Perspective on AnA Global timicrobial Resistance

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National Center for Emerging and Zoonotic Infectious Diseases Perspective on AnA Global timicrobial Resistance Dawn M. Sievert, PhD, MS Associate Director for Antimicrobial Resistance Division of Foodborne, Waterborne, and Environmental Diseases Centers for Disease Control and Prevention USAHA One Health Committee October 18, 2017

Global Burden of AMR

Deaths attributable to AMR every year by 2050

Every country is a global importer/exporter of AR 1 billion people cross international borders each year.

Antibiotic Resistance: Acting to Combat a Global Issue

CDC s Role in Global Efforts to Combat AMR

CDC International AMR Activities Transatlantic Taskforce for Antimicrobial Resistance technical collaborations to advance AMR programs domestically and abroad WHO Antimicrobial Resistance Collaborating Centers Using CDC expertise to help WHO develop global AMR solutions Global Health Security Agenda Engaging 17 countries to strengthen laboratories, surveillance networks and develop action plans

Trans-Atlantic Task Force on Antimicrobial Resistance Key Focus Areas & Activities Improve appropriate therapeutic use of antimicrobial drugs in medical and veterinary communities. Developing strategies to measure drug use in animals Assessing appropriate drug use in humans Prevent healthcare and community-associated drug-resistant infections. Harmonizing definitions of resistance for improved surveillance Developing strategies to translate surveillance data into prevention interventions

Trans-Atlantic Task Force on Antimicrobial Resistance Key Focus Areas & Activities Develop strategies for improving the pipeline of new antimicrobial drugs. Developing incentives for drug development Harmonizing and coordinating the drug approval regulatory process

CDC WHO Antimicrobial Resistance Collaborating Centers Key Activities Building international collaborations for surveillance of AMR pathogens Providing technical guidance for the laboratory detection of resistance and for implementing surveillance Improving international communication of new or emerging AMR pathogens

A Challenge - Improving Global AMR Data The first WHO GLASS Report described insufficient AMR surveillance data in many parts of the world

GHSA AMR Action Package Prevent avoidable catastrophes 5-Year Target: Integrated and global package of activities to combat AMR Antimicrobial Resistance Desired Impact: Enhance infection prevention and control Prevent the emergence and spread of AMR, especially among drug-resistant bacteria Strengthen surveillance and laboratory capacity

Joint External Evaluation (JEE) The purpose of the JEE is to identify the most critical gaps within a country s health systems using a multi-sectoral approach; prioritize opportunities for enhanced preparedness and response; and engage with current and prospective donors and partners to effectively target resources. As of May 2017, CDC experts have participated in more than 30 JEE deployments and coordinated with host countries to translate JEE findings and recommendations into action.

CDC Collaborations on Global Work to Combat AMR Develop international guidelines and policy in partnership with WHO, Codex, OIE, and FAO

Examples of CDC s Global Work to Combat AMR Innovation & Infection Control in Vietnam Piloting shorter-course preventive therapy to reduce TB disease and slow development of resistant TB Studying latent TB management by offering testing and treatment before traveling to the United States. Establishing national AR and HAI surveillance network of 16 sites to generate critical data Developing national infection control expertise through a national Technical Advisory Group to reduce HAIs and improve containment Improving TB Diagnostics in Mexico Linking patients diagnosed with TB to care and treatment First National TB Program in China Strengthening the Chinese TB surveillance system and collaborating on lab quality assurance programs Strengthening HAI/AR Programs in India Implementing HAI and AR surveillance in 30+ sites across country to better understand AR burden Initiating programs to prevent and reduce central line associated bloodstream infections Assessing stewardship programs to improve antibiotic use

Examples of CDC s Global Work to Combat AMR ABROAD Proctor and Gamble Broad Institute, MIT NARMS & FoodNet

Examples of CDC s Global Work to Combat AMR Improve capacity to detect, investigate, and respond to enteric outbreaks in-country, around the world

Contact: dsievert@cdc.gov

Thank You! For more information, contact CDC 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.