PHM-Exch> At the 66th WHA - side meeting on Antibiotic Resistence

[Claudio Schuftan]

From: shila kaur <kaur_shila at yahoo.com> HAIAP, Penang


*Side Meeting on “Antibiotic resistance – a threat to global health
security,” Pallais de Nations, Geneva, 21 May 2013, 12:30 – 14:00*



While  the plenary meetings of the 66th WHA continue to unfold in the
Assembly Hall of the Pallais de Nation, side meetings taking place mainly
during early mornings, lunchtime and evenings, and organized by country
delegations, other UN agencies and civil society groups have seen steady
and outstanding attendances from WHA delegates.



One such meeting – “Antibiotic resistance: a threat to global health
security” – was a crowd puller.  Organized by the delegations of the UK,
Northern Ireland and Sweden, the attraction for this side meeting was
obvious: a top-notch panel of high level public health officials and
leading world experts on antimicrobial resistance (AMR) and the urgency of
the subject matter.



Delegates and observers heard presentations from  Prof Otto Cars, leading
expert on AMR and Global Coordinator of ReACT; Dr Keiji Fukuda, Assistant
Director General, Health Security and Environment, WHO; Prof Dame Sally
Davies, Chief Medical Officer, UK; Mr Goran Hagglund, Minister of Health,
Sweden; Dr Madeleine de Rosas Valero, Under Secretary of Health,
Philippines; Mr R.K Jain, Ministry of Health, India; and Prof Chris
Baggely, Chief Medical Officer, Australia.



And the messages underpinning the presentations from all speakers were that
a strategic approach was needed to manage the state of AMR globally.  This
strategic approach  would involve increasing awareness around the topic of
AMR at all levels and strengthening national capacity to handle AMR.   In
addition there was an urgent need for innovation on existing antibiotics;
development of newer and better antimicrobials and therapeutic approaches;
as well as new diagnostic tests.  Apart from these, old business models had
to be discarded to make way for newer ones that promoted the longest
possible use for any antibiotic.  To this end, what was requisite was to
reach out to business and economists.



Prof Otto Cars urged national governments to consider putting in place
antibiotic survival plans.  “The science with respect to antibiotics is
difficult; in fact many scientists have left this area of study and work.  To
prevent misuse of newer antibiotics, new business models were imperative so
that there is no misuse/abuse through rampant and unregulated marketing.  Apart
from this, a massive education campaign on ABR must take place
concurrently,” he said



Dr Keiji Fukuda drove the point home when he stated, “The impact and
resolution of AMR is going to be measured in years and possibly decades.  AMR
has very concrete implications which will affect everybody.  Everyday
common infections are going to become untreatable.  Hospitals will begin to
close down because of an inability to combat and control AMR.  The HIV, TB
and Malaria games are going to be lost.”



Dr Fukuda reiterated the need for global surveillance and reporting on AMR
to establish baseline data on the state of AMR globally.



In her presentation, Dr Madeleine informed that, “In our rush to focus on
human health and AMR, we have forgotten the animals.”



“Antibiotics are used like vitamins in animals.  In the Philippines,
cockfights are a national sport and Filipinos believe that antibiotics are
necessary to enhance the performance  of the cocks and protect them from
harm.  After the cockfight, the birds are cooked in a special dish and
consumed, pesticides residues notwithstanding,” she added.



[image: F:\DCIM\101_PANA\P1010700.JPG]









The state of AMR in humans is excacerbated by the use of antibiotics in
veterinary practice.  “The withdrawal period is not adhered to, and so
antibiotic residues find their way into human food,” she stated.



According to Dr Madeleine, there is a mandatory policy in the Philippines
for a national health plan on AMR involving multi stakeholder collaboration
from the relevant government departments, including agriculture, health and
local government, as well as the private/business sector.



Mr Jain shared India’s experience and informed that the country had
launched several initiatives to combat AMR including the Jaipur Declaration
and the New Delhi Call for Action.  India is currently embarking on a
sentinel surveillance system to coordinate use of AB in view of widespread
use and easy availability of antibiotics in the country.



Prof Chris Baggely, Chief Medical Officer, Australia informed that when the
country introduced its  Antibiotics Stewardship Initiative, the result was
a decrease in the incidence of resistance in hospitals.  Australia’s Hand
Washing Hygiene Initiative has been emulated by other countries
worldwide.  “Since
2007, the reducing pipeline for antibiotics has become increasingly clear.  In
view of this, the role of infection control cannot be de-emphasised or
discounted,” he stated.



“By revamping the accreditation process, all hospitals ( both public and
private) must put in place antimicrobial stewardship programmes.  This is a
compulsory standard from January 2013.  As a result of this, the interest
in AMR by CEOs of all hospitals had skyrocketed.



Prof Dame Sally Davies and Mr Goran Hagglund, as co-chairs, were emphatic
in their concluding remarks: political will was pivotal to push forward the
AMR agenda nationally.  Health ministers present at the meeting were urged
to immediately implement national health plans for AMR.  What was clear
from the proceedings was that the nature of the debate around AMR was much
more than just medical.  The social, economic and political contexts could
no longer be ignored nor dismissed.



 Report prepared by:  Shila Kaur, Health Consultant, TWN Penang.

                                       21/5/13
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