global action plan on antimicrobial resistance - oecd amr 2015.pdf · global action plan on...

Global action plan on antimicrobial resistance

Global Action Plan on

Antimicrobial Resistance

Dr Marc Sprenger

Director Antimicrobial Resistance Secretariat


When are we entering the post-antibiotic era?

For some diseases we have already entered!

Fatal pneumonia because antibiotics are not working (K. pneunomiae)

Fatal infection with Neisseria gonorrhoeae


What is the cost of not taking action?

• By 2050, AMR could lead to

• 10 million deaths every year

• reduction of 2%-3.5% in GDP globally

• Between now and 2050, the world can expect to lose

US$ 600 to US$ 100 trillion worth of economic output


Global Action Plan on Antimicrobial Resistance

One year in development

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


0

10000000

20000000

30000000

40000000

50000000

60000000

2014-2015 2016-2017 USD

Increase in WHO organization-wide budget for AMR


AFRO

EMRO

EURO

Headquarters

SEARO

WPRO

AMRO/PAHO

Financial projections for 2016-2017:

distribution by WHO Regional Office

Total: USD 53,792,873


Five 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


Five strategic objectives, my translation:

1. EAAD / WAAW: handle AB with care

2. Set up lab and surveillance and report

3. Good IPC in hospital

4. AB: only prescription & instruction & duration

5. Invest in R&D


Implementation of the GAP Guiding Principles

1. Realistic and achievable objectives

2. Work streams approach

3. Take into account different capacities of Member States

4. Involve FAO and OIE, where appropriate

5. All-inclusive approach (HIV, TB and malaria)

6. Joint ownership between HQ and regions when possible

7. Coordination and alignment across WHO (monthly meetings with

Global Technical Coordination Group)


Implementation of the GAP Organizational structure

Global Policy

Group

Steering Group

HQ & RO technical

staff

Technical

Coordination Group

AMR Coordinating

Secretariat

Marc Sprenger

Director

Liz Taylor

Technical Officer

Ellen Attafuah

Assistant

Pravarsha Prakash

Technical Officer

Katie Barker

Technical Officer


AMR Steering Group


Implementation of the GAP Role of the WHO Steering Group

Make high-level recommendations and decisions need

to implement AMR policy

Agree WHO work plan on AMR

Implementation plan proposal for donors and partners

Organization-wide resource mobilization strategy

Prioritize activities and address budget and funding

allocation

Provide guidance to the Technical Coordination Group

Meet quarterly


Implementation of the GAP

Nine work streams

1. Launch and maintain a global communications campaign

2. Support MS in developing their National Action Plans

3. Global Antimicrobial Resistance Surveillance System (GLASS)

4. Support measures to improve infection prevention and control (IPC)

5. Monitor use and enhance stewardship of antibiotic use

6. Encourage R&D and explore new business models

7. Improve point of care diagnostics

8. Address the environmental drivers

9. Engage the United Nations General Assembly


Implementation of the GAP National action plans

In May 2015: 34 out of 133 responding countries have

a national action plan on AMR

By May 2017: all Member States to have plans aligned with the GAP

WHO is supporting Member States by:

- developing tools and templates & training material

- working with ROs and COs to roll out activities and plans in Member States

- developing a monitoring and evaluation framework

- collecting data on the status of national action plans

- reporting back to WHA by 2017


2015: Launch global awareness campaign

• conduct baseline public survey on current understanding and

awareness of antibiotic resistance and self-reported

behaviours related to antibiotics

• launch 'Antibiotics: Handle with care' campaign

• mark the first World Antibiotic Awareness Week (WAAW)

2016: Strengthen global awareness campaign; groundwork

for behaviour change programme

• adoption of WHA resolution to make WAAW an official annual

observance; all Regions to actively participate

• conduct targeted research among health & ag profs and

policy makers on their awareness and understanding of

antibiotic resistance, self-reported behaviours and

willingness to change

• develop a globally-applicable module for a behaviour change

programme, building on the global awareness campaign and

results of current pilot testing the Tailoring of Antimicrobial

resistance Programme (TAP) in the WHO European Region

2017: Pilot test behaviour change programme

• Pilot test and evaluate the behaviour change module in 2

countries in each WHO Region

• conduct second global public survey to measure

trends/changes in public awareness, understanding and

behaviours

• provide comms support for WAAW and launch of major

technical reports, e.g. on national action plans and GLASS

Evolution of the campaign: 2015 – 2017


1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010

Salvarsan

Penicillin

Sulfonamide

Streptomycin Bacitarin

Nitrofurans

Chloramphenicol

Polymyxin

Cholrtetracycline

Cephalosporin

Pleuromutilin

Erythromycin

Isoniazid

Vancomycin

Streptogramin

Cycloserine

Novobiocin

Rifamycin

Metronidazole

Nalidixic acid

Trimethoprim

Lincomycin

Fusidic acid

Fosfomycin

Mupirocin

Carbapenem

Oxazolidinone

Monobactam

Daptomycin

No new antibiotic

class discoveries

Antibiotic class discoveries in 20th century


Gobal Action Plan: Project on R&D

Possible deliverables to start with:

1. Tracking of resource flows for R&D through global health R&D

observatory, including annual report on pipeline

2. Report on role and possible priority vaccines

3. Report on options for global development & stewardship

framework

4. Exploration of product development partnership: WHO/DNDi

proposal for a Global Antibiotic Research and Development

Facility to promote research, responsible use, and access to new

antibiotics

5. Coordination of research initiatives – under discussion


Global Antibiotic R&D Facility

Aim: A product development partnership that develops in cooperation

with private and academic partners antibiotics that focus on global

health needs,

tries to conserve them as long as possible while ensuring equitable

access for all

Part of implementation of Objective 5

DNDi ready to play role as "incubator"

Next step: WHO & DNDi Consultation, 13 November 2015, Geneva


Why was DNDi created?

To develop

and deliver treatments

With Public

and Private Funding

Conducts

research with:

Biotechnology

& Pharmaceutical

Industries

Universities

For underprivileged pat

ients

Ministries

of Health Public Research

Institutions


DNDi’s success is only possible through innovative partnerships

Universities & Research Institutes

PDPs

Int. Org. & NGOs

Biotechs

CROs

Pharmaceutical

companies

CRITERIA FOR SUCCESS •Share the same vision •Mutual understanding •Involvement throughout the whole process

RESEARCH

TRANSLATION

DEVELOPMENT

IMPLEMENTATION

PLATFORM MEMBER COUNTRIES

DNDi WORLDWIDE

FOUNDING PARTNERS

Business Plan 2015-2023


After 20h flight: reality check


No prescription needed, just take 2


No knowledge, no instruction


What did they tell me…

No medical microbiology lab in main hospital

No infection and prevention control in hospital

No drug regulation

No knowledge, no awareness

No money for GP

But committed local people and Country Office WHO


Thank you


WHA requests the Director-General (68.7):

Establish and resource a Secretariat

Mobilize all levels of WHO

Strengthen collaboration with FAO and OIE

Develop framework for monitoring and evaluation

Develop and implement GLASS

Establish network of WHO Collaborating Centres

Develop a global stewardship framework for use and access

Promote investment

UN General Assembly 2016

Provide support and technical assistance to countries

Report back to the WHA


Conclusion

1. Global Action Plan AMR is ambitious

2. Global Action Plan AMR: joint responsibility

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