AMR Global Overview

and Action Plan

Dr Khanchit Limpakarnjanarat
WHO Representative to Indonesia

Seminar on AMR, Balai Kartini, 5 August 2015

Presentation Outline
1. Global and Regional Overview
2. The Global Action Plan on AMR

3. Framework for Action on AMR

4. Summary

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World Health Organization | 05-Aug-2015

AMR ..(1)
Irrational use is main driver of selection pressure that
contributes to Antibiotic resistance:
50% antibiotics are prescribed inappropriately;
50% patients have poor compliance;
50% of populations do not have access to essential
antibiotics;
50% of antibiotics in some countries are used for
animal growth promotion;

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World Health Organization | 05-Aug-2015

AMR..(2)
Alexander Fleming, inventor of Penicillin (18811955)

The time may come when penicillin

can be bought by anyone in the shops.
Then there is a danger that the
ignorant man may easily under dose
himself and by exposing his microbes
to non lethal quantities of the drug
make them resistant.. (Alexander
Fleming, Nobel Lecture, Dec 11,
1945)*
* http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-lecture.pdf
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World Health Organization | 05-Aug-2015

Global and Regional Overview(1)

This (AMR) is the single greatest
challenge in infectious diseases
today.This is happening in all parts
of the world, so all countries must do
their part to tackle this global threat.

While there is a lot to be

encouraged by, much more work
needs to be done to combat one
of the most serious global health
threats of our time
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World Health Organization | 05-Aug-2015

Dr Keiji Fukuda,
WHOs ADG for Health Security

Global and Regional Overview(2)

In 2013, there were estimated 480,000
new cases of MDR-TB globally with
210,000 deaths. 3.5% of new and
20.5% of previously treated TB cases
are estimated to have MDR-TB. On
average, an estimated 9% of people
with MDR-TB have XDR-TB.
As of 2010, pre-treatment resistance to
HIV among adults were about 5%. Since
then, reports suggesting that pretreatment resistance is increasing,
peaking at 22% in some areas;
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World Health Organization | 05-Aug-2015

Global and Regional Overview(3)

High proportions of antibiotic resistance in bacteria that
cause common infections (e.g. urinary tract infections,
pneumonia, bloodstream infections);
A high percentage of hospital-acquired infections are
caused by highly resistant bacteria such as methicillinresistant Staphylococcus aureus (MRSA) or multidrugresistant Gram-negative bacteria.

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Global and Regional Overview(4)

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Invention of New Antibiotics

Will it be the End of the Road?

Only few new ABs

were invented

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Golden Era of
Antibiotics Invention

World Health Organization | 05-Aug-2015

Global and Regional Overview(6)

WHO report on Worldwide country
situation analysis (April 15) focusing to
country progress on:
Comprehensive, financed national plan with
accountability and civil society engagement.
Surveillance and laboratory capacity;
Access to essential medicines of assured
quality;
Regulation and promotion of rational use of
medicines, and ensure proper patient care;
Infection prevention and control;
Innovation, research and new tools.

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WHO Report 2015

Countries Involved in the Analysis

http://apps.who.int/iris/bitstream/10665/163468/1/9789241564946_eng.pdf?ua=1&ua=1

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WHO Report 2015

(i) Countries with Financed National Plan

45%

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WHO Report 2015

(ii) Countries with Surveillance and Lab Capacity.(1)
No and % of Member States that had conducted AMR surveillance

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WHO Report 2015

(ii) Countries with Surveillance and Lab Capacity.(2)

Member States
which developed
reports on
surveillance for
antimicrobial
resistance (in the
past 5 years)

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36%

WHO Report 2015

(iii) Access to Quality-assured Antimicrobial Medicines(1)
Countries with National Regulatory Authority
81.8%
63.6%
54.5%

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WHO Report 2015

(iii) Access to Quality-assured Antimicrobial Medicines(2)
No and % of Member States that had a list of essential medicines

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WHO Report 2015

(iv) Use of Antimicrobial Medicines

%
%
%

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WHO Report 2015

(v) Promotion of Public Awaraness on AMR
No. and % of Member States that had conducted a campaign about
use of antimicrobial medicines in the previous 2 years

45.4%

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WHO Report 2015

(vi) Infection Prevention and Control Programme

81.8%

63.6%

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The Global Action Plan on AMR(1)

Rationale: AMR (including antibiotic resistance, the most
urgent drug resistance trend) is occurring everywhere in
the world, compromising the ability to treat infectious
diseases.
Goal: to ensure, for as long as possible, continuity of
successful treatment and prevention of infectious diseases
with effective and safe medicines that are quality-assured,
used in a responsible way, and accessible to all who need
them.
Has been endorsed at 68th WHA (2015)

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The Global Action Plan on AMR(4)

The five strategic objectives :
1. Improve awareness and understanding of AMR
(OneHealth);
2. Strengthen the knowledge and evidence base through
surveillance and research (human and animal);
3. Reduce the incidence of infection (IPC);
4. Optimize the use of antimicrobial agents (action plan);
and
5. Develop the economic case for sustainable investment
in new medicines, diagnostic tools, vaccines and other
interventions (med, diagnosis, vaccine).
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INDONESIA: Way Forward

1. Advocate to all stakeholders AMR is a global issue;
2. Adapt the Global AMR Action Plan into a comprehensive
National AMR Action Plan;
3. Develop necessary policies and regulations to support the
implementation of National AMR Action Plan;
4. Resource mobilization to adequately finance the National
AMR Action Plan;
5. Actively engage all relevant ministries and bodies within the
government, private institutions, International agencies,
Professional Organizations, NGOs, CSOs and widercommunity to implement the National Action Plan.
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Summary
AMR is a serious threat to global public health;
AMR is caused natural phenomenon that is propagated by
several factors that can be prevented;
AMR threatens the prevention and treatment of infections that
may lead to higher morbidity, mortality and economic loss;
AMR - The Global Action Plan is reference to develop
Country Action Plans involving all relevant government
sectors and society;
AMR Program M&E to measure effectiveness;
AMR can be effectively tackle by International collaboration.

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THANK YOU

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World Health Organization | 05-Aug-2015