CSO Project in CSO Project in ThailandThailand

Niyada Kiatying-Angsulee, Ph.D.Drug System Monitoring & Development Program

Chulalongkorn University

Thailand at a GlanceSoutheast AsiaPopulation (2012)GDP per capita (2012) Infant mortality rateHealth insurance scheme

Health care system

Burden of diseaseExcessive use AB

69.5 million (US$)5,67816.7/1000 live births3 major insurance schemes

(CSMBS, SSS, UC)Majority public services

(MoPH, university, Local authority)

HIV/AIDS, CVS, Cancer, Accident,

national AB use 16-22% of total drug use

Increase AB use rate 11 % per annum

ABR in Thailand

Acinetobacter buamanmii : resist to many antibiotics (aminoglycosides, beta actam, quinolones, carbapinems, emipenems)

Streptococcus pneumoniae : resist to penicillins, erythromycin

>100,000 Thai people infected with antibiotic resistant bacteria

1 million days of extra hospital stay30,000 deaths annually, leading to economic

loss of more than 10,000 million baht

Thailand attempts NARST (National Antimicrobial Resistance

Surveillance Thailand)National Drug Policy

Subcommittee on RUD = 7 strategies for RUD = AMR

One subcommittee to combat AMRDrug System Monitoring and Development

Program (one focus is on ABR)Antibiotic Smart Use Program of FDA (ASU)Health System Research Institute (HSRI) Program

on antibiotic resistanceSome hospital stewardship program, e.g. Siriraj

hospital, Ramathibodi hospital, etc.

Press Conference for World Health Day 2011 by Deputy Minister of Public Health

(Combat drug resistance - No action today, no cure tomorrow) 

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Subcommittee to re-evaluate antimicrobial medicines (human, animal)Appointed by Drug Committee (belongs to

Drug Act)Met Sept 30th, 2012Re-evaluate all antimicrobials according to

WHO and OIE, and Thai contextPropose for re-classify, control of distribution,

and restriction of use

DMD and ABR campaignFolk Media (2 pieces)Painting (22 pieces)Calendar (2012)Competition on artsMOU with MoPH, with local authoritySupport of Medical Student CampaignSupport ASU, and othersCSO projectsABR in Contract Farm

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Arts by Health Professions on AMR and Health

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Puppet show on rational use of antibiotic

Meet and greet with students on competition

CSO Activities so far1. Preparation meetings2. Development and test of curriculum in BKK3. Prepare of media 4. TOT in BKK5. Survey of people awareness and behaviour6. MOU in Chiang Mai

Curriculum Development and Testing

With teacher, parents, and students in school

Civil Society Organization, TOT

MOU : Subdistrict, Family Network Foundation, DMD : ABR action at community level (21 Dec 2012)

Support of University Support of University ActivityActivitySIMIC 2012, 2013CU Medical students road show at schoolsChiang Mai University Hospital Trainng Ramathibodi Hospital IC

SIMIC 2013 SIMIC 2013 (Med students and staff 36 teams from 11 countries)

Campaign workshop Simulated patientCompetition

Training Health Volunteer in Chiang MaiWith Faculty of Medicine, Chiang Mai

University

ASU Activities all over the ASU Activities all over the Province: Nakorn Sri Province: Nakorn Sri ThammarathThammarath

Antibiotic Smart Use ASU: 3 illnesses without antibiotic

Future: a long way to go

Antibiotic and Contract Farm Antibiotic Awareness day 18th Nov

2013: ASU Kids

Antibiotic and Contract Farm Support knowledge on health and AB useSurvey of health behaviour and medicines

usedSurvey of AB used in contract farmCampaign

Antibiotic Awareness day 18th Nov 2013: ASU KidsWith Institute of Child Health (MoPH), and

alliesSeminar to the publicLunch symposium update on AMRMed student campaign

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