Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015

1. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
WHO Regional Office
for Europe
Priorities and activities for
addressing antibiotic
resistance
Dr Danilo Lo Fo Wong
Programme Manager AMR
On behalf of the WHO/Europe AMR Working Group

2. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
European strategic action plan on antibiotic
resistance (2011 – 2016)
• 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

3. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
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

4. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
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, Kyrgyzstan, Moldova, Tajikistan, Uzbekistan, Turkmenistan

5. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
CAESAR Network
(Central Asian and eastern European Surveillance of Antimicrobial Resistance)
• Network of national surveillance networks in non-EU MS
• Joint initiative
– European Society of Clinical
Microbiology and Infectious
Diseases (ESCMID)
– Dutch National Institute of
Public Health (RIVM)
• Close collaboration with ECDC
– Use methodology compatible to EARS-Net

6. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
Expanding AMR surveillance
throughout Europe
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)
Central Asian and eastern
European Surveillance of
Antimicrobial Resistance (CAESAR)

7. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
Region-wide AM use data
• Technical workshops
– Training, data collection and
analysis of national AM use data
– Non-EU Member States
• Joined initiative
– University of Antwerp, Belgium
• Close collaboration ECDC
– Use methodology compatible
with EU Member States
Lancet Infect Dis 2014
Published Online, March 20, 2014
http://dx.doi.org/10.1016/S1473-3099(14)70071-4

8. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
Expanding AM use surveillance
throughout Europe
European Surveillance of Antimicrobial
Consumption Network (ESAC-Net)
WHO/Europe-ESAC Project
Group
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

9. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
Infection prevention and control
• Global Infection Prevention and Control
Network (GIPCN)
• SAVE LIVES: Clean Your Hands - WHO's
global annual campaign
• 2014 – link to AMR

10. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
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)
• Global Foodborne Infections Network (GFN)

11. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
Materials:
• Infograph
• Website
• Video
• Press release
• Presentation
Activities
• Country events (press conferences, seminars)
• EC/ECDC/WHO twitter chat
Awareness day

12. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
Campaign support
Call for proposals (April 2014)
- Template, SMART objectives, selection criteria
Proposal review (May 2014)
- Panel of expert partners (WHO, RIVM, ECDC, BAPCOC)
Grants awarded (ARM, BIH, GEO, KGZ, MKD, MNE, SRB)
- Implementation June 2014 to February 2015
Workshop (February 2015)
- Exchange experiences and expertise

13. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
Partnership

14. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
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
– Nina Sautenkova
– Ganna Bolokhovets
• Influenza & other Respiratory Pathogens
– Caroline Brown
• Vaccine Preventable Diseases &
Immunization
– Robb Butler
• Alert and Response Operations
– Ana Paula Coutinho
– Jukka Pukkila

15. Strengthening the fight against antimicrobial resistance in Bosnia and Herzegovina:
current situation and future challenges, 29 October 2013
3rd Joint Meeting of the Antimicrobial Resistance and
Healthcare-Associated Infections (ARHAI) Networks
11-13 February 2015, Stockholm, Sweden
No action today…
No cure tomorrow
Thank you for
your attention