The National Action Plan on Antimicrobial resistance in Vietnam Period from 2013 to 2020

Transcription

1 The National Action Plan on Antimicrobial resistance in Vietnam Period from 2013 to 2020 Ha Ngo Thi Bich Medical Service Administration Ministry of Health of Vietnam

2 MINISTER OF HEALTH DEPUTY MINISTER NGUYỄN THỊ XUYÊN DEPUTY MINISTER LÊ QUANG CƯỜNG DEPUTY MINISTER PHẠM LÊ TUẤN DEPUTY MINISTER NGUYỄN THANH LONG DEPUTY MINISTER NGUYỄN VIẾT TIẾN CABINET MEDICAL SERVICE MOTHER & CHILD HEALTH TRADITIONAL MEDICINE PREVENTIVE MEDICINE HIV/AIDS CONTROL SCIENCE, TECHNOLOGY & EDUCATION DRUG MANAGEMENT HEALTH EDUCATION HEALTH ENVIROMENT HEALTH INSPECTION HEALTH LEGISLATION POPULATION & FAMILY PLANNING INTERNATIONAL COOPERATION HEALTH INSURANCE INFORMATION TECNOLOGY PLANING & FINANCING ORGANIZATION & HUMAN RESOURCE

3 Public Hospital Network MINISTRY OF HEALTH Tertiary 42 MoH's hospitals beds 11,6 % total beds 63 PROVINCIAL DEPARTMENT Secondary 420 Provincial Hospitals beds 49.7% 641 DISTRICT HEALTH BUREAU First Medical Referral 614 Dítrict Hospitals beds 30,4% COMMUNITIES Primary care Commune Health Centre

4 Introdution The extent and rate of drug resistance are increasing. The burden of drug resistance: increased cost of treatment, days of hospitalization last, high morbidity and mortality, ect. The problem of drug resistance is becoming more emergency and requires the efforts of society to prevent this situation. Responding to the call of the World Health Organization: no action today, no cure tomorrow National Action Plan on antimicrobial resistance period from 2013 to 2020 have issued (Decision No. 2174/QD-BYT June 21, 2013).

5 The National Action Plan on AMR Part one: RATIONAL Background Practical basis The legal basis Part two: THE CONTENT OF THE PLAN Goal Activities Part Three: SOLUTIONS Part four: IMPLEMENTATION

6 The reality In the community, the majority of antibiotics are sold without a prescription: urban (88%) and rural (91%). Infection of bacterial resistance often fail to conventional therapy, prolonged treatment, increasing the cost and risk of death. In cultivation and livestock antibiotics are used to stimulate the growth or prevention and treatment of disease, if that is not controlled it would cause great risk to the environment and human health due to drug resistance.

7 Treatment by antibiotic 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% KS không thích hợp KS thích hợp 84% 74% 67% 33% 26% 16% Tổng cộng E.coli hay Klebsiella Acinetobacter hay Pseudomonas Unappropriate use of antibiotic is 74% and appropriate one is 26% (similar to results of Kollef et al. in 1998 (73.3%)) MSA s research in at 19 hospitals in HN, HCM, HP

8 Bacteria s resistance Figure 2. Resistance rates for four common Gram-negative bacteria isolated from routine clinical sample (sputum, urine, blood, pus) in hospitalized patients, MoH,

9 Type of hospital infection & common isolated bacteria Hospital infection: pneumonia by machine or not, septicaemia Negative gram bacteria, include Acinetobacter spp, Klebsiella pneumonia, Pseudomonas aeruginosa, E. coli

10 Goal Promote activities to prevent drug resistance, contribute to improving the quality and effectiveness of the prevention and control of epidemics, treatment to protect, care and improve people's health. Activities Raising awareness of the community and health workers on drug resistance Enhance, improve capacity of the national surveillance system for antibiotic use and antimicrobial resistance Ensuring adequate supply of quality essential drugs Improve safe and rational use of medicine Strengthen infection control Part two: CONTENT Strengthen safe, appropriate antibiotic use in livestock, poultry, aquaculture and cultivation.

11 Part three: SOLUTIONS 1. Policy, mechanism and management 2. Information, communication and education 3. Technical expertise and training 4. Finance 5. Scientific research and international cooperation

12 Challenges Workforce development limited Awareness of population, health workers, policy makers Cooperation mechanism between MoH and MoARD Capacity of microbiological laboratories remains weak in both quantity and quality. The quality of medicine is not been controlled closely Poor infection control practices Misuse, overuse of antibiotic and treatment of diseases caused by not bacteria, lack of data on resistant bacteria Buy antibiotic without physician s prescription

13 Solutions Set up the National Steering Committee on AMR including MoH and MoARD. Set up subcommittee for surveillance AMR in community and health facilities Guideline on antibiotic use issued Guideline for Antimicrobial Stewardship Program in hospital developing. Survey of the reality of human resource, qualifications, equipments of all microbiological departments in the whole country. Developing a Circular regulating functions and duties for microbiological laboratory in hospital is

14 Solutions Implementing communication plans to raise awareness of the population and health workers about AMR (radio, TV spot, news, meeting, to parade the streets) Strengthening activities of infection control in hospitals Establishment a national surveillance network on AMR Closely co-ordination between treatment system and preventive medical one Enhancing technical assistance and financing of the development partners such as WHO, FAO, OIE, UK, CDC.US, Sweden, ect.

15 Antibiotics are a precious resource We need to preserve this resource by working together

16 Thank you for your attention!