First-year experiences in implementing Thailand s National Strategic Plan on AMR 2017-2021 Dr. Nithima Sumpradit Food and Drug Administration Ministry of Public Health, Thailand Regional Workshop on AMR in South-East Asia Penang, Malaysia 26-28 March 2018
Talk outline Prior to National Strategic Plan on AMR Development of NSP-AMR Implementation of NSP-AMR Monitoring and Evaluation of NSP-AMR Examples of Actions The ways forward
Prior to the National Strategic Plan on AMR Infection Prevention and Control (IPC) National Infection Control Committee (NICC) National AMR Surveillance Center, Thailand (NARST) Formal education / training programs for ID doctors, pharmacists and ICN /veterinary professionals Regulations on antimicrobials, animal feeds and food Initiatives in promoting appropriate use of antibiotics National Policy on EID National Policy on Medicine But, the rates of AMR is still on rise.
Gap identification 1. No national coordination & no political engagement 2. Poor awareness on AMR esp. in policy makers & the public Policy-driven approach Public-driven approach 3. Inadequate evidence e.g., size and cause of problems Research-driven approach 4
I. Principles in tackling AMR challenges in Thailand Policy-driven approach (National Strategic Plan on AMR 2017-2021) Researchdriven approach (RTG-WHO CCS-AMR Program 2017-2021) One-Health approach (Human-Animal- Environment) Public-driven approach (National Health Assembly Resolution on AMR, 2015)
Development of National Strategic Plan on AMR
A full engagement of multisectoral partners 16 months for development Endorsed by the Cabinet on August 17, 2016.
Thailand s National Strategic Plan on AMR 2017-2021 Goal 1. Morbidity due to AMR reduces by 50% 2. Antimicrobial use in human reduces by 20% 3. Antimicrobial use in animal reduces by 30% 4. Public awareness on AMR and optimal AM use increases by 20% 5. AMR management systems achieves level 4 of JEE Strategy 1: AMR surveillance under One- Health approach Strategy 2: Control of antimicrobial distribution Strategy 3: IPC & antimicrobial stewardship in hospital, clinic & pharmacy Strategy 4: AMR prevention & antimicrobial stewardship in agriculture & animals Strategy 5: Public awareness on AMR & optimal use of antimicrobials Strategy 6: Governance & coordination mechanism at policy level to execute AMR national action plan 8
Implementation of National Strategic Plan on AMR
Political Commitment UNGA (Sep 2016) Thailand (Chair of G77) by PM delivered a speech on behalf of G77 and China to support the UNGA resolution on AMR.
Prime Minister launched the mission Thailand marks the spot to stop AMR Royal Thai Government House (Nov 2017)
Deputy Prime Minister signed the declaration on Call-to-Action on AMR, Thailand
The Declaration of Call-to-Action on AMR was co-sponsored by 25 organizations (23 November 2017)
National Policy Committee on AMR (Chaired by Deputy PM) 1. Sub-com on AMR strategy 2. Sub-com on AMR surveillance under One-Health Approach 3. Sub-com on reducing AMR impacts in hospitals 4. Sub-com on AMR prevention and control in agriculture and animals 5. Sub-com on awareness and behavioral change re AMR Tripartite: Ministry of Public Health, Ministry of Agriculture and Cooperatives & Ministry of Environment and Natural Resources
Strategies 1. AMR surveillance under One- Health approach 2. Control antibiotic distribution 3. IPC and AM stewardship in hospitals, clinics, pharmacies 4. AMR control and prudent use in agriculture and animal Examples of actions Examples of Action GLASS implementation Establishment of a center for AMR surveillance under One-Health approach Drug withdrawn e.g., oral colistin (human) Reclassification of antimicrobials -Pharmacist-dispense drugs e.g., amoxicillin -Prescription drugs e.g., colistin inj. (human) Good Pharmacy Practice (GPP) Integrated AMR management System in hospitals Model development on Antibiotic-free farm 5. Public awareness Antibiotics Smart Use Program Antibiotic Awareness Week
Monitoring, Evaluation & Research to support the implementation of National Strategic Plan on AMR Royal Thai Government WHO Country Cooperation Strategy 2017-2021
Monitoring and Evaluation 5 Goals Development of M&E system Baseline data Morbidity due to AMR -National Point Prevalence Survey -National AMR Detection and Response System (on-going) Q4 of 2018 Antimicrobial use in human Thai Surveillance of Antimicrobial Consumption (Thai-SAC) (on-going) Q4 of 2018 Antimicrobial use in animal Thai-SAC (on-going) Q4 of 2018 Public awareness on AMR and optimal AM use Health Welfare Survey (2017) Yes AMR management systems achieves level 4 of JEE Joint External Evaluation Tool (JEE) on AMR (2017) Yes
The ways forward Strengthen & Maintain AMR at the high-level policy The inside-out and outside-in momentum Multisectoral collaboration Initiate Wider stakeholder engagement Research stakeholder mapping & research prioritization Deal with Constraint of human and financial resources Competing interest
More information
www.amrthailand.net
First National Forum on AMR (31 Jan 2018)