OIE strategy on AMR and the Prudent Use of Antimicrobials

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Dr. Jocelyn Mérot OIE Sub-Regional Representation for North Africa OIE strategy on AMR and the Prudent Use of Antimicrobials 14th JPC REMESA 19-20 July 2017 Naples (Italy)

The OIE Strategy on AMR and the Prudent Use of Antimicrobials

The OIE Strategy on AMR and the Prudent Use of Antimicrobials The OIE Strategy supports the objectives established in the Global Action Plan on antimicrobial resistance (AMR), developed by WHO with a strong contribution from FAO and OIE. It reflects the mandate of the OIE, through four main objectives: Improve awareness and understanding Strengthen knowledge through surveillance and research Support good governance and capacity building Encourage implementation of international standards

1 Improve awareness and understanding Support Member Countries through the development of targeted communications and advocacy materials Promote awareness of AMR through Veterinary Statutory Bodies and Veterinary Education Establishments to encourage a professional culture that supports the responsible and ethical use of antimicrobials in animals Continue to support professional development goals by conducting workshops, conferences and symposia that promote the prudent use of antimicrobials and address the issue of AMR Expand the portfolio of OIE guidance, education and scientific reference materials Collaborate with WHO and FAO to ensure alignment and coordination of policy and advocacy initiatives World Organisation for Animal Health Protecting animals, Preserving our future 4

2 1 Strengthen knowledge through surveillance & research Support Member Countries in developing and implementing monitoring and surveillance systems Build and maintain a database for collecting data on the use of antimicrobial agents in food-producing and companion animals, with associated analysis and annual reporting Enhance the development, use and functionality of WAHIS to allow analysis of data on antimicrobial use Guide and support research into alternatives to antibiotics to encourage the development and uptake of new tools, products and methodologies Identify and pursue opportunities for public-private partnerships in AMR research and risk management World Organisation for Animal Health Protecting animals, Preserving our future 5

2 13 Support good governance and capacity building Provide assistance to Member Countries in developing and implementing National Action Plans, promoting a One Health approach Provide tools and guidance to assist Member Countries in their AMR risk assessment initiatives Ensure Veterinary Services have the capacity to implement OIE international standards, through engagement in the PVS Pathway Support Member Countries to develop and modernise legislation governing the manufacture, marketing authorisation, importation and distribution and use of veterinary products Provide regular training of Focal Points on Veterinary Products Ensure that well-trained veterinarians and veterinary paraprofessionals are at the forefront of national and regional efforts World Organisation for Animal Health Protecting animals, Preserving our future 6

2 4 1 Encourage implementation of OIE standards Support Member Countries in their efforts to implement OIE standards Disseminate and encourage adoption of recommendations in the OIE List of Antimicrobials of Veterinary Importance Strengthen multilateral support for implementation of OIE standards among policy makers Build on the success of the OIE standards development work programme to continue to advance for the animal sectors our comprehensive framework of quality, science-based standards that support the Global Action Plan on AMR Collaborate with WHO and FAO to support the development of a comprehensive and aligned framework of standards and guidelines across human health, animal health, agriculture and the food chain World Organisation for Animal Health Protecting animals, Preserving our future 7

The One Health approach

The ONE HEALTH approach ONE HUMANS, H EECOSYSTEMS and A ANIMALS LLIVING TOGETHER T H HARMONIOUSLY

OIE standards and guidelines related to antimicrobial resistance (AMR)

Standards and guideline related to antimicrobial resistance OIE Terrestrial Animal Health Code Section 6. Veterinary Public Health Chapter.6.6. Introduction to the recommendations for controlling antimicrobial resistance Chapter 6.7.Harmonisation of national antimicrobial resistance surveillance and monitoring programmes Chapter 6.8.Monitoring of the quantities and usage patterns of antimicrobials agents used in food producing animals Chapter 6.9.Responsible and prudent use of antimicrobial agents in veterinary medicines Chapter 6.10. Risk analysis for antimicrobial resistance arising from the use of antimicrobial agents in animals http://www.oie.int/international-standard-setting/terrestrial-code/access-online/

Standards and guideline related to antimicrobial resistance OIE Aquatic Animal Health Code Section 6. Antimicrobial use in aquatic animals Chapter.6.1. Introduction to the recommendation for controlling antimicrobial resistance Chapter 6.2. Principles for responsible and prudent use of antimicrobial agents in aquatic animals Chapter 6.3. Monitoring of the quantities and usage patterns of antimicrobial agents used in aquatic animals Chapter 6.4. Development and harmonisation of national antimicrobial resistance surveillance and monitoring programmes for aquatic animals Chapter 6.5. Risk analysis for antimicrobial resistance arising from the use of antimicrobial agents in aquatic animals http://www.oie.int/international-standard-setting/aquatic-code/access-online/

Standards and guideline related to antimicrobial resistance Manual of Diagnostic Test and Vaccines for Terrestrial Animals Part 3. Specific Recommendations Chapter 3.1 Laboratory methodologies for bacterial antimicrobial susceptibility testing http://www.oie.int/international-standard-setting/aquatic-code/access-online line

Standards and guideline related to antimicrobial resistance OIE List of Antimicrobial Agents of Veterinary Importance Adopted in the 75th General Session in May 2007, but further updated and adopted in May 2013 and May 2015 by the World Assembly of OIE Delegates. VCIA Veterinary Critically Important Antimicrobial Agents Both Criteria 1 and Criteria 2 VHIA Veterinary Highly Important Antimicrobial Agents Criteria 1 or Criteria 2 VIA Veterinary Important Antimicrobial Agents Neither Criteria 1 or 2 http://www.oie.int/fileadmin/home/eng/our_scientific_expertise/docs/pdf/eng_oie_list_antimicrobials_ May2015.pdf

Standards and guideline related to antimicrobial resistance OIE List of Antimicrobial Agents of Veterinary Importance Any use of antimicrobial agents in animals should be in accordance with the OIE Standards on the responsible and prudent use laid down in the Chapter 6.9. of the Terrestrial Animal Health Code and in the Chapter 6.3. of the Aquatic Animal Health Code. Recommendations of restricted use VCIA Veterinary Critically Important Antimicrobial Agents Not to be used as preventive treatment applied by feed or water in the absence of clinical signs in the animal(s) to be treated. Not to be used as a first line treatment unless justified, when used as a second line treatment, it should ideally be based on the result s of bacteriological tests. Extra-label/off label use should be limited and reserved for instances where no alternatives are available. Such use should be in agreement with the national legislation in force.

First OIE Annual report on the use of antimicrobial agents in animals: Better understanding of the global situation

Contents (extracts) 3. Global analysis General information Quantity of antimicrobial agents reported 4. Analysis by OIE Region (first phase) General Information by OIE Region Africa Americas Asia and the Pacific Europe Middle East http://www.oie.int/fileadmin/home/eng/our_scientific_expertise/docs/pdf/amr/survey_on_monitoring_ antimicrobial_agents_dec2016.pdf

Conclusions information provided represents a remarkable first step in better understanding the global use of antimicrobial agents in animals OIE Member Countries expressed desire to further increase transparency on the use of antimicrobial agents in animals around the world need to provide additional support to Member Countries to improve their national monitoring systems allow countries to provide their information through an electronic portal http://www.oie.int/fileadmin/home/eng/our_scientific_expertise/docs/pdf/amr/survey_on_monitoring_ antimicrobial_agents_dec2016.pdf

TECHNICAL ITEM 1 Global action to alleviate the threat of antimicrobial resistance: progress and opportunities for future activities under the One Health initiative

OIE 85th General Session-May 2017 Technical Item 1: with questionnaire (sent to 180 OIE Members) Global action to alleviate the threat of antimicrobials resistance: progress and opportunities for further activities under One Health initiative The Objectives of the Technical Item were to: 1.Strengthen OIE s commitment to the global initiative against AMR 2.Monitor the implementation of OIE Strategy by OIE Member Countries 3.Better understand needs of Members Countries and expectations for OIE support Video/presentation available =>

OIE Resolutions 38 (2017) Resolution 38 Global action to alleviate the threat of antimicrobial resistance: progress and opportunities for future activities under One health initiative The OIE review the List of antimicrobial agents of veterinary importance including considering the purposes for use of antimicrobial agents in animals... The OIE complement the specific standards and recommendations on laboratory methodologies for antimicrobial susceptibility testing to determine bacterial resistance and interpret the test results in the context of AMR, working with WHO and FAO to achieve integrated surveillance. The OIE put in place tools to monitor the actions undertaken to implement its strategy on AMR, while also taking into account the evaluation developed in collaboration with its Tripartite partners and future work of the UN IACG

OIE s ongoing AMR work programme 1.Monitoring programmes for implementation of GAP and OIE Strategy 2.Prudent Use communication campaign to empower veterinarians 3.Improve the Global Database collection and analysis on use of antimicrobial agents in animals more information on type of use, animal groups and route of administration develop denominator for more valid comparison 4.Ongoing development and maintenance of OIE Standards Key definitions: therapeutic use, preventive use and growth promotion Species-pathogen combinations for surveillance (core set) 5.OIE 2nd Global Conference on AMR and the Prudent Use of Antibiotics in 2018 (TBC)

A multi-sectorial group created to address antimicrobial resistance issues at high level

The Interagency Coordination Group (IACG) on Antimicrobial Resistance was convened by the UN Secretary-General, according to General Assembly Resolution A/RES/71/3, in which the group will report to the Secretary-General during the 73rd session of the UN General Assembly. The group of 28 members, including representatives of relevant organisations such as OIE, is jointly chaired by the UN Deputy Secretary-General and the Director-General of WHO. The tripartite Secretariat including an OIE staff member is hosted in Geneva. It will provide practical guidance for approaches needed to ensure sustained effective global action to address antimicrobial resistance, including options to improve coordination, taking into account the global action plan on antimicrobial resistance

Reporting back to the 73rd Session of the United Nations by September 2019 Major actions expected include: Mapping activities against the Global Action Plan for Tripartite, other UN agencies, and the wider stakeholder community (NGOs, private sector) Monitoring framework for Global Action Plan and National Action Plans Stakeholder engagement system to provide channels for dissemination of information and coordination of activities Effective advocacy to retain awareness of AMR at the highest international and national political levels http://www.who.int/antimicrobial-resistance/interagency-coordinationgroup/iacg-firstmtgreport.pdf

OIE AMR Communication Campaign

A dedicated page about AMR on the OIE website

OIE communication tools on AMR

Communication AMR questionnaire In the framework of the global action plan on Antimicrobial Resistance and as part of its AMR strategy, the OIE is developing a communication campaign aimed at encouraging veterinarians and animal health players all around the world to collect data about antimicrobial use in animals and to apply the OIE standards on the prudent and responsible use of antimicrobial agents. OBJECTIVES 1. Help you transferring the knowledge in your country about the responsible and prudent use of antibiotics. 2. Understand the communication habits in your country to deliver the most adapted communication material for transfer of knowledge locally. 3. Better understand your needs (main actions to focus on, main targets, main messages, ) we will endeavour to provide you with communication materials to ensure efficient transfer of knowledge to your main local targets.

Section 1 : Informations 1 - To help us know you and to stay connected, please fill in the fields in the form below : NAME COUNTRY POSITION EMAIL WEBSITE

Section 2 : Actions in your country 2 Please rank the following actions about AMR according to their importance to communicate on in your country (Rank in order of importance from 1 to 7, where 1 is the most important, and 7 the least important) Good governance of veterinary services Implement standards in national legislation on the prudent use of antibiotics Train future veterinarians on the prudent use of antibiotics (initial curriculum) Train veterinarians and para-veterinarians (continuous education) Improve the level of laboratories Ensure quality control of circulating antibiotics in your country National programs of surveillance and monitoring of AMR

Section 3 : Targets in your country 3.1 - The transfer of knowledge is essential to achieve our OIE strategy on AMR. How important are the following communication targets for AMR in your country? (Please, rank in order of importance from 1 to 7, where 1 is the most important, and 7 the least important) Competent authorities Veterinary pharmaceutical industry Veterinarians & Para-veterinarians Food animal producers Animal feed manufacturers Veterinary education establishments General Public

Section 4 : Communication MATERIAL for transfer of knowledge in your country 4 Have you ever used printed material (leaflet, brochures, poster, ) in previous communication campaigns? (if you did not, please go directly to Section 5) Yes No

Section 4 : Communication MATERIAL for transfer of knowledge in your country 4.1 - Did you send postal letters in previous communication campaigns? (if you did, please select one or more targets reached with this communication material) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this type of communication material

Section 4 : Communication MATERIAL for transfer of knowledge in your country 4.2 - Did you use printed brochures or guidelines in previous communication campaigns? (if you did, please select one or more target reached with this communication material) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this type of communication material

Section 4 : Communication MATERIAL for transfer of knowledge in your country 4.3 - Did you use printed leaflets in previous communication campaigns? (if you did, please select one or more target reached with this communication material) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this type of communication material

Section 4 : Communication MATERIAL for transfer of knowledge in your country 4.4 - Did you use posters in previous communication campaigns? (if you did, please select one or more target reached with this communication material) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this type of communication material

Section 5 : Communication EVENTS for transfer of knowledge in your country 5 - Did you ever set up physical meetings in the framework of previous communication campaigns implementation? (if you did not, please go directly to section 6) Yes No

Section 5 : Communication EVENTS for transfer of knowledge in your country 5.1 - Did you organize continuous education training events in previous communication campaigns? (if you did, please select one or more targets attempting this event) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 5 : Communication EVENTS for transfer of knowledge in your country 5.2 - Did you organize regional professional meetings (informative meeting, group discussion, etc) in previous communication campaign? (if you did, please select one or more targets attempting this event) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 5 : Communication EVENTS for transfer of knowledge in your country 5.3 - Have you ever had a stand (booth) in a national meeting or congress in previous communication campaigns? (if you did, please select one or more targets attempting this event) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Students Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.1 - Did you ever use media in previous communication campaigns? (if you did not, please go directly to the question 6.2) Yes No

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.1.1 - Did you use press advertising in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.1.2 - Did you use radio spots or interviews as a communication channel in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.1.3 - Did you use press releases or press books sent to national and regional medias in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.2 - Did you ever use digital, web and mobile channels in previous communication campaigns? (if you did not, please go directly to section 7) Yes No

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.2.1 - Did you send emails or newsletters in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.2.2 - Did you develop a website in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.2.3 - Did you sent text messages to your target s mobile phone in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.2.4 - Did you use Whatsapp as communication channel in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 6 : Communication CHANNELS for transfer of knowledge in your country 6.3 - Did you use movies as communication channel in previous communication campaigns? (if you did, please select one or more targets reached by this communication channel) Competent Authorities Pharmaceutical Industry Yes, for Veterinarians & Para-veterinarians Education Establishments Yes, for the General Public No, I did not use this communication channel

Section 7 : Habits in your country 7 - What is the Internet access situation in your country? (select one or more situations that described your country situation) My targets have an easy and good access to internet My targets use internet mainly on a computer My targets use Internet mainly on a mobile My targets have an easy acces to Wifi My targets have an easy acces to connected mobile My targets use facebook My targets use twitter My targets use youtube My targets use Whatsapp My targets have no (or little) access to internet

Section 8 : Your involvement in the new AMR campaign 8 - Do you want to be involved in the preparation and / or test of a new OIE AMR COMMUNICATION CAMPAIGN? Yes No

Section 8 : Your involvement in the new AMR campaign 8.1 In order to help us better understand the communication habits in your country and to deliver the most adapted communication material, we are collecting as much documentation as possible on any previous campaigns on this AMR topic, implemented by your services, veterinary authorities, veterinary education establishments, veterinary pharmaceutical industries... For exemple : advertising campaigns, leaflets, brochures, newsletters, website adress Please, send us all your previous communication material on this email adress : amr.oie@life-ah.com

Thank you for your attention Dr. Jocelyn Mérot 12, rue de Prony, 75017 Paris, France www.oie.int media@oie.int - oie@oie.int