Transcript Document

UK Five Year Antimicrobial
Resistance Strategy
2013-2018
(published 10th September 2013)
Claire Boville – Department of Health
European Antibiotic Awareness Day 2013 @ UCL
Wednesday 20th November
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CMOs Annual Report (published March 2013)
The Chief Medical Officer (CMO) for England annual report set out:
• the scale of the global antimicrobial resistance (AMR) issue,
• its implications for public health and;
• the need for urgent action at a national and international level to
slow down and stem the spread of antimicrobial resistance.
The report highlighted the need for:
• action on a global scale to ensure better surveillance data
nationally and internationally;
• more work to preserve existing drugs and;
• encourage the development of new antibiotics and rapid
diagnostics.
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The UK Antimicrobial resistance strategy 2013-2018
Status of Antimicrobial Resistance in the UK
• Multi-drug resistant bacteria are spreading in the UK and world wide.
•
Increasing levels of resistant Gram negative bacteria are the most
pressing problem for the UK.
• Levels of resistance to carbapenem antibiotics, the last line drugs
used to treat infections caused by Gram negative bacteria, are low
but increasing.
Increasing resistance and a lack of new drugs means a risk of
infections that cannot be treated and more deaths
unless urgent action is taken.
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The UK Five Year Antimicrobial Resistance Strategy 2013-2018
What is needed?
• Improved infection prevention and control,
• Strengthened antimicrobial stewardship to conserve the
effectiveness of the antibiotics we have,
• Improve understanding of transmission pathways with a focus
on human, animal and wider environmental aspects,
• Develop better diagnostics and more targeted treatments,
• Stimulate the development of new antimicrobials and novel
Treatments.
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The UK Five Year Antimicrobial Resistance Strategy 2013-2018
UK Five Antimicrobial Resistance Strategy
(2013-2018)
• The UK Five year AMR strategy builds on the work of the first
UK AMR Strategy (2000) and has an holistic “one health“
focus.
• The strategy responds to the EU call to Member States to
produce national plans to tackle AMR
(2011 EU AMR Strategic Action Plan and the 2012 EU Council conclusions).
•
Its content was informed by:
• developments in other international fora (including WHO),
•
•
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the challenges set out in CMOs 2012 annual report; and
consultation with a wide range of technical experts and others
The UK Five Year Antimicrobial Resistance Strategy 2013-2018
Strategic Aims
The overarching goal of the Strategy is to slow the development and
spread of AMR.
It will do this by focusing activities around three strategic aims to:
1. improve the knowledge and understanding of AMR.
2. conserve and steward the effectiveness of existing treatments,
3. stimulate the development of new antibiotics, diagnostics and
novel therapies.
This will involve work in seven key areas for action, underpinned by
work needed to strengthen the evidence base and improve our
knowledge and understanding of AMR.
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The UK Five Year Antimicrobial Resistance Strategy 2013-2018
Seven Key Areas for Action
1. Improving infection prevention and control practices (PHE).
2. Optimising prescribing practice (PHE).
3. Improving professional education, training and public engagement
(PHE).
4. Developing new drugs, treatments and diagnostics (DH).
5. Better access to and use of surveillance data (PHE).
6. Better identification and prioritisation of AMR research needs
(DH).
7. Strengthened international collaboration (DH).
Note: Defra/VMD leads on all animal health aspects.
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The UK Five Year Antimicrobial Resistance Strategy 2013-2018
Implementation
• The DH, PHE and Defra/VMD lead work to implement the strategy.
• A new Interdepartmental High Level Steering Group has been
established to oversee implementation, working across all sectors.
• We are working with and through a wide range of stakeholders to:
influence opinion, galvanise support and mobilise action
needed to effect positive change of the scale and pace required
to avert a return to a pre-antibiotic era
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The UK Antimicrobial resistance strategy 2013-2018
Interdepartmental High Level Steering Group
(HLSG)
It is charged with:
• developing an implementation plan to be published by April
2014,
• developing detailed outcome metrics, to be published by April
2014
• publishing an annual report on progress outputs and
outcomes each year from November 2014
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The UK Five Year Antimicrobial Resistance Strategy 2013-2018
Outcome Measures
The HLSG, working with expert advisors, will develop detailed
measures in the following areas:• trends in changes in resistance in key infections
• assessing improvement in knowledge of antimicrobials and
their use,
• assessing improvements in the quality of prescribing in
primary and secondary care compared to baseline,
• monitoring use of antibiotics in animals – in particular, the 3
CIAs,
• assessing global alignment in addressing AMR.
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The UK Five Year Antimicrobial Resistance Strategy 2013-2018
Priority areas for UK International Activity
• Strengthen surveillance arrangements - improving our ability to quickly
identify new AMR threats or changing patterns in resistance,
• Extend the life of antibiotics by promoting better stewardship and
conservation of antibiotic use in human, animal and wider environment,
• Stimulate a sustainable supply of antibiotics and development of
innovative alternative treatments,
•
Encourage collaboration to develop rapid and robust point of care
diagnostics which can be used on a routine basis in clinical settings,
• Develop the evidence base to better understand the links between
resistance in animals and humans and transmission pathways,
•
Develop analysis of the economic burden of AMR for society,
• Engage effectively with society to promote the social responsibility,
• Use of behavioural science and communication mechanisms for take
action which will effect positive change.
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The UK Antimicrobial resistance strategy 2013-2018
European Antibiotics Awareness Day (EAAD)
• Communication, Awareness raising and understanding of AMR is
crucial to effecting positive change.
• A central plank to this is our work to promote and support EAAD
throughout the year.
• We are expanding the reach and impact of this work, for example
this year we have:
• established a link to Self Care Week and engaged more
community pharmacists
• sought to increase local participation through local
authorities;
• secured greater involvement of veterinary colleagues
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The UK Antimicrobial resistance strategy 2013-2018
The Focus of AMR International work
The UK international work programme will aim to deliver the following:
• galvanise international collaboration to prevent the global spread of
AMR (infection prevention and control, stewardship and
conservation aspects),
• garner support for a “one health” approach to tackling AMR and
developing evidence on the AMR transmission interface between
human, animal and wider environment,
• Be instrumental in and take a leading role in work with UN and
other key international bodies to develop innovative financing and
regulatory (licensing) approaches which will help stimulate
development of new antibiotics.
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The UK Antimicrobial resistance strategy 2013-2018
UK International Work
We continue to:
• press the EU and WHO to accelerate progress on implementation
of AMR strategic action plans,
• Secure political commitment to tackle AMR through a wide range
of fora such as G8, G20 and World Health Innovation Summit,
• Spearhead new initiatives to improve IPC, surveillance and
stewardship capability in lower income countries and developing
twinning projects across the Commonwealth
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The UK Antimicrobial resistance strategy 2013-2018
How we are doing this
The UK is actively participating on AMR work in a wide range of
international fora including:
• Promoted AMR issues during UK G8 Presidency at Science
Ministers meeting,
• Sponsoring international Chatham House round table
discussions on AMR
• Working with WHO and other UN bodies (OIE, FAO, Codex)
• Working with EU Commission on surveillance, research,
legislative and drug pipeline issues to tackle AMR.
• Working with the Commonwealth to support improved
surveillance and infection prevention and control,
• WISH Conference – CMO chairing the panel on AMR which will
highlight areas requiring further international action,
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The UK Antimicrobial resistance strategy 2013-2018
We need to get to a point where:
• good infection prevention and control measures to help prevent
infections occurring in the first place become the norm in all
sectors of human and animal health,
• infections can be diagnosed quickly and the right treatment
deployed,
• patients and animal keepers fully understand the importance of
antibiotic treatment regimens and adhere to them,
• surveillance is in place which quickly identifies new threats or
changing patterns in resistance, and
• There is a sustainable supply of new, effective antimicrobials for
human use.
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The UK Antimicrobial resistance strategy 2013-2018