Johan Struwe Sakkunnig, Infektionsläkare

Transkript

1 Johan Struwe Sakkunnig, Infektionsläkare

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3 Sid.

4 Det finns inte tillräckligt med information för att uppskatta humanitära och ekonomiska konsekvenser European Union 500m invånare 25,000 dödsfall/ år 2.5m extra vårddygn United States 300m invånare >23,000 dödsfall/ år s >2.0m sjuktillfällen Thailand 70m invånare >38,000 dödsfall/ år >3.2m vårddygn Overall societal costs ( 900 million, hosp. days) Approx. 1.5 billion per year Overall societal costs Up to $20 billion direct Up to $35 billion indirect Overall societal costs US$ mill. direct >US$1.3 billion indirect Källa: ECDC 2007 Källa: US CDC 2013 Källa: Pumart US CDC et al Antimicrobial Resistance: Global Surveillance

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6 Sjukdomsspecifika program Tuberkulos (2006) Artemisininresistent Malaria (2011) Antimicrobial resistance in N. Gonorrhoea (2012) Anti-HIV resistens (2012) Det finns ett gap vad gäller vanliga bakterier som orsakar vanliga sjukdomar Antimicrobial Resistance: Global Surveillance

7 2011: World Health Day policy package A call for action by Member States Comprehensive plan, accountability, civil society engagement Strengthen surveillance and laboratory capacity Access to essential medicines of assured quality Rational use of medicines Enhance infection prevention and control Foster innovation and R&D for new tools Antimicrobial Resistance: Global Surveillance

8 WHO Technical consultation on surveillance I December 2012 ledde till WHOs första globala report om resistensläget

9 Tillgängliga nationella data* för resistens hos 9 utvalda bug/ drug kombinationer 2013 *National data means data obtained from official sources, but not that data necessarily are representative for the population or country as a whole

10 Antibiotikaresistens finns överallt, i samhället och i vården Höga siffror Stor variation Begränsningar Osäkert underlag Ingen enhetlig metodologi Ingen information om patienter/populationen (huvudsakligen % resistenta bakterier) Kunskapsluckor

11 WHO Technical consultation on AMR surveillance II Mars 2014 bildande av arbetsgrupper Standards -Epidemiologisk information -Labmetoder inklusive kvalitet Former/ ramverk för samarbete September 2014 arbetsgruppernas förslag

12 Världshälsoförsamlingen maj 2014 Resolution WHA67.25 WHO Ta fram ett utkast till handlingsplan tillsammans med partners (FAO, OIE) som säkerställer att medlemsländerna har en nationell plan för att motverka AMR Medlemsländer Övervaka omfattningen av AMR -utveckla övervakningssystem för att kartlägga AMR Hos sjukhuspatienter Hos öppenvårdspatienter och i samhället Hos djur, inklusive icke-human användning av antibiotika

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14 WHO Global AMR Surveillance A foundation to monitor national, regional and global AMR Based on a Collaborative Platform for Member States To address AMR in a coordinated and cohesive manner; assess impact of interventions Standardised metrics; quality assured, validated data

15 What we need to achieve Global (WHO, with FAO, OIE): Report regularly on global and regional trends Integrate surveillance (human, animal, agriculture) National (countries): ability to systematically collect and analyse.....from both healthcare facilities and community meet recommendations of AGISAR, OIE animal codes, Codex A. share information Antimicrobial Resistance: Global Surveillance

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17 What is needed? Standards, protocols and methods EQA Training and education Data management tools Analysis and reporting Pathogen or disease specific expertise Regional coordination Monitoring and evaluation Enhanced collaboration with FAO and OIE: integrated surveillance: human, animal health and agriculture Needs analysis Antimicrobial Resistance: Global Surveillance

18 Standards guidance En meny : Prioriterade sjukdomar Prioriterade mikroorganismer Datainsamling och hantering Mikrobiologiska metoder Kvalitet Antimicrobial Resistance: Global Surveillance

19 Collaboration platform Collect, analyse comparable, validated AMR data Share information for decision making + advocacy + action Support capacity building; provide guidance to address gaps Overview of available technical and human resources Facilitate networking across sectors nationally, internationally Samarbetsavtal IT-struktur Stödjande dokument Antimicrobial Resistance: Global Surveillance

20 Hur tillgodoser vi behoven? National capacity Bi-lateral, multilateral cooperation Collaborating Centres Regional centres or hubs WHO resources (global, regional, country) Other agencies, non-governmental organizations Design Antimicrobial Resistance: Global Surveillance

21 Hur går vi vidare och implementerar? Use or adaptation of existing capacity WHO CCs Regional networks Twinning and other forms of direct support Fill the gaps Extend existing capacity Share practices New... Implementation Antimicrobial Resistance: Global Surveillance

22 Moving towards Global AMR Surveillance: establishing Standards and a Collaborative Platform Antimicrobial Resistance: Global Surveillance

23 Outline Plan Early implementation full implementation Needs analysis report Country situation analysis Global action plan Design Evaluation of early implementation (lessons learned) Antimicrobial Resistance: Global Surveillance

24 Outcome statement Ej publicerat än: Agree to work in support of Early Implementation Phase Sid.

25 Outcome statement Ej publicerat än: Agree to work in support of Early Implementation Phase Sid.

26 Sid.

27 Vad blir Sveriges roll? Sid.

28 Vad gör folkhälsomyndigheten internationellt? EU / Europeiska samarbeten Bilaterala samarbeten WHO Sid.

29 WHO-bilder från: Monica M Lahra, WHO Collaborating Centre for STD South Eastern Area Laboratory Services, Sydney NSW Australia Jean B Patel, WHO Collaborating Centre for International Monitoring of Bacterial Resistance to Antimicrobial Agents, Centers for Disease Control and Prevention, Atlanta, GA, USA Charles Penn, WHO HQ, Geneva, Switzerland Nalini Singh WHO HQ, Geneva, Switzerland Antimicrobial Resistance: Global Surveillance

30 Tack! Sid.