WHO Regional Office for Europe European strategic action plan on antibiotic resistance (2011 – 2020) & Global action plan on AMR (2015) Dr Danilo Lo Fo Wong Programme Manager AMR WHO Regional Office for Europe

WHO efforts on antimicrobial resistance 2001 2011 2013 2012 2014 2015 WHO efforts on antimicrobial resistance 2003

Global report on surveillance Most important findings of this report: Very high rates of resistance observed in all WHO regions. Many gaps in information on pathogens of major public health importance. Key tools to tackle AMR, e.g. surveillance systems, do not exist in many countries http://www.who.int/drugresistance/documents/surveillancereport/en/

Worldwide country situation analysis Most important findings of this report: 33/133 countries have action plan Widespread over-the-counter sales Lack standard treatment guidelines Lack infection prevention and control Low public awareness $

Global AMR Action Plan - Strategic Objectives Improve awareness and understanding Strengthen knowledge and evidence base Reduce incidence of infection Optimize use of antimicrobial agents Develop economic case for sustainable investment

Framework for action http://apps.who.int/gb/ebwha/pdf_files/EB136/B136_20-en.pdf

European strategic action plan on antibiotic resistance (2011 – 2020) 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

Action Plan Strategic Objectives Strengthen intersectoral coordination Strengthen surveillance of antibiotic resistance Promote rational use and strengthen surveillance of antibiotic consumption Strengthen infection prevention and control and surveillance in health care settings Prevent emerging resistance in veterinary and food sectors Promote innovation and research on new drugs Improve awareness, patient safety, and partnership

WHO/Europe vs global action plan European Action Plan Global AMR Action Plan Awareness Knowledge Prevention Optimize use Business case Coordination X   Surveillance Rational use Agriculture X  Innovation

Expanding AMR surveillance throughout Europe European Antimicrobial Resistance Surveillance Network (EARS-Net) Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR) 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

Expanding AM use surveillance throughout Europe European Surveillance of Antimicrobial Consumption Network (ESAC-Net) WHO Antimicrobial Medicines Consumption network (AMC) 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

Infection prevention and control SAVE LIVES: Clean Your Hands - WHO's global annual campaign 2014 – link to AMR

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) World Health Day 7 April 2015

Awareness Day Materials: Activities Infograph Website Video Press release Presentation Activities Events & twitter chat

> 40 European countries join the European Antibiotic Awareness Day World Health Organization 3 October 2017 > 40 European countries join the European Antibiotic Awareness Day

The first WAAW – 16-22 November 2015

AMR is everyone's business World Health Organization AMR is everyone's business 3 October 2017

Five key campaign messages for the public World Health Organization 3 October 2017 https://youtu.be/BtXaMy1Nvjs Antibiotics don’t cure viral diseases like colds and flu Only take antibiotics a health professional has prescribed to you Always finish your course of antibiotics Never share antibiotics Wash your hands to prevent infections

European Region joins new WAAW WHO/Europe urges all countries in the European Region to join the first “Antibiotics: Handle with Care” campaign Join the global community to advocate for rational use Action to decrease antibiotic resistance globally

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 Guillaume Dedet Influenza & other Respiratory Pathogens Caroline Brown Pamela Hepple Vaccine Preventable Diseases & Immunization Robb Butler Catharina de Kat-Reynen Alert and Response Operations Ana Paula Coutinho

Thank you for your attention

EC vs WHO/Europe action plans European Commission SO 1 Intersectoral collaboration SO2 ABR surveillance SO3 AB consumption and rational use SO4 IPC & surv health care settings SO5 ABR in Veterinary and food sector SO6 Research & innovation new drugs SO7 Awareness, patient safety, partnership AP1 Appropriate use of AMs X AP2 regulatory framework Vet meds and feed AP3 Prudent use in Vet AP4 IPC health care settings AP5 Legal tool for IPC in animals AP6 RTD new drugs AP7 New Abs in Vet Med AP8 Prevention & control of AMR in all sectors AP9 Surv human AMR and consumption AP10 Surv animal AMR and consumption AP11 Coordinate Research efforts AP12 Survey & comparative effectiveness research