Global Action Plan on AMR and Follow up Awa AIDARA KANE World Health Organization, Geneva, Switzerland
Alexander Fleming's Nobel Prize Lecture ex It is not difficult to make microbes resistant to penicillin. The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily under dose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant. 1929
Antibiotics: precious but diminishing resource A Team Science Approach for Protection of Animal, Human and OIE REGIONAL SEMINAR FOR FOCAL POINTS FOR VETERINARY, JAPAN, 2 4 Animal PRODUCTS Interface, International School on One Health, 3/4/2016 Ludhiana, 9 15 February 2016 3
Fuel & Potable Ethanol COMPLEXITY OF ANTIMICROBIAL RESISTANCE Fuel Ethanol Producers AQUACULTURE Sea / Lakes Drinking Water Swimming Distillers Grain By Products Land Fill Drinking water Farm Effluents and Manure Spreading Rivers and Streams SOIL Sewage Industrial & Household Antibacterial Chemicals Animal Feeds Rendering Re mix COMPANION ANIMALS SHEEP VEAL CALVES Dead stock SWINE FOOD ANIMALS OTHER FARMED LIVESTOCK CATTLE POULTRY Offal Commercial Abattoirs / Processing Plants WILDLIFE Meat Vegetation, Seed Crops, Fruit Handling Preparation Consumption HOSPITALIZED EXTENDED CARE FACILITIES HUMAN COMMUNITY URBAN RURAL TRAVELLERS Direct Contact After Linton AH (1977), modified by Irwin RJ 2012 version IMPORTS
WHO Global Action Plan (GAP) on AMR World Health Assembly, May 2014 Requests the Director General to develop a global plan WHO leads development of the plan, May to Dec 2014 With advice from experts, Member States, forums and web consultations WHO Executive Board, Jan 2015 Expresses strong support to take plan to World Health Assembly World Health Assembly, May 2015 Adopts the Global Action Plan over 50 supporting statements Passes new resolution to support action over 60 country sponsors 3/4/2016 5
Global Action Plan on AMR 3/4/2016 6
Increase in WHO organization wide budget for AMR 60000000 50000000 40000000 30000000 20000000 10000000 0 USD 2014 2015 2016 2017 3/4/2016 7
GAP Implementation: 5 Strategic Objectives 1. Improve awareness and understanding 2. Strengthen the knowledge through surveillance and research 3. Reduce the incidence of infection 4. Optimize the use of antimicrobial medicines 5. Ensure sustainable investment 3/4/2016 8
GAP Implementation: Guiding Principles Realistic and achievable objectives Work streams approach Take into account different capacities of Member States Involve FAO and OIE, where appropriate Joint ownership between HQ and regions when possible Coordination and alignment across WHO (monthly meetings with Global Technical Coordination Group) 3/4/2016 9
GAP Implementation: 10 Work Streams Global awareness campaign National Action Plan Global Antimicrobial Resistance Surveillance System (GLASS) Infection prevention and control Optimizing use of antimicrobials and regulation Innovative diagnostics for AMR Vaccines for AMR Environmental drivers of AMR Research and development and investment for AMR One Health (Cross Cutting) 3/4/2016 10
WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR) Established in 2008 Support WHO Member States to minimize the public health impact of AMR associated with the use of antimicrobials in food animals Comprised of 36 internationally renowned experts in AMR in a broad range of disciplines (microbiologists, veterinarians, physicians, epidemiologists) New Terms of Reference for 2015 2019 agreed in June 2015 (right after the GAP adaptation) in order to support the GAP implementation 3/4/2016 11
AGISAR Objectives: Support WHO on Containment of AMR from the food chain Capacity building for integrated surveillance of AMR Monitoring of antimicrobial use WHO List of critically important antimicrobials (CIA list) for human medicine FAO/OIE/WHO tripartite activities and Codex Alimentarius activities on AMR Support GAP 3/4/2016 12
AGISAR Activities: Overview Five year Strategic Framework: 5 Thematic Working Groups 1. Knowledge management and communication 2. Critically Important Antimicrobials (CIA) list 3. Optimal use of antimicrobial agents in food production (Tripartite Collaboration) 4. Laboratory methods in antimicrobial susceptibility testing 5. Data integration and analysis Capacity building in countries Training workshops Pilot Projects 3/4/2016 13
Optimal use of antimicrobial agents in food production (Tripartite Collaboration) Objectives agreed in June 2015 Ensure compliance with OIE and Codex Alimentarius standards Promote a conducive regulatory environment to ensure improved implementation and compliance Support sustainable collection of antimicrobial consumption in animals and support the OIE database Guidance for treatment protocols for first, second, and third choice of antibiotics use in animal health, based on WHO and OIE CIA Lists Help define and strengthen veterinary stewardship, taking into account OIE and Codex standards 3/4/2016 14
Building capacities in the countries: Trainings Workshops on Integrated Surveillance of Foodborne diseases and AMR Discuss the current surveillance system of foodborne diseases and antimicrobial resistance Train participants on components of successful integrated surveillance of antimicrobial resistance Practice laboratory methods for detection and identification of Salmonella, Campylobacter spp. and antimicrobial susceptibility testing "One Health "approach : Promote communication, collaboration and data sharing between microbiologists and epidemiologists from food, animal and human health sectors within and between countries Day1 Day2 Day3 Day4 Day5 Lab Epi 3/4/2016 15
Building capacities in the countries: Pilot Projects (Next call for proposal March/April 2016) Viet Nam Cambodia Peru Argentina Ecuador Paraguay Uruguay Venezuela Columbia Ghana Uganda Rwanda Kenya Tanzania Ethiopia Lebanon Bangladesh India 3/4/2016 16
1 st World Antibiotic Awareness Week, Nov 2016 Antibiotic Awareness Week http://www.oie.int/en/for the media/amr/waaw2015/ Access the WHO page dedicated to World Awareness Week 2015 http://www.oie.int/es/para los periodistas/amr es/related links es/ 3/4/2016 17 MARCH, 17 2016
LINK: http://www.who.int/dg/speeches/2015/g7 antimicrobial resistance/en/ Addressing Antimicrobial Usage in Asia's Food Animal Production Sectors: Toward a Unified, One Health Approach to Preventing and Controlling Resistance Dr Monique Eloit Director General of the OIE One Health approach WHO and OIE lists Surveillance and Monitoring 3/4/2016 PMAC SIDE MEETING BANGKOK, THAILAND, 27 28 JANUARY, 2016 18
Thank you 3/4/2016 19