9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Introduction to the Global AMR Action
PlanDr Danilo Lo Fo WongProgramme Manager
Antimicrobial Resistance
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Antibiotic resistance
• WHO meetings, consultations, workshops in 1971, 1977, 1981, 1982, 1994, 1996, 1997, 1998, 1999, 2002, 2004, 2008, 2009
• World Health Assembly resolutions in 1986, 1988, 1990, 1992, 1994, 1996, 1998, 2001, 2005, 2007, 2009
• WHO global strategy for containment of antimicrobial resistance published in 2001
• Despite progress, strategies for containment not widely implemented
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Renewed global efforts
• Centralized secretariat at WHO HQ (December 2011)
• WHO Global AMR Task Force
• AMR Strategic and Technical Advisory Group (STAG)
• High-level awareness raising, e.g. World Health Assembly
AMR Side Events2012 – hosted by Sweden, Ghana2013 – hosted by Sweden, UK2014 – hosted by Netherlands, UK and Turkey
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Global AMR Action Plan
• Resolution adopted at World Health Assembly (May 2014)
• Call for Global Action Plan by WHA 2015
• Stakeholder and public engagement
• Technical consultations– AMR surveillance (Dec ’12, Mar ’14, Sep ‘14)
– STAG (Sept ‘13, Apr ’14, Oct ‘14, Feb ‘15)
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Global AMR Action Plan
• Online consultation– 4 July to 1 September 2014
– Contributions from MS, NGOs, Private, Academia, Int Organizations
• High-level ministerial meetings– Netherlands (June 2014)
– Norway (Nov 2014)
– Sweden (Dec 2014)
• Submit to World Health Assembly 2015
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Global AMR Action Plan
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Guiding principles
• Whole-of-society engagement
• Actions based on best available knowledge and evidence
• Prevention first
• Access not excess
• Sustainability
• Incremental targets for implementation
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Five strategic objectives:
1. Improve awareness and understanding
2. Strengthen the knowledge and evidence base
3. Reduce the incidence of infection
4. Optimize the use of antimicrobial medicines
5. Develop the economic case for sustainableinvestment
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Framework for actionhttp://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_20-en.pdf
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Implementing, monitoring and evaluation• Countries to develop and implement national action plans
– “building blocks”
– National priorities, circumstances
• WHO to develop monitoring & evaluation framework– Reporting every 2 years
• Other stakeholders to develop own action plans and report within normal reporting cycle
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
European strategic action plan on antibiotic resistance (2011 – 2016)
• WHO European action plan adopted by all 53 Member States
• Recognizing
– AMR neglected in many countries of the region
– No systematic AMR surveillance in large part of the Region
– Need for intersectoral coordination
– International spread through travel and trade
– Need for international standards and data sharing
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Action Plan Strategic Objectives1. Strengthen intersectoral coordination
2. Strengthen surveillance of antibiotic resistance
3. Promote rational use and strengthen surveillance of antibiotic consumption
4. Strengthen infection prevention and control and surveillance in health care settings
5. Prevent emerging resistance in veterinary and food sectors
6. Promote innovation and research on new drugs
7. Improve awareness, patient safety, and partnership
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Implementation activities• Country situation analysis
– Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Kyrgyzstan, Moldova, Tajikistan, Turkmenistan, Uzbekistan
• National AMR workshops
– Belarus, The former Yugoslav Republic of Macedonia,Georgia, Moldova, Serbia, Turkey, Uzbekistan
• International AMR workshops– November 2013, Bilthoven, The Netherlands
– July 2014, Tbilisi, Georgia
– February 2015, Copenhagen, Denmark
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Central Asian and eastern European Surveillance of
Antimicrobial Resistance (CAESAR)
European Centre for Disease Prevention and Control World Health Organization Regional Office for Europe
Countries submitting data to CAESARCountries visited for CAESAR participationCountries to be visited for CAESAR participationCountries participating in EARS-Net
European Antimicrobial Resistance Surveillance Network
(EARS-Net)
Expanding AMR surveillance throughout Europe
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Expanding AM use surveillance throughout Europe
European Surveillance of Antimicrobial Consumption Network (ESAC-Net)
WHO/Europe-ESAC Project Group
European Centre for Disease Prevention and Control World Health Organization Regional Office for Europe
Countries which reported 2011 data to WHOCountries in the process of collecting dataCountries invited to joinCountries participating in ESAC-Net
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Infection prevention and control• SAVE LIVES: Clean Your Hands - WHO's
global annual campaign
• 2014 – link to AMR
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Kgs. Lyngby, Denmark
AMR in the food chain
• Booklet: AMR from a food safety perspective
• National workshops– Albania, Tajikistan, Uzbekistan, Turkmenistan
• Subregional workshops– Balkans (Albania), Central Asia (Kazakhstan)
• Advisory Group on Integrated Surveillance of AMR (AGISAR)
• World Health Day 7 April 2015
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Materials:• Infograph
• Website
• Video
• Press release
• Presentation
Activities• Country events (press conferences, seminars)
• EC/ECDC/WHO twitter chat
Awareness day
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Campaign support
Call for proposals (April 2014)‐ Template, SMART objectives, selection criteria
Proposal review (May 2014)‐ Panel of expert partners (WHO, RIVM, ECDC, BAPCOC)
Grants awarded (ARM, BIH, GEO, KGZ, MKD, MNE, SRB)‐ Implementation June 2014 to February 2015
Workshop (February 2015)‐ Exchange experiences and expertise
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Kgs. Lyngby, Denmark
Partnership
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
Acknowledgments
• Division of Communicable Disease, Health Security & Environment
– Guenael Rodier– Cristiana Salvi– Siff Malue Nielsen
• AMR Coordination– Danilo Lo Fo Wong– Nienke van de Sande-Bruinsma– Saskia Nahrgang
• Food Safety– Hilde Kruse
• Health Systems and Public Health– Hans Kluge
• Health Technologies and Pharmaceuticals
– Hanne Bak Pedersen– Nina Sautenkova
• Influenza & other Respiratory Pathogens– Caroline Brown
• Vaccine Preventable Diseases & Immunization
– Robb Butler– Catharina de Kat-Reynen
• Alert and Response Operations– Ana Paula Coutinho
9th EURL-AR Workshop 201523 - 24 April 2015
Kgs. Lyngby, Denmark
No action today… No cure tomorrow
Thank you for your attention