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Global action plan on antimicrobial resistance
Global Action Plan on
Antimicrobial Resistance
Dr Marc Sprenger
Director Antimicrobial Resistance Secretariat
Global action plan on antimicrobial resistance
When are we entering the post-antibiotic era?
For some diseases we have already entered!
Fatal pneumonia because antibiotics are not working (K. pneunomiae)
Fatal infection with Neisseria gonorrhoeae
Global action plan on antimicrobial resistance
What is the cost of not taking action?
• By 2050, AMR could lead to
• 10 million deaths every year
• reduction of 2%-3.5% in GDP globally
• Between now and 2050, the world can expect to lose
US$ 600 to US$ 100 trillion worth of economic output
Global action plan on antimicrobial resistance
Global Action Plan on Antimicrobial Resistance
One year in development
World Health Assembly, May 2014 Requests the Director General to develop a global plan
WHO leads development of the plan, May to Dec 2014 With advice from experts, Member States, forums and web consultations
WHO Executive Board, Jan 2015 Expresses strong support to take plan to World Health Assembly
World Health Assembly, May 2015 Adopts the Global Action Plan – over 50 supporting statements
Passes new resolution to support action – over 60 country sponsors
Global action plan on antimicrobial resistance
0
10000000
20000000
30000000
40000000
50000000
60000000
2014-2015 2016-2017 USD
Increase in WHO organization-wide budget for AMR
Global action plan on antimicrobial resistance
AFRO
EMRO
EURO
Headquarters
SEARO
WPRO
AMRO/PAHO
Financial projections for 2016-2017:
distribution by WHO Regional Office
Total: USD 53,792,873
Global action plan on antimicrobial resistance
Five strategic objectives:
1. Improve awareness and understanding
2. Strengthen the knowledge through surveillance and
research
3. Reduce the incidence of infection
4. Optimize the use of antimicrobial medicines
5. Ensure sustainable investment
Global action plan on antimicrobial resistance
Five strategic objectives, my translation:
1. EAAD / WAAW: handle AB with care
2. Set up lab and surveillance and report
3. Good IPC in hospital
4. AB: only prescription & instruction & duration
5. Invest in R&D
Global action plan on antimicrobial resistance
Implementation of the GAP Guiding Principles
1. Realistic and achievable objectives
2. Work streams approach
3. Take into account different capacities of Member States
4. Involve FAO and OIE, where appropriate
5. All-inclusive approach (HIV, TB and malaria)
6. Joint ownership between HQ and regions when possible
7. Coordination and alignment across WHO (monthly meetings with
Global Technical Coordination Group)
Global action plan on antimicrobial resistance
Implementation of the GAP Organizational structure
Global Policy
Group
Steering Group
HQ & RO technical
staff
Technical
Coordination Group
AMR Coordinating
Secretariat
Marc Sprenger
Director
Liz Taylor
Technical Officer
Ellen Attafuah
Assistant
Pravarsha Prakash
Technical Officer
Katie Barker
Technical Officer
Global action plan on antimicrobial resistance
Implementation of the GAP Role of the WHO Steering Group
Make high-level recommendations and decisions need
to implement AMR policy
Agree WHO work plan on AMR
Implementation plan proposal for donors and partners
Organization-wide resource mobilization strategy
Prioritize activities and address budget and funding
allocation
Provide guidance to the Technical Coordination Group
Meet quarterly
Global action plan on antimicrobial resistance
Implementation of the GAP
Nine work streams
1. Launch and maintain a global communications campaign
2. Support MS in developing their National Action Plans
3. Global Antimicrobial Resistance Surveillance System (GLASS)
4. Support measures to improve infection prevention and control (IPC)
5. Monitor use and enhance stewardship of antibiotic use
6. Encourage R&D and explore new business models
7. Improve point of care diagnostics
8. Address the environmental drivers
9. Engage the United Nations General Assembly
Global action plan on antimicrobial resistance
Implementation of the GAP National action plans
In May 2015: 34 out of 133 responding countries have
a national action plan on AMR
By May 2017: all Member States to have plans aligned with the GAP
WHO is supporting Member States by:
- developing tools and templates & training material
- working with ROs and COs to roll out activities and plans in Member States
- developing a monitoring and evaluation framework
- collecting data on the status of national action plans
- reporting back to WHA by 2017
Global action plan on antimicrobial resistance
2015: Launch global awareness campaign
• conduct baseline public survey on current understanding and
awareness of antibiotic resistance and self-reported
behaviours related to antibiotics
• launch 'Antibiotics: Handle with care' campaign
• mark the first World Antibiotic Awareness Week (WAAW)
2016: Strengthen global awareness campaign; groundwork
for behaviour change programme
• adoption of WHA resolution to make WAAW an official annual
observance; all Regions to actively participate
• conduct targeted research among health & ag profs and
policy makers on their awareness and understanding of
antibiotic resistance, self-reported behaviours and
willingness to change
• develop a globally-applicable module for a behaviour change
programme, building on the global awareness campaign and
results of current pilot testing the Tailoring of Antimicrobial
resistance Programme (TAP) in the WHO European Region
2017: Pilot test behaviour change programme
• Pilot test and evaluate the behaviour change module in 2
countries in each WHO Region
• conduct second global public survey to measure
trends/changes in public awareness, understanding and
behaviours
• provide comms support for WAAW and launch of major
technical reports, e.g. on national action plans and GLASS
Evolution of the campaign: 2015 – 2017
Global action plan on antimicrobial resistance
1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010
Salvarsan
Penicillin
Sulfonamide
Streptomycin Bacitarin
Nitrofurans
Chloramphenicol
Polymyxin
Cholrtetracycline
Cephalosporin
Pleuromutilin
Erythromycin
Isoniazid
Vancomycin
Streptogramin
Cycloserine
Novobiocin
Rifamycin
Metronidazole
Nalidixic acid
Trimethoprim
Lincomycin
Fusidic acid
Fosfomycin
Mupirocin
Carbapenem
Oxazolidinone
Monobactam
Daptomycin
No new antibiotic
class discoveries
Antibiotic class discoveries in 20th century
Global action plan on antimicrobial resistance
Gobal Action Plan: Project on R&D
Possible deliverables to start with:
1. Tracking of resource flows for R&D through global health R&D
observatory, including annual report on pipeline
2. Report on role and possible priority vaccines
3. Report on options for global development & stewardship
framework
4. Exploration of product development partnership: WHO/DNDi
proposal for a Global Antibiotic Research and Development
Facility to promote research, responsible use, and access to new
antibiotics
5. Coordination of research initiatives – under discussion
Global action plan on antimicrobial resistance
Global Antibiotic R&D Facility
Aim: A product development partnership that develops in cooperation
with private and academic partners antibiotics that focus on global
health needs,
tries to conserve them as long as possible while ensuring equitable
access for all
Part of implementation of Objective 5
DNDi ready to play role as "incubator"
Next step: WHO & DNDi Consultation, 13 November 2015, Geneva
Global action plan on antimicrobial resistance
Why was DNDi created?
To develop
and deliver treatments
With Public
and Private Funding
Conducts
research with:
Biotechnology
& Pharmaceutical
Industries
Universities
For underprivileged pat
ients
Ministries
of Health Public Research
Institutions
Global action plan on antimicrobial resistance
DNDi’s success is only possible through innovative partnerships
Universities & Research Institutes
PDPs
Int. Org. & NGOs
Biotechs
CROs
Pharmaceutical
companies
CRITERIA FOR SUCCESS •Share the same vision •Mutual understanding •Involvement throughout the whole process
RESEARCH
TRANSLATION
DEVELOPMENT
IMPLEMENTATION
PLATFORM MEMBER COUNTRIES
DNDi WORLDWIDE
FOUNDING PARTNERS
Business Plan 2015-2023
Global action plan on antimicrobial resistance
What did they tell me…
No medical microbiology lab in main hospital
No infection and prevention control in hospital
No drug regulation
No knowledge, no awareness
No money for GP
But committed local people and Country Office WHO
Global action plan on antimicrobial resistance
WHA requests the Director-General (68.7):
Establish and resource a Secretariat
Mobilize all levels of WHO
Strengthen collaboration with FAO and OIE
Develop framework for monitoring and evaluation
Develop and implement GLASS
Establish network of WHO Collaborating Centres
Develop a global stewardship framework for use and access
Promote investment
UN General Assembly 2016
Provide support and technical assistance to countries
Report back to the WHA