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. Draft Global Action Plan for AMR
Global action plan to combat
antimicrobial resistance

2. Draft Global Action Plan for AMR
Resolution on AMR
World Health Assembly May 2014 ... To develop a
draft global action plan to combat AMR ... to ensure
that all countries ... have the capacity to combat
AMR.
– Takes into account existing action plans and
all available evidence and best practice
– To apply a multisectoral approach by
consulting.....
Submit to 2015 Health Assembly through
the Executive Board January 2015
– November 2014

3. Draft Global Action Plan for AMR
Why now?
Increasingly serious global public health
threat
– New evidence and information
• Untreatable infections
• 25,000 deaths/yr across EU
– Desperation over "dry pipeline"
Economic impact
– by 2050, lead to 10 million deaths every year
– reduction of 2 to 3.5 percent in GDP
– costing the world up to $100 trillion
Growing awareness and commitment
– Political, professional, public

4. Draft Global Action Plan for AMR

5. Draft Global Action Plan for AMR
WHO Executive Board January 2015
• Strong support to take plan to World Health Assembly
• 39 country statements, plus 5 NGOs
• Some requests for modification
• WHO FAO OIE tripartite meeting 10 Feb 2015
• WHO Advisory Group meeting 24-25 Feb 2015
• Resubmit to Health Assembly March 2015
email to amractionplan@who.int with the subject line ‘SUBSCRIBE TO MAILING LIST’
EB web site at http://apps.who.int/gb/e/e_eb136.html
It is listed as document EB136/20. Available in 6 languages.
Supplementary material is available on our AMR webpages at http://www.who.int/
drugresistance/global_action_plan/en/

6. Draft Global Action Plan for AMR
Draft global action plan based on…
5 Guiding principles
– Whole of society engagement and one-health
– Prevention first
– Access
– Sustainability
– Incremental targets for implementation

7. Draft Global Action Plan for AMR
Five strategic objectives:
Improve awareness and understanding
Strengthen the knowledge and evidence base
Reduce the incidence of infection
Optimize the use of antimicrobial medicines
Develop the economic case for sustainable
investment
Commitments to report progress

8. Draft Global Action Plan for AMR
Strengthen the knowledge and evidence base
Capacity to collect, analyse and report data
 Global surveillance based on national capacity
Integration of data between human and animal sectors
Develop global public health research agenda
 Implement (research funders to support)
Repository of information
 Global health R&D observatory
 Knowledge, information, data

9. Draft Global Action Plan for AMR
Global surveillance: countries
Develop a national surveillance system:
 National reference (coordination) centre to collect and analyse data
 Reference laboratory operating to agreed quality standards
 Data from hospital, and community
 Meet recommendations of:
 AGISAR (food borne pathogens),
 OIE terrestrial and aquatic animal codes
 FAO Codex Alimentarius codes of practice
 Share information
 Detect and report new resistance
 New knowledge important to global programme
 Public health concern under IHR

10. Draft Global Action Plan for AMR
Global surveillance: WHO
Develop global surveillance programme:
 Standards
 External quality assessment
 Collaborating Centres and other technical support
Report regularly
Integrated surveillance
 Work with FAO and OIE
 Measures of resistance in food chain as indicators of risk to
human health

11. Draft Global Action Plan for AMR
Global surveillance: others
FAO, OIE
 Review and update regularly their Codes of Practice
International research community
 Studies to understand impact of AMR on agriculture, food
security
 Impact of agricultural practices on development and spread of
AMR
Support for developing countries to build capacity
 Technical
 financial

12. Draft Global Action Plan for AMR
"low hanging fruit"
• Strong commitment
• Stockholm, December 2014
• Many existing networks
• Laboratory methods, standards, EQA
exist
• Many countries have established
capacity, report (tend to be hospital
based data)
• Many collaborating centres, national
reference laboratories
• Strong disease (pathogen) specific
networks
• E.g. TB, HIV, malaria, N. gonorrhoea

13. Draft Global Action Plan for AMR
But the full harvest.......
.......will require:
 Effort (investment)
 Collaboration
– Multisectoral
– International
 Innovation

14. Draft Global Action Plan for AMR
Global surveillance: a means to an end
To know burden, prevalence, trends
 Priorities, case for investment and action
 Evidence of effectiveness of action
Assess risk, drivers of resistance
 Integration human-animal-agriculture
 Connecting AMR with drug consumption in all sectors
New resistance
 Adjust methods, standards, priorities
 Public Health response
Local patterns, prevalence
 Local treatment guidance
 Patient treatment decisions

15. Draft Global Action Plan for AMR
Thank you