1. MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS THE REPUBLICAN RESEARCH PRACTICAL CENTER FOR EPIDEMIOLOGY AND MICROBIOLOGY AMR SURVEILLANCE IN THE REPUBLIC OF BELARUS Leonid Titov Hanna Verashchak Liudmila Slaikovskaya

2. Surveillance of the antimicrobial resistance Antimicrobial resistance is a very important problem for public health in Belarus. Our aim - improve of the national AMR surveil- lance system that links regional networks and provide comparable and validated data on the prevalence and trends of antimicrobial resistan- ce to Ministry of Health and European CAESAR database. International cooperation

3. THE REPUBLIC OF BELARUS The Republic of Belarus is situated in the Eastern Europe. Territory of Belarus is 207.6 km2 (13th country in Europe). Belarus consists of 6 regions (Brest, Vitebsk, Gomel, Grod- no, Mogilev, Minsk) and city of Minsk (capital). Population - 9 643 566. Life expendancy at birth 72.2 year (66 – 78). Physicians density- 5.2 / 1000 population; Hospital beds density – 11.23 beds/ 1000 population.

4. AMR SURVEILLANCE EFFORTS IN BELARUS

5. CARRENT AMR SYSTEM IN THE REPUBLIC OF BELARUS From 1997г. - 10 conferen- cies and 12 seminars; Journal of Health - round tables on AMR, hospital infections; Annually 15-20 reports and articles on the AMR; National report on AMR; Awareness AMR day; Cooperation Plan – Belarus – WHO 2012-13 years; Cooperation Plan – Belarus- WHO 2014-2015 years; Department of Epidemiology and Hygiene at the Ministry of Health of Belarus (Dr. E. Fedorov, I. Karaban) Republican Research Prac- tical Center for Epidemiology and Microbiology (Director V.A.Gorbunov) Laboratory of Clinical and Experimental Microbiology (Head Prof. Leonid P Titov) Bacteriology laboratories Centers for Hygiene and Epide- miology City of Minsk and in re- gions (Brest, Vitebsk, Gomel, Grodno, Mogilev, Minsk). Bacteriology laboratories in hospitals.

6. WHO MISSION FOR BELARUS AMR SYSTEM EVALUATION (4-8 June, 2012) WHO EURO country assessment on АMR Date of the Mission: 4-8 June 2012 Dr. Lo Fo Wong (WHO) Dr. van Nienke (WHO) Мr. Jos Monen (RIVM,NL) Dr. Oscar Ekelund (ESCMID, Sweden) Country: Belarus 1.Promoting national coordination: a.National coordinating groups; b.AMR focal point (country representative for AMR); c.National AMR strategy and action plan, d.Multidisciplinary and intersectoral collaboration (veterinary medicine). 2.Strengthening surveillance of antibiotic resistance: a.Laboratory methods susceptibility testing; b.Existing surveillance on AMR; c.IT support; d.Laboratory capacity; e.Data quality and laboratory standards; f.Quality assurance system; g.Strengthening surveillance networks.

7. 26-27 of March, 2013. WHO-Belarus Seminar on WHONET using

8. PERSPECTIVES: THE NATIONAL STRATEGIC AMR ACTION PLAN IMPLEMENTATION National strategic plan – intersectoral document based on 7-th aims of the European Strategic Plan. It is mechanisms for actions coordination. National coordinator – Deputy minister of Health – Igor V Gaevsky Special committees: а) Antibiotics policy; b) AMR surveillance; c) Methods of the Resistance/Sensitivity testing; d) Quality control and professionals education; e) MIC (breakpoints)/zone diameters evaluation and EUCAST contacts; f) AMR surveillance in veterinary medicine; g) Infection control in hospitals; h) Antibiotics consumption at hospital and population level; i) Awareness on antibiotics using and risk of resistance increasing

9. PARTICIPATION IN BARN PROGRAM 1.BEEp – Baltic ESBL Epidemiology project 2.Hand hygiene project implementation of the WHO Guidelines 3.Happy Audit2 (prescribing antibiotics) 4.Preoperative Antibiotic Prophylaxis 5.Quality Assurance Survey in the Baltic Sea Region