Antibiotics and resistance in the WHO Regional Office for Europe. Dr Nienke van de Sande On behalf of the AMR Working Group

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Antibiotics and resistance in the WHO Regional Office for Europe Dr Nienke van de Sande On behalf of the AMR Working Group Strengthening the fight against antimicrobial Antimicrobial APRES resistance Symposium Resistance in Bosnia 28 Stakeholder th and of February Herzegovina: Meeting 2014 Royal Dutch current Academy situation 29 of and November Science, future Amsterdam, challenges, 2013, Tashkent, 29 The October Netherlands Uzbekistan 2013

Antibiotic resistance WHO meetings, consultations, workshops in 1971, 1977, 1981, 1982, 1994, 1996, 1997, 1998, 1999, 2002, 2004, 2008, 2009 World Health Assembly resolutions in 1986, 1988, 1990, 1992, 1994, 1996, 1998, 2001, 2005, 2007, 2009 WHO global strategy for containment of antimicrobial resistance published in 2001 Despite progress, strategies for containment not widely implemented

Renewed global efforts European strategic action plan on antibiotic resistance 2011 2016 Centralized secretariat at WHO HQ (December 2011) WHO Global AMR Task Force, Action Plan, AMR Report AMR Strategic and Technical Advisory Group (STAG) High-level awareness raising World Health Assembly 2012 Side event on AMR hosted by Sweden and Ghana World Health Assembly 2013 Side event on AMR hosted by UK and Sweden

Action Plan Strategic Objectives 1. Strengthen intersectoral coordination 2. Strengthen surveillance of antibiotic resistance 3. Promote rational use and strengthen surveillance of antibiotic consumption 4. Strengthen infection control and surveillance in health care settings 5. Prevent emerging resistance in veterinary and food sectors 6. Promote innovation and research on new drugs 7. Improve awareness, patient safety, and partnership

Action: Country assessments Country assessments Visit key Ministries, institutions, agencies, laboratories Mission report with observations and recommendations Follow-up activities Goal Appointment of National AMR Focal Point Installation of Intersectoral Coordination Mechanism (ICM) Development of national AMR action plan Setup national AMR surveillance Performed: Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Uzbekistan

Action: CAESAR Network (Central Asian and eastern European Surveillance of Antimicrobial Resistance) Network of national surveillance networks in non-eu MS Joint initiative (since October 2012) with the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) & Dutch National Institute of Public Health (RIVM) Close collaboration with ECDC (Methodology compatible to EARS-Net) CAESAR workshops: Serbia, FYR Macedonia; Turkey, Belarus Upcoming: - 2 nd CAESAR network meeting at ECCMID Barcelona, 10-13 May - First CAESAR Annual Report, November 2014

Action: Region-wide AM use data Technical workshops Training, data collection and analysis of national AM use data Member States, not part of ESAC-Net Joined initiative University of Antwerp, Belgium Close collaboration ECDC Use methodology compatible with ESAC-Net

Action: Infection control Global Infection Prevention and Control Network (GIPCN) WHO Infection control programmes SAVE LIVES: Clean Your Hands - WHO's global annual campaign 2014 link to AMR

www.who.int/gpsc/5may/en/

Action: European Antibiotic Awareness Day Materials Infograph, Website Video, Press release, Presentation Activities Country events: ALB, AZE, BLR; GEO, KAZ, KOS, KGZ, FYR MKD, MDA, MON, SRB, TJK, TUR; UZB (press conferences, seminars) - EC/ECDC/WHO twitter chat

Action: TAP Guide to tailoring AMR programmes (TAP) Towards prudent use of antibiotics in the WHO European region through targeted AMR programmes TAP For targeted AMR programmes

TAP guideline Based on the TIP (Tailoring Immunization Programmes) guideline developed by Who/Europe WHO/Europe in collaboration with RIVM Support MS with setting up targeted AMR programmes to improve the prudent use of antibiotics. Targeted programmes address a specific target audience rather than "spray campaigns" (disseminated to multiple audiences) and are country specific. TAP includes several activities that aim to achieve maintainable behaviour change (i.e. prudent antibiotic use) in target groups.

Action: CALL FOR SMALL GRANT PROPOSALS Antibiotic Awareness Campaign WHO/Europe is encouraging non-eu Member States in the European Region to apply for small grants, kindly provided by the Belgian government. Support the development and implementation of pilot campaigns or educational programmes improving infection prevention, prudent use and prudent prescription of antibiotics in non-eu countries of the Region. Educational materials, knowledge materials (e.g. promotion materials, toolkits, campaigns, TV-spots, digital media etc.) tailored to the specific country needs. Campaigns launched at the EAAD in November 2014.

Partnership (Europe)