From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Round table discussion on AMR from a food safety perspec-ve 30 June 2015, Tirana, Albania
European strategic action plan on antibiotic
resistance (2011 – 2020)
& Global action plan on
AMR (2015)
Dr Danilo Lo Fo Wong
Programme Manager AMR WHO Regional Office for Europe
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
WHO efforts on an-microbial resistance 2014
2015
2001 2003
2011
2013
2012
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Global report on surveillance
Most important findings of this report: • Very high rates of resistance observed in all
WHO regions.
• Many gaps in information on pathogens of major public health importance.
• Key tools to tackle AMR, e.g. surveillance systems, do not exist in many countries
http://www.who.int/drugresistance/documents/surveillancereport/en/
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Worldwide country situation analysis
Most important findings of this report: • 33 out of 133 countries have comprehensive
action plan
• Widespread over-the-counter sales
• Lacking standard treatment guidelines
• Lacking infection prevention and control programmes
• Low public awareness
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From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Global AMR Action Plan - Strategic Objectives
1. Improve awareness and understanding
2. Strengthen knowledge and evidence base
3. Reduce incidence of infection
4. Optimize use of antimicrobial medicines
5. Develop economic case for sustainable investment
http://www.who.int/drugresistance/global_action_plan/en/
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Framework for action http://www.who.int/drugresistance/global_action_plan/en/
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
European strategic action plan on antibiotic resistance (2011 – 2020)
• 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
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Action Plan Strategic Objectives 1. 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
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
WHO/Europe vs global action plan
European Ac,on Plan
Global AMR Ac,on Plan
Awareness Knowledge Preven-on Op-mize use Business case
Coordina,on X
Surveillance X
Ra,onal use X
Preven,on X
Agriculture X X X
Innova,on X X X X
Awareness X
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Implementation of action plan
Specific focus on supporting non-EU Member States
• National intersectoral coordination
• Development of national action plans
• Surveillance on antibiotic consumption and resistance for evidence-based action
• Advocacy and awareness raising For example through country assessments, national and subregional workshops, training, twinning, consultancies
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Country situation analysis • Country situation analysis
– Visit key Ministries, institutions, agencies, laboratories
– Mission report with observations and recommendations
– Follow-up activities
• Goal – Appointment of National AMR Focal Point
– Installation of Intersectoral Coordination Mechanism (ICM)
– Development of national AMR action plan
• Performed: Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan, Turkmenistan, Ukraine, Uzbekistan
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
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 CAESAR Countries visited for CAESAR participation Countries to be visited for CAESAR participation Countries participating in EARS-Net
European Antimicrobial Resistance Surveillance Network
(EARS-Net)
Expanding AMR surveillance throughout Europe
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Expanding AM use surveillance throughout Europe
European Surveillance of Antimicrobial Consumption Network (ESAC-Net)
WHO Antimicrobial Medicines Consumption network (AMC)
European Centre for Disease Prevention and Control World Health Organization Regional Office for Europe
Countries which reported 2011 data to WHO Countries in the process of collecting data Countries invited to join Countries participating in ESAC-Net
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Infection prevention and control • SAVE LIVES: Clean Your Hands - WHO's
global annual campaign
• 2014 – link to AMR
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
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
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Materials: • Infograph
• Website
• Video
• Press release
• Presentation
Activities • Country events (press conferences, seminars)
• EC/ECDC/WHO twitter chat
Awareness Day
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
> 40 European countries join the European Antibiotic Awareness Day
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
The first WAAW – 16-22 November 2015
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
AMR is everyone's business
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Five key campaign messages for the public https://youtu.be/BtXaMy1Nvjs
1. Antibiotics don’t cure viral diseases like colds and flu
2. Only take antibiotics a health professional has prescribed to you
3. Always finish your course of antibiotics
4. Never share antibiotics
5. Wash your hands to prevent infections
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Tailoring AMR Programmes (TAP)
• Knowledge alone not enough to change behaviour
• Methods/tools to design targeted behaviour change campaigns
• Based on behavioural science & social marketing
• Pilot projects in Sweden, England, The Netherlands
Forma- tive
phase
Imple-men- tation phase
Identify
Diagnose
Design
Situational analysis
Determine main target
Conduct additionalresearch
Segment and prioritizerisk populations
Mapping of behaviour
Set purpose andobjectives
Design andimplementation
Monitoring andevaluation
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
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 – Guillaume Dedet
• Influenza & other Respiratory Pathogens – Caroline Brown – Pamela Hepple
• Vaccine Preventable Diseases & Immunization
– Robb Butler – Catharina de Kat-Reynen
• Alert and Response Operations – Ana Paula Coutinho
From strategies to ac-on -‐ Addressing the challenges of AMR in the Northern Dimension area
19 November 2015, Berlin, Germany
Thank you for your aUen-on
