WORKSHOP AGENDA. Coordinated Research Initiative for the Implementation of Antimicrobial Resistance Control Strategies (CTI A (SCSC))

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Coordinated Research Initiative for the Implementation of Antimicrobial Resistance Control Strategies (CTI 25 2014A (SCSC)) Day 1 Awareness Objective: Enhance awareness, skills and knowledge in the field of AMR (focused on bacterial antimicrobial resistance), as a worldwide emerging issue in public health. Topic Speaker Details 8:30 9:00 Workshop registration 9:00 9:45 Official inauguration of the workshop Welcome speech Section Nº1: Workshop Presentation National authorities: Jaime Burrows Undersecretary of Health. Claudio Ternicier, Undersecretary of Agriculture. Santiago Urcelay, Dean, FAVET. Michel Leporati, Executive Secretary, ACHIPIA.

Andres Culagovski, Head of APEC Department, DIRECON. 9:45-10:00 Presentation of the project objectives Javiera Cornejo, FAVET Descriptions of the objectives for APEC project Coordinated Research Initiative for the Implementation of Antimicrobial Resistance Control Strategies 10:00 10:30 The Challenges and Importance of Integrated AMR Surveillance Patrick McDermott, FDA 10:30 10:50 Coffee break Section Nº2: The Antimicrobial Resistance Challenge 11:00 11:30 Animal production role in antimicrobial resistance, AGISAR initiative Enrique Perez, OPS 11:30 12:00 OIE standards and actions related to Antimicrobial Resistance Martin Minassian, OIE A brief overview will be provided on the challenges of developing integrated surveillance systems for AMR in the food supply. Description of the WHO's effort to minimize the public health impact of antimicrobial resistance associated with the use of antimicrobials in food animals. A short presentation of the OIE as an international standard setting body, describing standards an current actions in the field of AMR 12:00-12:20 FAO vision on AMR Deyanira Barrero, FAO 12: 20 12:50 Codex Approach to AMR Rebecca Irwin, CIPARS A brief overview will be provided on the Codex Guidelines For Risk Analysis of Foodborne Antimicrobial Resistance CAC/GL 77-2011 12:50-13:00 Questions 13:00 14:20 Lunch break 14:30-15:00 WHONET and the role of laboratory- John Stelling, Harvard A discussion of the complementary role of multi-level

based surveillance of antimicrobial resistance at local, national, and global levels WORKSHOP AGENDA University 15:00 15:40 Antimicrobial Stewardship in veterinary medicine Jaap Wagenaar, Utrecht University 15:40 16: 00 Questions 16:00 16:20 Coffee break 16:30-17:00 Antimicrobial resistance in aquaculture Peter Smith, University of Ireland 17:00 17:30 The path towards an integrated surveillance program of AMR Enrique Perez, OPS integrated surveillance to characterize and track evolving microbial populations to support clinical-decision making, outbreak detection, response preparedness, advocacy, public health policy, research, and capacity-building. Also a brief history of WHONET software and collaborations. Coordinated interventions designed to improve and measure the appropriate use of antimicrobials in veterinary medicine. Antibiotic therapy is an essential component of the farming of aquatic animals and resistance to antibiotics is the major factor limiting the success of such therapy. Data on the susceptibility or resistance of the bacteria isolated from aquatic animals is essential if economically sound, rational and prudent decisions are to be made in the choice of agent to use on farm. Responsible use of antibiotics also requires that the frequencies of resistance consequent of antibiotic use are regularly monitored. The use of internationally standardised testing methods and consensus derived interpretive criteria are essential if meaningful susceptibility data is to be obtained. The setting and performance of these standard methods will be discussed Description of the capacity building activities related to integrated surveillance of antimicrobial resistance (training

courses and technical support to set up national programs on integrated surveillance of antimicrobial resistance) and on collection of antimicrobial usage data 17:30-17:45 Survey Results: Status of Integrated AMR Surveillance Lisette Lapierre, FAVET General results of the survey carried out to gather the information or this project 17:45 18:00 Questions Day 2 Where are we? Objective: Strengthen technical competence of APEC economies representatives working in the areas related with AMR. This objective will be addressed by the lectures given by the invited experts that will participate in the workshop; these experts will provide APEC economies representatives with the tools to address this public health problem in order to work towards harmonized and standardized methodologies. Increase understanding of the control strategies of emergence and spread of AMR that have been used by other economies in the region and international organizations in order to improve economies control measures and regulatory oversight of this hazard. Topic Speaker Details Section Nº3: Surveillance and Monitoring Systems, National and International Guidelines 8:30 8:45 AMR situation in Indonesia Imron Suandy, Indonesia Brief description of the antimicrobial resistance situation in Indonesia Action plans on AMR with livestock in Mintra Lukkana, Thailand Brief description of the antimicrobial 8:45-9:00 Thailand resistance situation in livestock in Thailand 9:00-9.:15 AMR situation in Chile Juan Carlos Hormazabal, ISP Brief description of the antimicrobial

9:15 9:45 The U.S. National Antimicrobial Resistance Monitoring System (NARMS) 9:45 10:15 Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) WORKSHOP AGENDA Patrick McDermott, FDA Rebecca Irwin, CIPARS resistance situation in Chile Description of the U.S. NARMS program and its role in evaluating resistant foodborne bacteria. Established in 2002 CIPARS monitors resistance and antimicrobial use along the food chain. 10:15 10.45 Rational use of antimicrobials in Chile Betty San Martin, FAVET Brief description of the antimicrobial situation of antimicrobial use in Chile 10:45 11:15 Coffee break 11:20-11:40 Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS) Genetics and spread of antimicrobial resistance 11:40-12:00 12:00 12:30 Global survey of AMR surveillance and external quality assurance programs Pilar Donado, CORPOICA Ricardo Castellanos Tang, Utrecht University John Stelling Harvard University The COIPARS program was a established a s a pilot project to monitor AMR on poultry farms, slaughter houses and retail markets. Different molecular mechanisms can be responsible for the development of antimicrobial resistance. Harmonized tools for genetic analyses can help to understand the mechanisms of acquired resistance and its transfer amongst bacterial species and production sectors, and its geographical spread. A summary of national, regional, and global AMR surveillance and EQA programs.

12:30 13:00 Interventions to reduce antimicrobial usage EFFORT: joining forces against antimicrobial resistance Jaap Wagenaar; Utrecht University 13:00-13:30 Questions 13:30 14:50 Lunch break 15:00-15.30 Towards a risk analysis of antimicrobial Peter Smith, University of Ireland use in aquaculture Details of the Ecology from Farm to Fork Of microbial drug Resistance and Transmission (EFFORT) proyect. The use of antibiotics in the farming of aquatic animals has the potential to impact negatively on human health. Perceptions of the size of this risk will influence both the regulatory environment of global aquaculture and the acceptability of the product to the consumer and will, therefore, exert a significant effect on the economics of aquatic farming. Formal Risk Assessment is the process that attempts to provide the data that will allow the estimation of the size of the risk to move from a belief-based conjecture towards an evidence-based quantitation. A theoretical analysis will be presented that will aid in identifying the data that should be collected to facilitate a Formal Risk Assessment. 15:30 16:00 The use of whole genome sequencing Patrick McDermott, FDA A brief introduction into the power of whole

for surveillance of resistance in the food chain 16:00 16:15 Coffee break 16:20-16:50 Australia s Response to AMR and Food Steve Crossley, FSANZ Safety 16:50-17:30 From farm to fork, and across international borders: opportunities and barriers to effective intervention against antimicrobial resistance. Morgan Scott, Texas A&M University 17:30-18:00 Questions genome sequencing to characterize resistant bacteria tracked in surveillance Australia s strategy in response to the threat of AMR Integrated surveillance and food Case studies of surveillance conducted Existing and potential research agendas, in both biological and social sciences, as well as policy aspects that impact the highly complex problem of antimicrobial resistance. 18.00-20:00 Workshop Reception for All Participants

Only for APEC delegates: Day 3 How to implement a program? Objective: Build competency and capacity in AMR surveillance through knowledge transfer between APEC economies with ongoing surveillance programs and other developing APEC economies that do not have an ongoing surveillance program on this subject. Topic Speaker Details Section Nº4: Integrated surveillance programs and the challenges for their successful implementation. 9:00 10:00 Tutorial: WHONET Use and What a good platform system management must have? John Stelling, Harvard University A demonstration of WHONET s features for laboratory configuration, data entry, data analysis, and data sharing. Also the import of data from existing information systems using BacLink and recommendations about what any antimicrobial resistance data system management must have. 10:00-10:15 Working Group Session: Explanation of Constanza Vergara, ACHIPIA Instructions for the working group activity work methodology. 10:15-10:30 Coffee break 10:30 12:00 Working Group Session Rebecca Irwin Integrated surveillance of antimicrobial resistance: a perspective from Patrick McDermott developing economies that includes specific challenges of strategic

Enrique Pérez surveillance, an overview of the Latin American situation, What steps ahead in developing economies? 12:00-12:20 Group conclusion Each group will present briefly their conclusions. 12:20 12:35 Coffee break 12:40-13:00 Working Group conclusions Conclusions of the working group session 13: 00 13:15 Workshop conclusions and closure