1. Update SRA to SRIA 24 October 2018
Jean Yves Madec
Linda van Gaalen

2. SRA Update Milestone 17: Editorial board – December 2017
Linda van Gaalen (WG leader) Antoine Andremont (France)
Jessica Boname (United Kingdom) Martijntje Bakker (Netherlands)
Virginie Mouchel (France) Patriq Fagerstedt (Sweden)
Maria Josefina Ruiz Alvarez (Italy) Gian Maria Rossolini (Italy)
Kay Duggan-Walls (Ireland) Laura Plant (JPIAMR Secretariat)
Martine Batoux (France) Marita van de Laar (Support)
Monthly teleconferences
Meetings – work sessions (3)

3. SRA update; what has been done so far
Actions
Dates
SAB meeting on process of SRA update - Amsterdam
13/14 December 2017
SAB feedback and suggestions on SRA pillars
January 2018
General outline for updating SRA - CSA meeting - Brussels
1 February 2018
Editorial Board meeting - Brussels
2 February 2018
MB meeting update on SRA update - Stockholm
26 March 2018
SAB input on pillars Diagnostics and Therapeutics
13 May 2018
SAB input on rest of the pillars
27 May 2028
Presentation of pillars Diagnostics and Therapeutics the IMI scientific at the advisory group meeting
4-5 June 2018
EB Meeting to work session on revision of SRA with SAB and IMI comments - Utrecht
26-27 June 2018
Consultation JPIAMR member countries - via MB
From 9 July to 15 September 2018
Open consultation via open questionnaire

4. SRA update; Future plans
Actions
Dates
Editorial Board meeting - To process MB and science input
22 October 2018
MB discussion research priorities/enabling activities and other issues raised in consultations
24 October 2018
Collate 2nd draft version SRIA
October 2018
Survey MB on research priorities & enabling activities
Deadline 9 November 2018
Prioritisation & Roadmap Workshop Participants: SAB (old and new), SC and EB
6-7 December 2018
Preparing SRIA, priority list and Roadmap for MB last review
December 2018 to 20 January 2019
MB review SRIA, priority list and Roadmap
20 January 2019 to MB meeting Q1 2019
MB approval SRIA & roadmap
MB meeting Q
Edit, publish and promote SRIA
From MB Q onwards

5. MB consultation:
Germany, France, Netherlands, Sweden, Japan, Korea, Estonia, Norway and Ireland
215 comments
191 content / edit comments
5 extra references
29 unlisted comments

6. Open consultation:
Responses from 48 individuals
40 (83%) from Europe
8 (17%) from other parts of the world
No response from animal health or agricultural sector
Hospitals 26%; research institutes 32% (mostly human health & microbiologists)

7. Area of expertise and feedback per pillar
Number of responses

8. Comments Therapeutics (N=28)
Appropriateness: Yes 20 No 7 DK 1
Anything missing: Yes 20 No 3 DK 4
Reasonable but not inclusive;
Different scope between objectives 1-4 vs 5-8
Fungal resistance is missing (mentioned 14 times + one person provided details regarding objectives & rationale).
To better understand how local practices and beliefs affect treatment regimes in LMIC.
Number of references (specified, i.e. Lancet ID).
Barriers: access to industry; to policymakers; to data.
Lack of connectivity, and funding was mentioned as well.

9. Comments Diagnostics (N=20)
Appropriateness: Yes 13 No 7 DK 1
Anything missing: Yes 15 No 2 DK 3
Fungal resistance is missing (mentioned 10 times + details provided re objectives & rationale); viral infections (2 times)
Address more specifically LMIC and settings.
Merge 3rd and 4th objective.
Number of references (specified).
Barriers: access to samples; to policymakers; to data.
Lack of expertise, funding, interest in full spectrum was mentioned.

10. Comments Surveillance (N=17)
Appropriateness: Yes 13 No 4
Anything missing: Yes 9 No 1 DK 4
Fungal resistance is missing (mentioned 9 times)
Global surveillance builds on national systems; setting up infrastructures in LMIC; lack of cohesive reporting across countries.
Address more specifically WHO global systems and avoid setting up parallel systems.
Merge 2nd & 3rd objective, add for policy and intervention development.
Number of references (specified, ie. Lancet ID).
Barriers: access to data; to samples; data integration.
Missing networks: ESCMID Fungal Infection Study Group surveillance projects, ECMM Fungiscope; Antifungal surveillance; surveillance on antifungal resistance in yeasts and moulds

11. Comments Transmission (N=11)
Appropriateness: Yes 8 No 3
Anything missing: Yes 6 No 3 DK 2
Fungal resistance is missing (mentioned 3 times)
Lacking: more on methods and risk assessment; research infrastructure missing in most LMIC
Include broad microbial community research;
Focus on effective intervention of pathogens; scope is too narrow.
Not well separated for this topic and Environment.
Number of references (specified, i.e. Murray).
Barriers: data integration; access to data.
Lack of funding is mentioned

12. Comments Environment (N=14)
Appropriateness: Yes 14 No 0
Anything missing: Yes 10 No 2 DK 1
Objectives are very appropriate
Not well separated for this topic and Transmission.
Lacking: sources and reservoirs fungal infections
See specific suggestions made for improving the text
Number of references (specified, i.e. Murray).
Barriers: data integration; access to data; to samples.
Lack of funding is mentioned; lack of expertise “same people”; access to policymakers.

13. Comments Interventions (N=12)
Appropriateness: Yes 9 No 2 DK 1
Anything missing: Yes 7 No 3 DK 2
Intervention objectives for fungal infections (mentioned 4 times)
Stewardship is part of training – no need to single out – focus on prevention of infections is OK (not just on AMR)!
Merge objectives 4 & 5
Lacking: need for health economic research; behavioural research as well as social norms and beliefs
Long comment given on education and awareness, limited positive changes; why not address other means for behaviour change?
Number of references (specified, i.e. Murray).
Barriers: access to data; lack of appropriate skills; of expertise; access to industry partners.

14. Scientific Advisory Board

15. Scientific Advisory Board activities 2018
Input for SRA update
Input for call topics
Review of SRA pillars
Feedback on the updated SRA text
Providing candidates for new SAB
Participation of SAB nomination committee; Bruno Gonzalez Zorn, Gunnar Skov Simonsen, Mark Sobsey
“Old” and new SAB members are invited for the Prioritisation Workshop, 6 and 7 December 2018

16. Scientific Advisory Board - Election
2018
SAB Nomination Committee; consisting of 2 MB members and 3 former SAB members
Nominations for new SAB members and second term members
SAB Nomination Committee proposed 15 SAB candidates to MB
Online vote on new SAB membership. (October 6-7)
MB appoints new SAB members (October 23)
Election new SAB Chair (November - December)
2019
Jan 1st New SAB membership term starts

17. SAB views on Fungi and antifungal resistance
Emerging problem (Candida and Aspergillus fumigatus)
Immune compromised individuals, health care facilities etc.
Relation between antibiotic use and fungal infections and resistance
Agricultural use and antifungal resistance pose a risk to human health
Relatively low prevalence, but high morbidity and mortality rates
Increasing discussions in several countries, CDC, ECDC, WHO
At this point the SRIA does not address antifungal resistance or other emerging resistance issues.

18. SAB views on Emerging resistance issues
Will JPIAMR address emerging topics in future, such as antifungal resistance, if the urgency increases? Should the JPIAMR SRIA leave the option open to address antifungal resistance in any way?
YES / NO
Capacity building
ICARe (International Course on Antibiotics and Resistance)
Network calls followed by research calls
Interaction SAB – SC
Contribution of the SAB to assessment of monitored projects
JPIAMR-VRI Task Force

19. Thank you! @: