WHO - AMR Global Overview and Action Plan

AMR Global Overview and Action Plan

Dr Khanchit Limpakarnjanarat

WHO Representative to Indonesia

Seminar on AMR, Balai Kartini, 5 August 2015

World Health Organization | 05-Aug-20152 |

Presentation OutlinePresentation Outline

1. Global and Regional Overview

2. The Global Action Plan on AMR

3. Framework for Action on AMR

4. Summary


AMR …..(1)AMR …..(1) Irrational use is main driver of selection pressure that

contributes to Antibiotic resistance:– 50% antibiotics are prescribed inappropriately;– 50% patients have poor compliance;– 50% of populations do not have access to essential

antibiotics;– 50% of antibiotics in some countries are used for animal growth promotion;


AMR…..(2)AMR…..(2)

Alexander Fleming, inventor of Penicillin (1881–1955)

* http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-lecture.pdf

“ The time may come when penicillin can be bought by anyone in the shops. Then there is a danger that the ignorant man may easily under dose himself and by exposing his microbes to non lethal quantities of the drug

make them resistant..” (Alexander Fleming, Nobel Lecture, Dec 11, 1945)*

http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-lecture.pdf




Global and Regional Overview…(1)Global and Regional Overview…(1)

“This (AMR) is the single greatest challenge in infectious diseases today….This is happening in all parts of the world, so all countries must do their part to tackle this global threat.”

“While there is a lot to be encouraged by, much more work needs to be done to combat one of the most serious global health

threats of our time ”… Dr Keiji Fukuda ,WHO’s ADG for Health Security



In 2013, there were estimated 480,000 new cases of MDR-TB globally with 210,000 deaths. 3.5% of new and 20.5% of previously treated TB cases are estimated to have MDR-TB. On average, an estimated 9% of people with MDR-TB have XDR-TB.

As of 2010, pre-treatment resistance to HIV among adults were about 5%. Since then, reports suggesting that pre-treatment resistance is increasing, peaking at 22% in some areas;



High proportions of antibiotic resistance in bacteria that cause common infections (e.g. urinary tract infections, pneumonia, bloodstream infections);

A high percentage of hospital-acquired infections are caused by highly resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) or multidrug-resistant Gram-negative bacteria.




Invention of New Antibiotics

Will it be the End of the Road?

Golden Era of Antibiotics Invention

Only few new ABs were invented



WHO report on Worldwide country situation analysis (April ‘15) focusing to country progress on: Comprehensive, financed national plan with

accountability and civil society engagement. Surveillance and laboratory capacity; Access to essential medicines of assured

quality; Regulation and promotion of rational use of

medicines, and ensure proper patient care; Infection prevention and control; Innovation, research and new tools.


WHO Report 2015Countries Involved in the Analysis

WHO Report 2015Countries Involved in the Analysis

http://apps.who.int/iris/bitstream/10665/163468/1/9789241564946_eng.pdf?ua=1&ua=1




WHO Report 2015(i) Countries with Financed National Plan

WHO Report 2015(i) Countries with Financed National Plan

45%


WHO Report 2015(ii) Countries with Surveillance and Lab Capacity….(1)


No and % of Member States that had conducted AMR surveillance




Member States which developed reports on surveillance for antimicrobial resistance (in the past 5 years)

36%


WHO Report 2015(iii) Access to Quality-assured Antimicrobial Medicines…(1)


Countries with National Regulatory Authority

81.8%

54.5%63.6%




No and % of Member States that had a list of essential medicines


WHO Report 2015(iv) Use of Antimicrobial Medicines

WHO Report 2015(iv) Use of Antimicrobial Medicines

%

%

%

%


WHO Report 2015(v) Promotion of Public Awaraness on AMR

WHO Report 2015(v) Promotion of Public Awaraness on AMR

No. and % of Member States that had conducted a campaign about use of antimicrobial medicines in the previous 2 years

45.4%


WHO Report 2015(vi) Infection Prevention and Control Programme

WHO Report 2015(vi) Infection Prevention and Control Programme

63.6%81.8%


The Global Action Plan on AMR…(1)The Global Action Plan on AMR…(1)

Rationale: AMR (including antibiotic resistance, the most urgent drug resistance trend) is occurring everywhere in the world, compromising the ability to treat infectious diseases.

Goal: to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.

Has been endorsed at 68th WHA (2015)


The Global Action Plan on AMR…(4)The Global Action Plan on AMR…(4)

The five strategic objectives :1. Improve awareness and understanding of AMR

(OneHealth);

2. Strengthen the knowledge and evidence base through surveillance and research (human and animal);

3. Reduce the incidence of infection (IPC);

4. Optimize the use of antimicrobial agents (action plan); and

5. Develop the economic case for sustainable investment in new medicines, diagnostic tools, vaccines and other interventions (med, diagnosis, vaccine).


INDONESIA: Way ForwardINDONESIA: Way Forward

1. Advocate to all stakeholders – AMR is a global issue;

2. Adapt the Global AMR Action Plan into a comprehensive National AMR Action Plan;

3. Develop necessary policies and regulations to support the implementation of National AMR Action Plan;

4. Resource mobilization to adequately finance the National AMR Action Plan;

5. Actively engage all relevant ministries and bodies within the government, private institutions, International agencies, Professional Organizations, NGOs, CSOs and wider-community to implement the National Action Plan.


SummarySummary

AMR is a serious threat to global public health; AMR is caused natural phenomenon that is propagated by

several factors that can be prevented; AMR threatens the prevention and treatment of infections that

may lead to higher morbidity, mortality and economic loss; AMR - The Global Action Plan is reference to develop

‘Country Action Plans’ involving all relevant government sectors and society;

AMR Program M&E to measure effectiveness; AMR can be effectively tackle by International collaboration.


THANK YOUTHANK YOU

WHO - AMR Global Overview and Action Plan

Health & Medicine

world health organization

amr global overview

health security

serious global health

global threat

global action plan

invention of new antibiotics

resistant bacteria