Dr Liz Tayler Antimicrobial Resistance Secretariat Global action plan on antimicrobial resistance

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1 Global Action Plan on Antimicrobial Resistance Dr Liz Tayler Antimicrobial Resistance Secretariat

2 Resistance was foreseen early The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant many may easily under dose himself, and by exposing his microbes to non lethal quantities of the drug make them resistant Alexander Fleming Nobel Lecture 1945

3 Technical concerns and attempts to address AMR 1959 WHO scientific gorup on antibiotics research recommends studies on resistance WHO scientific working group on antimicrobial resistance report included guidelines for the appropriate use of antibiotics 2001 WHO Global strategy for containment of antibiotic resistance 2011 World Health Dat Antimicrobial resistance No action today, no cure tomorrow Policy package 2012 The evolving threat of antimicrobial resistance, Options for action 2015 Global Action Plan endorsed 2016 UN General Assembly

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5 Five strategic objectives: 1. Improve awareness and understanding (WAAW) 2. Strengthen knowledge through surveillance & research 3. Reduce the incidence of infection (IPC\Sanitation) 4. Optimize the use of antimicrobial medicines 5. Ensure sustainable investment (R&D) National Action Plans

6 Implementation GAP: Guiding Principles 1. Realistic & achievable objectives 2. Take into account different capacities of Member States 3. Involve FAO and OIE, where appropriate 4. All-inclusive approach (HIV, TB and malaria) 5. Joint ownership between HQ and Regions 6. Communication!

7 Implementation GAP: 10 work streams 1. Global communications campaign (Liv Lawe-Davies) 2. Support National Action Plans of MS (Carmem Pessoa) 3. Global Antimicrobial Resistance Surv System (Carmem Pessoa) 4. Support measures to improve IPC (Benedetta Allegranzi) 5. Monitor use & enhance stewardship of antibiotic use (Gilles Forte) 6. Encourage R and D and explore new business models (Peter Beyer 7. Improve Point of Care diagnostics (Francis Moussy) 8. Address the Environmental Drivers (Kate Meddlicott) 9. Vaccines to prevent AMR (Martin Friede) 10.One Health Liaison (Awa Aidara Kane) Additional HTM NTD STI Maternal Health Workforce.

8 Development of new technologies Identification of R&D gaps & needs Clarify scope: Medicines, diagnostics, vaccines, other interventions R&D has to financed De-Linkage underlying principle which disincentives excess use, allows public control and lower prices

9 Resolution WHA 68.7 Requests the to develop options for establishing a global development and stewardship framework to support the (1) development, (2) control, (3) distribution and (4) appropriate use of new antimicrobial medicines, diagnostic tools, vaccines and other interventions, while preserving existing antimicrobial medicines, and promoting affordable access to existing and new antimicrobial medicines and diagnostic tools, taking into account the needs of all countries, and in line with the global action plan on antimicrobial resistance, and to report to the Sixty-ninth World Health Assembly

10 Access for millions. of people without antimicrobials. Development of new antimicrobials Stewardship to maintain effectiveness of existing drugs Based on Hoffman et al. (2015)

11 Access without conservation & innovation will speed resistance Development Innovation without access is unjust, and without conservation wasteful Stewardship can constrain access and undermine innovation Based on: Hoffman et al. (2015)