declare what they have indiscriminate use is possible, especially on the border because that's where there's a land border with Indonesia and people who travel in and out using that land border in antibiotics at the airport. So if people brought in indiscriminately the antibiotics from overseas via the airport, it would likely be found because there's scanning of bags there so it's less likely so the most common route of unauthorized entry so to say is through the land border. So maybe let's see further question coming in the in the chat but in any case so you have already highlighted some of the next things that you're going to do so. What is more specifically I mean that you are going you are planning like what it is for seeing for the next year since we are at the end of the year now so more specifically what are you going to do. Thanks for the question so on a mar monitoring. Next year will be focusing more on obtaining samples from broiler chickens because that has shown to be quite a high prevalence with low number of samples. Continuing with a mass sampling in cattle so this that's for a mass surveillance for am use surveillance. The focus would be on strengthening animal level data collection by improving the app that's being used collected and expanding it to more municipalities and from a one health partnership perspective. Trying to link that data as Francesca mentioned with the human health data and also about communicating these results to stakeholders. And also try to formulate this information into policy recommendations for the government to adopt. Yes so quite many different things to do but I think that I mean you have quite sure like that it has been a quite I mean a progress so it's. I mean looking really forward to see what if this can be sustained and then also upscale because in some activity it's only a pile. Okay, so I don't see any other questions I think that maybe we can close here for this part. And then so Sean in any case, well, just to remember that the people will be watching also the video so you might get some questions like also after from people that have not participated in the online. I'm happy to receive questions. Thank you very much for really like yet telling us about the story in people less. And it has been a pleasure to have you and then really, I mean, again, very excellent presentation or very clear and good luck for the clinic in people less there also for continuing this work. Thank you, Francesca. Thank you for the invitation and nice to see all of you. Thanks. And now, if you give me the screen. I will share for the next part. Yes. Okay, so just to remind the colleague that we will have the next knowledge dissemination dialogue in this plan, the 28th of November. We will be at 930 in the morning for the one which are in Europe and it is on the meeting the invisible visible the rule of the laboratories to tackle antimicrobial resistance. And that will be on me. And then just remind you that please, we will send the feedback questionnaire if you can complete it will be, I mean, this helps us to improve for next time. And then for any question, you can also contact us including if you have some interesting finding or like interesting research study that you would like to share with us so please contact and then you might be the next speaker. So thank you very much to all of you for attending this and then, again, Sean very thank you to you for participating also because it's quite late in Australia. And I wish you a good rest of the day and then see you next time. Bye.