Regional strategic action plan on antibiotic resistance...Background AMR costs money, livelihoods and lives, and undermines health programmes World Health Assembly resolutions in 1984,1998,

WHO strategic action plan on

antibiotic resistance in Europe Strengthening surveillance


antibiotic resistance in Europe Strengthening surveillance

Strategic action plan on antibiotic resistance 23 – 25 November 2011

Dr Danilo Lo Fo Senior Adviser AMR

Dr Danilo Lo Fo Senior Adviser AMR


antibiotic resistance in Europe –Strengthening surveillance


antibiotic resistance in Europe –Strengthening surveillance

Dr Danilo Lo Fo WongSenior Adviser AMR

Dr Danilo Lo Fo WongSenior Adviser AMR

BackgroundBackground

� AMR costs money, livelihoods and

lives, and undermines health programmes

� World Health Assembly resolutions in

1984,1998, 2001, 2005


� WHO global strategy for containment of

AMR published in 2001

� Despite progress, strategies for AMR containment not

widely implemented

BackgroundBackground

AMR costs money, livelihoods and

lives, and undermines health programmes

World Health Assembly resolutions in

WHO global strategy for containment of

Despite progress, strategies for AMR containment not

WHD 2011 WHD 2011


2011 slogan 2011 slogan

World Health Day World Health Day

Toolkit for Health Ministers, stakeholders & partners:

� Policy Package background paper

� Policy Briefs


� Events and Press briefings

� Press kit (incl. news release, statement,

photos, videos)

World Health Day 2011World Health Day 2011

Toolkit for Health Ministers, stakeholders & partners:

Policy Package background paper

(incl. news release, statement,

Cornerstones of strategic directionCornerstones of strategic direction

I. Surveillance - to document the problem

II. Prevention - to slow the emergence of HAI and AMR

III. Containment - to reduce the spread


IV. Research & Innovation -

new tools, new drugs & guidelines

Multi-dimensional aspects - multisectoral

Cornerstones of strategic directionCornerstones of strategic direction

to document the problem

to slow the emergence of HAI and AMR

to reduce the spread

to develop

new tools, new drugs & guidelines

multisectoral, interdisciplinary

Eur

Directo

E

Di

uropean strategic action plan on

antibiotic resistance

2011–2016

Dr Guenael Rodier

ctor, Division of Communicable Diseases, Health Security

and Environment

European strategic action plan on


2011–2016

Dr Guenael Rodier

Director, Division of Communicable Diseases, Health Security

and Environment

Regional Committee for Europe

Resolution, Baku, Azerbaijan,



Member States

� Ensure political commitment and resources for developing

and implementing national plans

� Strengthen surveillance and monitoring of antibiotic

resistance and consumption


resistance and consumption

� Establish multisectoral and comprehensive

coordination and cooperation mechanisms

� Adhere to infection control

� Raise awareness through national campaigns


Baku, Azerbaijan, 12-15 September 2011



Ensure political commitment and resources for developing

and implementing national plans

Strengthen surveillance and monitoring of antibiotic

and comprehensive

coordination and cooperation mechanisms

Raise awareness through national campaigns





WHO Regional Office for Europe

� Provide strategic leadership, guidance and tools for

implementing the strategic action plan

� Support Member States in implementing national plans


� Support Member States in implementing national plans

� Create platforms for sharing and analysing data and

experience

� Engage in broad regional and global partnerships

� Promote innovation and research





WHO Regional Office for Europe

Provide strategic leadership, guidance and tools for

implementing the strategic action plan

Support Member States in implementing national plansSupport Member States in implementing national plans

Create platforms for sharing and analysing data and

Engage in broad regional and global partnerships

Promote innovation and research

Action Plan Strategic ObjectivesAction Plan Strategic Objectives

• Comprehensive national action plans

• Multisectoralmechanisms

1. Strengthen intersectoralcoordination

1. Strengthen intersectoralcoordination

• National surveillance systems, collecting, analysing and reporting data to monitor trends

• Regional databases, tools and standards2. Strengthen surveillance of

antibiotic resistance2. Strengthen surveillance of



• National mechanisms for coordination

• National guidelines on prudent use of antibiotics

• Surveillance of antibiotic consumption

3. Promote rational use of antibiotics and strengthen surveillance

3. Promote rational use of antibiotics and strengthen surveillance

• Prevention of hospital

• Hospital infection control and surveillance committees4. Strengthen infection control and

surveillance in health care settings

4. Strengthen infection control and surveillance in health care settings


Comprehensive national action plans

Multisectoral and interdisciplinary national coordination mechanisms

National surveillance systems, collecting, analysing and reporting data to monitor trends

Regional databases, tools and standards

National mechanisms for coordination

National guidelines on prudent use of antibiotics

Surveillance of antibiotic consumption

Prevention of hospital-acquired infections

Hospital infection control and surveillance committees

Action Plan Strategic Action Plan Strategic

• Prudent use of antibiotics in these sectors

• Integrated systems for surveillance of antibiotic resistance and use

5. Prevent emerging resistance in veterinary and food sectors

5. Prevent emerging resistance in veterinary and food sectors

• International surveillance networks and information sharing on promising research areas

• Active role in research for governments and academic networks; national and international task forces

6. Promote innovation and research on new drugs

6. Promote innovation and research on new drugs


networks; national and international task forceson new drugs on new drugs

• Educational initiatives, behaviour change campaigns and awareness programmes for health care providers and the public

• Broad partnership at national, regional and global levels7. Improve awareness, patient

safety, and partnership7. Improve awareness, patient

safety, and partnership


Prudent use of antibiotics in these sectors

Integrated systems for surveillance of antibiotic resistance and use

International surveillance networks and information sharing on promising research areas

Active role in research for governments and academic networks; national and international task forcesnetworks; national and international task forces

Educational initiatives, behaviour change campaigns and awareness programmes for health care providers and the public

Broad partnership at national, regional and global levels

Considerations for implementation

and monitoring


and monitoring

� Strategic action plan with:

– time frame for implementation

– estimated resource needs

– input, process and output indicators to monitor progress

� Stepwise approach:


� Stepwise approach:

– mapping of available data,

– identification of current practices

� Support to Member States in:

– developing and implementing national action plans

– establishing national coordinating mechanisms


and monitoring


and monitoring

time frame for implementation

input, process and output indicators to monitor progress

identification of current practices

Support to Member States in:

developing and implementing national action plans

establishing national coordinating mechanisms

Cycle of (Veterinary) Public Health

Protection


Protection

Surveillance

Risk management


Research

Risk management


Protection


Protection

Surveillance

Epidemiological evaluationRisk assessmentRisk assessment

Research

AMR SurveillanceAMR Surveillance

Needed to:

� Detect resistant strains of public health importance

� Support prompt notification and investigation of outbreaks


� Inform clinical treatment decisions

� Guide policy recommendations

� Monitor efficacy of interventions

(incl. infection control measures)

SurveillanceSurveillance

Detect resistant strains of public health importance

Support prompt notification and investigation of outbreaks

Inform clinical treatment decisions

Guide policy recommendations

Monitor efficacy of interventions

(incl. infection control measures)

European Antimicrobial ResisEuropean Antimicrobial Resis


sistance Surveillance Networksistance Surveillance Network

Antimicrobial Use MonitoringAntimicrobial Use Monitoring

Needed to:

� Track use, overuse and misuse

of antimicrobials

� Provide insights to assess the


� Provide insights to assess the

public health consequences

Antimicrobial Use MonitoringAntimicrobial Use Monitoring

Track use, overuse and misuse

Provide insights to assess the Provide insights to assess the

European Surveillan

Consumption (ESAC)

European Surveillan

Consumption (ESAC)

Strategic action plan on antibiotic resistance 23 – 25 November 2011http://app.esac.ua.ac.be/public/

ESAC is a project funded by ECDC

ance of Antimicrobial

Consumption (ESAC)

ance of Antimicrobial

Consumption (ESAC)

http://app.esac.ua.ac.be/public/

ESAC is a project funded by ECDC

Strengthening surveillanceStrengthening surveillance

� Focus on non-EU Member States

� Promote national committees and action plans

� Gradually set up a surveillance network compatible with

EARS-Net and ESAC-Net


EARS-Net and ESAC-Net

� Close coordination with EC and ECDC

� Collaboration with strong technical partners

Strengthening surveillanceStrengthening surveillance

EU Member States

Promote national committees and action plans

Gradually set up a surveillance network compatible with

Close coordination with EC and ECDC

Collaboration with strong technical partners

WHO Collaborating Centres (Europe)WHO Collaborating Centres (Europe)

� WHO CC for Reference & Research on Hospital Infections

– Health Protection Agency, London, United Kingdom

� WHO CC on Patient Safety

– University of Geneva Hospitals - Geneva, Switzerland

� WHO CC for Antimicrobial Resistance in


� WHO CC for Antimicrobial Resistance in

– National Food Institute, Copenhagen, Denmark

� WHO CC for Research and Training in Surveillance of

Communicable Diseases and Antimicrobial Resistance

– National Centre for Infectious and Parasitic Diseases, Sofia, Bulgaria

� WHO CC for Drug Statistics Methodology

– Norwegian Institute of Public Health

WHO Collaborating Centres (Europe)WHO Collaborating Centres (Europe)

WHO CC for Reference & Research on Hospital Infections

Health Protection Agency, London, United Kingdom

Geneva, Switzerland

WHO CC for Antimicrobial Resistance in Foodborne PathogensWHO CC for Antimicrobial Resistance in Foodborne Pathogens

National Food Institute, Copenhagen, Denmark

WHO CC for Research and Training in Surveillance of

Communicable Diseases and Antimicrobial Resistance

National Centre for Infectious and Parasitic Diseases, Sofia, Bulgaria

WHO CC for Drug Statistics Methodology

Norwegian Institute of Public Health - Oslo, Norway

� ECDC

� DG SANCO/ DG Research

� RIVM (National Institute for Public Health and the Environment )

� ESCMID (European Society of Clinical Microbiology and Infectious Diseases)

PartnersPartners


� HPA (UK Health Protection Agency)

� EMA (European Medicines Agency)

� EFSA (European Food Safety Authority)

� CDC (Centers for Disease Control and Prevention, United States of America

� … and many more

(National Institute for Public Health and the Environment )

(European Society of Clinical Microbiology and Infectious Diseases)

PartnersPartners

for Disease Control and Prevention, United States of America)

Thank you for

your attention


your attention

Thank you for

your attentionyour attention

Documents

Regional strategic action plan on antibiotic resistance...Background AMR costs money, livelihoods and lives, and undermines health programmes World Health Assembly resolutions in 1984,1998,