presentation: antimicrobial resistance
Post on 07-Jul-2018
224 Views
Preview:
TRANSCRIPT
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
1/36
Combating AntimicrobialResistance
Dr Klara Tisocki
Coordinator for Essential Medicines and Health Technologies,WHO Regional Office for the Western Pacific
18 April, 2016, Manila
ADB seminarDisclaimer: The views expressed in this paper/presentation are the views of the author and do notnecessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board ofGovernors, or the governments they represent. ADB does not guarantee the accuracy of the dataincluded in this paper and accepts no responsibility for any consequence of their use. Terminologyused may not necessarily be consistent with ADB official terms.
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
2/36
Overview
The Global Threat of AntimicrobialResistance
Global Action Plan on Antimicrobial
Resistance
Ongoing Work in the Region to Contain Antimicrobial Resistance
Feed-back from Tokyo AMR meeting
Summary (Photo by CDC)
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
3/36
The “miracle” of antibiotics
2. Armstrong GL et al, JAMA 1999;281(1):61-66
Crude mortality rates for all causes, noninfectious causes and
infectious diseases over the period 1900-1996.
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
4/36
Antibiotics
Antibiotics the pillar of basic
health care and modern medicine
Wound
infections
Urinary
tract
infections
PneumoniaBlood
infections
Gonorrhoe
aPreterm
babies
Complicate
d deliveries
Hip
Replaceme
nt
Organ
Transplants
Cancer
Treatment
Maternal and
child health
Modern
medicine
Basic
health care
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
5/36
Antibiotics: precious but diminishing resource
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
6/36
A Global Health Security Threat
Antimicrobial resistance has an impact on the health of globalpopulations, food safety, the environment and the economy.
The prevention and control of antimicrobial resistance is complex
which requires multi-sectorial collaboration between:
human health care, animal health,
agriculture, food safety, food production, and
environmental protection sectors.
http://ecdc.europa.eu/http://www.oie.int/https://www.google.com/url?q=http://www.environmentalgovernance.org/featured/2013/10/fao-publishes-state-of-food-insecurity-2013/&sa=U&ei=5NwuU5LFHO-20QXi_IHAAQ&ved=0CC8Q9QEwAQ&usg=AFQjCNG8dF54fyo_x32GjUPvpngsmYYCPAhttps://www.google.com/url?q=https://plus.google.com/%2Bwho&sa=U&ei=o9wuU8CyFqPF0QX36YCwBg&ved=0CC0Q9QEwAA&usg=AFQjCNHAj-LL9iWj25jQxWyu8L6v09dObw
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
7/36
AMR on the international agenda
Global Health Security Agenda: GHSA Antimicrobial Resistance Action Package(GHSA Action Package)
APEC Enhancing Health Security – International campaign program to control
antimicrobial resistance in the Asia-Pacific
ASEAN AMR is a priority in ASEAN post 2015 development Agenda
G7 Leaders statement on AMR June 2015
Berlin declaration of G7 Health Ministers October 2015 and
Asia Pacific Health Ministers meeting on AMR – 16 April 2016
recommendation to go to G7 summit in Japan May 2016
September 2016: G20 Leaders Meeting , UN General Assembly
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
8/36
Estimates of Burden of Antibacterial
Resistance
European Unionpopu lat ion 500m
25,000 deaths per year
2.5m extra hospital days
Overall societal costs( € 900 million, hosp. days)
Approx. €1.5 billion per year
United Statespopu lat ion 300m
>23,000 deaths
>2.0m illnesses
Overall societal costsUp to $20 billion direct
Up to $35 billion indirect
Source: ECDC 2007 Source: US CDC 2013
Thailand populat ion 70m
>38,000 deaths
>3.2m hospital days
Overall societal costsUS$ 84.6 –202.8 mill. direct
>US$1.3 billion indirect
Source: Pumart et al 2012
Global information is insufficient to show complete disease burden impacts and costs
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
9/36
The world stands on the edge of a post-
antibiotic era…..
“A post -antibio t ic era means , in effect, an end tomodern medic ine as we know i t. Things as commonas strep throat or a child’s scratched knee couldonce again kill.”
9
Dr Margaret Chan
(WHO)
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
10/36
Antimicrobial resistance- where do we fail?
Final threat to Modern MedicineNo effective treatment for serious pathogens
EconomyNo new medicine due to inadequate market incentives
Evolution
Premature resistance due to inappropriate use
EcologyAvoidable infections due to inadequate public health
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
11/36
Common Factors driving AMR across
different diseases including Tuberculosis Health system factors
o poor surveillance, poor diagnostic capacity
o poor quality antimicrobial products, unregulatedprescribing/dispensing weak infection control, lack of rapiddiagnostic tools
Behavioural factors
o patients poor adherence, self-medication, culturalpreferences/beliefs
o unclear diagnosis, financial incentives, industry promotion
Medicines factors
o long drug half-life, cross-resistance between classes, treatmentlength and complexity, monotherapy, lack of effective newcombinations
11
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
12/36
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
13/36
WHO Global Action Planendorsed at World Health Assembly on 27 May, 2015
Principles:
Whole-of-society engagement, including a one-health approach
Prevention first
o good sanitation, hygiene and infection prevention and control
Ensure Access
o preserve the ability to prevent and treat infections
Sustainability
o all countries to have a National Plan by 2017
Incremental targets for implementationo different states for different countries
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
14/36
Th d f liti l it t
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
15/36
The need for political commitments
international cooperation
International problem with
unknown magnitude
Multisectoral problem -
cross-sectoral interventions
Conservation of effectiveness ofantibiotics = global public good
Health security/ economic &
development threats
High level sustained politicalattention to AMR globally,regionally
National cross-sectoral
commitments to implementnational plans on AMR
Sustained financing ofinvestments for newproducts (diagnostics,medicines)
Globally, regionallycoordinated efforts tochange attitudes,behaviours, health systempractices to tackle AMR
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
16/36
AMR in SDGs? - It is not there!
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
17/36
SDG GOAL 12: Sustainable production & consumption
SDG GOAL 2: Hunger and food securitySDG GOAL 3: Health & UHC
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
18/36
Antimicrobial Resistance
Awareness
andAdvocacy
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
19/36
UHC
Building resilient health system to contain
AMR - UHC
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
20/36
UHC
‘One Health’
‘One Health’ – a multisectoral approach to AMR
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
21/36
UHC
‘One Health’
SDGs
Containment of AMR as a Development Agenda
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
22/36
UHC
‘One Health’
SDGs
GOVERNANCE OF AMR as a development agenda
National, Regional and Global actions to
contain AMR
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
23/36
UHC
‘One Health’
SDGs
GOVERNANCE OF AMR as a development agenda
Enhance R&D(new antibiotics and
diagnostics)
Nationa
l
Region
alGlobal
Harmonization ofsurveillance and
regulations
National ActionPlan on AMR
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
24/36
Governance of AMR Philippines
AO 42 series of 2014 – Creation of an Inter-Agency Committee for the Formulation
and Implementation of a Nat Action Plan to Combat AMR in the Philippines
Co Chairs: Dept of Health and Dept of Agriculture
Members: Dept of Trade and Industry, Dept of Interior and Local Govt, Dept ofScience and Technology
Key Stakeholders
- Other Government Sectors: Dept of Education, Commission on Higher Education
- Academe: association of deans, national student groups
- Professional Societies: Professional Regulatory Boards and med societies- Civil Societies and Patient Organizations: Med Transparency Alliance, Phil Assoc
of Patient Organizations
- Pharmaceutical Industry organizations
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
25/36
Governance of AMR Japan
MHLWMinistry of Health,
Labour andWelfare
MAFFMinistry of
Agriculture,Forestry and
Fisheries
FSC/CAOFood SafetyCommission,Cabinet Office
Cabinet Secretariat (CAS)
- Coordination Office of Measures on Emerging InfectiousDiseases
- Office of Healthcare Policy
MEXTMinistry of Education,
Culture, Sports,Science andTechnology
MOFAMinistry of
Foreign Affairs
MOEMinistry of theEnvironment
NIIDNational
Institute ofInfectiousDiseases
NCGMNational
Center forGlobal
Health andMedicine
NVALNational
Veterinary Assay
Laboratory
PMDAPharmaceutical and Medical
Devices Agency
AMEDJapan
Agency forMedical
Researchand
NARONational
Agricultureand FoodResearch
Organization
FAMICFood and
AgriculturalMaterialsInspection
Center
JICAJapan
InternationalCooperation
Agency
FRAFisheriesResearch Agency
Prime Minister’s Office
- Ministerial Meeting on Measures on Emerging InfectiousDiseases
25
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
26/36
Progress on National comprehensive actionplan on AMR in the Region
1. Launch of National Plans on AMR :
• Japan April 2016
• Philippines - (2015)
• Australia (2015)
• Cambodia (2015)
• Fiji (2015)
• Viet Nam (2013)
2. In progress:
• Republic of Korea
• Samoa• Cook Island
• Lao and others
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
27/36
Progress on AMR
2. Support antimicrobial stewardship training
Philippines
Lao People’s Democratic Republic
Mongolia
3. Actions towards the Development of aGlobal AMR Surveillance System GLASS
Target: assess impact and trends of AMR
Surveillance standards defined
Surveillance manual developed
Information platform soon to be launched
Country enrolment to start in 2016
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
28/36
WHO’s ongoing work in the Region
4. WHO promoted World Antibiotic Awareness Week 16-22November 2015:
2015 Theme - Antibiotics: Handle with Care
21+ Countries in the Region participated
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
29/36
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
30/36
Ministerial Communique
Control of Antimicrobial Resistance requires coordinatedstrategies involving multiple sectors:
o Human health
o Animal health
o Agriculture, food safety, food production
o Environmental protection sectors
Call for collective action at the national, regional and global
level
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
31/36
Asia Pacific
Technical Consultation on AMR in Asia 14-15 April, Tokyo, Japan
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
32/36
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
33/36
Tokyo AMR Communique, Health Ministers 12 countries
Acknowledge the urgent need for:
Increased advocacy, education and awareness-raising activities involving all
stakeholders in relevant sectors about AMR and the responsible use of antimicrobials; Accelerated progress towards universal health coverage (UHC) to ensure access
to quality essential health-care services and to promote access to safe, quality,
effective and affordable antimicrobial medicines, diagnostics and vaccines for all,
including antimicrobials under proper measures to preserve their effectiveness;
Cross-cutting, multisectoral “One Health” approaches in all countries, involvingdifferent stakeholders, such as human and veterinary medicine, agriculture,
aquaculture, the environment and others, as appropriate to enable collaborative action
to minimize AMR and attain optimal health for humans and animals;
Global, regional and national cooperation and collaboration to preserve the
effectiveness of antimicrobials as a global public good;
Implementing and monitoring regulations, including production, distribution and use
of vaccines, diagnostics and antimicrobials for both human and animal use;
Accelerated research and development (R&D) in AMR, including the development
of new antimicrobials, diagnostics and vaccines;
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
34/36
Do hereby declare launching an “Asia-Pacific One HealthInitiative on AMR” to jointly identify and tackle challenges posed by
AMR in the Asia-Pacific region by drawing a roadmap to actualize the
regional frameworks on AMR in the following priority areas of work:
Surveillance system and laboratory network; Health-care management;
Antimicrobial access and regulation;
Research and development;
Tokyo AMR Communique, Health Ministers 12 countries
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
35/36
Summary
The antimicrobial resistance threat is already affecting
all countries. Every day people die from infections that do not
respond anymore to antibiotics.
Collaborative action is needed by public healthofficials, politicians, scientists, healthcare professional,agriculture sector, and health care industry
We all have the responsibility to
take action.
-
8/18/2019 PRESENTATION: Antimicrobial Resistance
36/36
Thank you
Dr Klara Tisocki
Coordinator Essential Medicines and Health TechnologiesWHO Western Pacific Regional Office
tisockik@wpro.who.int
www.wpro.who.int/topics/drug_resistance/en/
36
top related