180 likes | 191 Views
Explore strategies and policies for a cohesive global response to antimicrobial resistance. Learn from experts on the One Health approach, challenges in governance, and practical actions to combat AMR effectively.
E N D
Strategy and Policy Cohesion:“The One Health Agenda: will it deliver” Elizabeth J. Phillips, MD, FRCPC,FRACP, FACTM Professor & Director, Centre for Clinical Pharmacology & Infectious Diseases Institute for Immunology & Infectious Diseases, Murdoch University John A. Oates Chair in Clinical Research Professor of Medicine & Pharmacology Director of Personalized Immunology Oates Institute for Experimental Therapeutics Vanderbilt University School of Medicine
“Drugs Don’t Work”Allan Roses, December 2003VP of Genetics (GSK) >90% of drugs have efficacy in 30-50% of people
Overview of Global and National Response • Social, financial and environmental depth • Education and communication • National antimicrobial resistance response documents supporting commitment • Global antimicrobial response • Implementation – what are the measurable outcomes
The AMR One Health Policy Toolkit: Animal-Human Interface • Awareness • Surveillance (obstacles to data collection) and antimicrobial stewardship in agriculture • Education and Communication • Evidence base (decreased AMR after voluntary withdrawal) and ongoing effectiveness monitoring • Broad agricultural implications and complexity of the “AMR web” (aquaculture, the plant connection) • Alternatives to antimicrobials in agriculture • Industry and regulatory issues
Globalisation & Governance of AMR • Challenges in developing world parallel those in developed world – political & cultural considerations • Defining extent of problem, educational compaigns • Conservation of antibiotics and promote stewardship and infection control • Challenges of global demand for animal protein (antimicrobial consumption in agriculture) – need incentives to change practice, non-antibiotic approaches, infection control • AMR shows no boundaries
One Health Approach • Broadly engage • Doctors, veterinarians, farmers, industry and community • Consistent approaches • Infection prevention, optimize antibiotic utilization in human and animal sectors, new treatments and diagnostic methods • Simple messages • What can be done now? • Reinforce positive achievements, raise awareness of risk, attention to health science, social, environmental and economic issues and uncertainties surrounding all Australian Colloquium 2013
Multidisciplinary Toolkit • System change • Training and education • Evaluation • Reminders (eg workplace) • Safety climate • Adapt to culture Dr. Didier Pittet
Partnership, Leadership & Innovation • The Human health and social care sector • Livestock, food retail and veterinary sectors • Research councils, other research funders and academics • Pharmaceutical industry • Local governments, professional boards, scentific and other advisory committees UK 5 year antimicrobial resistance strategy 2013-2018
WHO Global Action Plan • Building Block 1: AWARENESS • Building Block 2: IDENTIFYING and OPERATIONALIZING INFECTION PREVENTION APPROACHES • Building Block 3:OPTIMIZING ANTIMICROBIAL USE IN HUMAN & ANIMAL HEALTH & AGRICULTURE • Building Block 4: CLOSING KNOWLEDGE GAPS • Building Block 5: INNOVATION • Building Block 6:COSTS AND INVESTMENT
US National Goals, Sept 2014 • 1. Slow Emergence of AMR • 2. Strengthen National One-Health Surveillance Efforts • 3. Advance development of rapid diagnostic tests to identify and characterize AMR. • 4. New Antibiotics, therapeutics and vaccines • 5. Global effort on AMR prevention, surveillance, control and antibiotic R&D.
Canadian AMR Response • ACTION 1: establish and increase surveillance in both animal and human settings • ACTION 2: promote appropriate antibiotic use in animal and human settings • ACTION 3: work with animal agriculture sector (antibiotic stewardship in veterinary medicine) • ACTION 4: promote innovation October 2014
Where to go from here? • Definition and measurement of problem, awareness and broad and global engagement • Build on existing success and models that have a proven track record • What can we do now and defining priorities • What are the short and long-term measurable outcomes • Diagnostic test development • Antibiotic pipeline (a lengthy process that will not modify behavior or attack root of the problem) • Other approaches (vaccine, non-antimicrobial)