Overview of Day 1. Dr. Alex Costa World Health Organization. National AMR Workshop Phnom Penh, Cambodia May 2014

Transcription

1 Overview of Day 1 Dr. Alex Costa World Health Organization National AMR Workshop Phnom Penh, Cambodia May 2014

2 SESSION 1: GLOBAL AND REGIONAL AMR SITUATION

3 Introduction to Antimicrobial Resistance (Alex Costa) Antimicrobial Resistance (AMR) is possibly the single biggest threat facing the world in the area of infectious diseases. Treatment options for common infections are running out while development of new antimicrobial drugs is limited. Antimalarial drug resistance is a global threat that is being addressed by Cambodia. MDR-TB and XDR-TB are growing problems in Cambodia and the government is taking strong measures to control it. Antibiotic resistance around the world and in Cambodia have reached alarming levels and it requires an urgent response. 3 AMR Situation in Cambodia

4 Global and regional AMR Situation (John Stelling) High levels of resistance to common antibiotics were reported in all continents in both healthcare facilities and in the community. Treatment options for common infections are running out Antibacterial resistance has a negative effect on patient outcomes and health expenditures Most countries do not have a national policy, coordinating mechanism or any national action plan to contain AMR Over the counter sales of antimicrobials is common in the Western Pacific region Most countries are not measuring the use of antibiotics Despite limitations, the global report demonstrates high prevalence of antibiotic resistance worldwide and surveillance gaps 4 AMR Situation in Cambodia

5 AMR Situation in Vietnam (Heiman Wertheim) History of AMR program in Vietnam VINARES project: develop an antibiotic stewardship program Antibiotic consumption in hospitals Antibiotic resistance in communities Antibiotic dispensation/sales in pharmacies Antibiotic use in agriculture and animals Surveillance and data sharing is possible in SE Asia Community/agriculture should not be left out MoH and MARD are key to the solution, but need funds to implement Implementation requires microbiology data, databases, quality assurance Besides surveillance, a clear need for interventions Stop the use of last resort antibiotics in agriculture Control human use without restricting it 5 AMR Situation in Cambodia WE CAN NOT ONLY KNOW - WE MUST ALSO DO

6 National antimicrobial resistance surveillance and current AMR situation in Thailand (Wantana) Development of the National Antimicrobial Resistance Surveillance (NARST) system o Road map for development of a laboratory-based surveillance system of antimicrobial resistance. Current AMR situation in Thailand o Growing trend of antibiotic resistance to many antibiotics Systematic infection control and antibiotic stewardship are urgently needed. Guideline for treatment of bacterial infections. National Plan on AMR. 6 AMR Situation in Cambodia

7 SESSION 2: AMR SITUATION IN CAMBODIA

8 AMR Country Situation Analysis in Cambodia (Dr Bun Sreng) Country situation analysis: Develop a comprehensive, financed national plan to combat AMR Strengthen surveillance and laboratory capacity Ensure uninterrupted access to essential medicines of assured quality Regulate and promote the rational use of medicines in human health Regulate and promote the rational use of medicines in foodproducing animals Enhance Infection Prevention and Control Reversal of AMR is possible 8 AMR Situation in Cambodia

9 Economic Burden of Antimicrobial Resistance: The Cambodian Situation (Dr Rasul Baghirov and Cory Peddigrew) Macro Health Financing Situation In Cambodia Antibiotic use and Expenditure Challenges of Estimating the Economic Burden of AMR: - Perspective, Assumptions - Data / Cost Issues Cambodia: Next Steps 9 AMR Situation in Cambodia

10 Activities of DDF-MoH to Improve the Quality of Medicines in Cambodia (Heng Bun Kiet) Current situation of drug distribution channels, drug outlets and drug registration in Cambodia How to ensure the quality of medicines Summary of actions taken and joint collaboration with antieconomic crime police in confiscating counterfeit and smuggled medicines Raising awareness about quality of medicines Possible factors facilitating the circulation of Counterfeit and Substandard Medicines 10 AMR Situation in Cambodia

11 Access to Essential Medicines in Cambodia (Oudam Roath) Actions to Improve Access to Medicines Guide for actions Rational Selection Affordable Price Sustainable Financing Reliable supply systems Challenges to accessibility to medicines 11 AMR Situation in Cambodia

12 Antibiotic stewardship program (Erika Vlieghe) Develoment of a hospital stewardship program: 1. Multidisciplinary team 2. Collect data 3. Priorities 4. Make and implement guidelines 5. Permanent activities 6. Intermittent activities 12 AMR Situation in Cambodia

13 AMR Surveillance and Laboratory Capacity (Dr Sau Sokunna) History of laboratory system in Cambodia Progress against IHR/APSED capacity development Lab capacity in Kampong Cham Key challenges 13 AMR Situation in Cambodia

14 SESSION 3: MANAGING AMR IN CAMBODIA

15 Emergency Response to Artemisinin Resistance in Greater Mekong Subregion (ERAR) (Dr Bayou Fatunmbi) Antimalarial drug resistance continues to pose great threats to the achievement of the malaria elimination targets around the world Lessons learned from Cambodia had informed the Emergency Response to Artemisinin Resistance (ERAR) in the GMS as well as the Global Program Political commitment and intensified efforts by all is needed 15 AMR Situation in Cambodia

16 Managing Antimalarial Resistance in Cambodia (Dr Lek Dysoley) History of Antimalarial Drug Resistance Key Strategies to manage Antimalarial Drug Resistance in Cambodia Antimalarial drug resistance poses a great threat to the achievement of the malaria elimination targets Concerted efforts by governments and partners and stakeholders, including manufacturers, in and around affected areas should be intensified 16 AMR Situation in Cambodia

17 Programmatic management for drug resistant TB in Cambodia (Dr Khann Sokhan) Global burden of TB/DR-TB TB/DR-TB Burden in Cambodia Interventions to prevent DR-TB in Cambodia Interventions against DR-TB in Cambodia 17 AMR Situation in Cambodia

18 Antibiotic resistance in Cambodia 18 AMR Situation in Cambodia Source: European Center for Disease Prevention and Control

19 Antibiotic resistance in Cambodia Variability in data coming from different hospitals/facilities Different samples Different epidemiology of the hospital Variations in methodology Alarming levels of resistance of indicator and pathogenic bacteria to various classes of antibiotics 19 AMR Situation in Cambodia

20 Contamination by commensal and pathogenic microorganisms along the chicken value chain, and antimicrobial resistance, (Yith Vuthy) Evidence of contamination at various stages of the chicken slaughter chain, including high contamination of E. coli Some bacteria presented worrying AMR profile ( e.g. ESBL resistant profile) Need to improve awareness of AMR among farmers and veterinary authorities Promote better hygiene practices at primary production and chicken slaughter chain Need to establish systems to collect and share information on hazards offered by animal populations 20 AMR Situation in Cambodia

21 Thanks

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