AMR Presentation_WR SM_Final1 - Dr Khanchit

7/24/2019 AMR Presentation_WR SM_Final1 - Dr Khanchit

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AMR Global Overview

and Action Plan

Dr Khanchit Limpakarnjanarat

WHO Representative to Indonesia

Seminar on AMR, Balai Kartini, 5 August 2015


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World Health Organization |05-Aug-20152|

Presentation Outline

1. Global and Regional Overview

2. The Global Action Plan on AMR

3. Framework for Action on AMR4. Summary


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AMR..(1)

Irrational use is main driver of selection pressure thatcontributes to Antibiotic resistance:

50%antibiotics are prescribed inappropriately;

50%patients have poor compliance;

50%of populations do not have access to essentialantibiotics;

50%of antibiotics in some countries are used for

animal growth promotion;


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AMR..(2)

Alexander Fleming, inventor of Penicillin (18811955)

lecture.pdf-/fleming1945www.nobelprize.org/nobel_prizes/medicine/laureates/://http*

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


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Global and Regional Overview(1)

This (AMR) is the single greatestchallenge 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

encou raged by, much more work

needs to b e done to combat one

of the most serious global heal ththreats of our time Dr Keiji Fukuda,

WHOs ADG for Health Security


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In 2013, there were estimated 480,000new 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;


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High proportions of antibiotic resistance in bacteria thatcause 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.


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Invention of New Antibiotics

Will it be the End of the Road?

Golden Era of

Antibiotics Invention

Only few new ABs

were invented


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WHO report on Worldwide countrysituation 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.


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WHO Report 2015

Countries Involved in the Analysis

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WHO Report 2015

(i) Countries with Financed National Plan

45%


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WHO Report 2015

(ii) Countries with Surveillance and Lab Capacity.(1)

No and % of Member States that had conducted AMR surveillance


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WHO Report 2015

(ii) Countries with Surveillance and Lab Capacity.(2)

Member States

which developed

reports on

surveillance for

antimicrobial

resistance (in the

past 5 years)

36%


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

Countries with National Regulatory Authority

81.8%

54.5%

63.6%


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WHO Report 2015(iii) Access to Quality-assured Antimicrobial Medicines(2)

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


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WHO Report 2015

(iv) Use of Antimicrobial Medicines

%

%

%

%


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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%


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WHO Report 2015(vi) Infection Prevention and Control Programme

63.6%81.8%


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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 68thWHA (2015)


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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 investmentin new medicines, diagnostic tools, vaccines and other

interventions (med, diagnosis, vaccine).


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INDONESIA: Way Forward

1. Advocate to all stakeholdersAMR 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.


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Summary

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.


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THANK YOU

AMR Presentation_WR SM_Final1 - Dr Khanchit

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