WHO initiatives to build global AMR surveillance capacity

Transcription

1 WHO initiatives to build global AMR surveillance capacity Dr Danilo Lo Fo Wong Programme Manager An*microbial Resistance

2 AMR Surveillance Local National Regional Global Needed to: Guide patient treatment Inform local, national and regional action Monitor effectiveness of interventions Understand resistance development and spread Detect newly emerged resistance Major objective of European (2011) and Global (2015) AMR action plans

3 Expanding AMR surveillance throughout Europe European Antimicrobial Resistance Surveillance Network (EARS-Net) Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR) European Centre for Disease Prevention and Control World Health Organization Regional Office for Europe Countries submitting data to CAESAR Countries visited for CAESAR participation Countries to be visited for CAESAR participation Countries participating in EARS-Net

4 CAESAR Network Central Asian and Eastern European Surveillance of An2microbial Resistance Network of networks Strengthen national AMR surveillance Member States, not part of EARS-Net of EU Joined initiative European Society of Clinical Microbiology and Infectious Diseases (ESCMID) National Institute of Public Health in the Netherlands (RIVM) Close collaboration ECDC Use methodology compatible to WHO/Europe

5 CAESAR Methodology Pathogens under surveillance S. aureus (MRSA) S. pneumoniae (Pen R) E. coli (ESBL, Carbapenemases) K. pneumoniae (ESBL, Carbapenemases) E. faecium and E. faecalis (VRE) P. aeruginosa (MDR) Acinetobacter spp.

6 CAESAR Methodology Routinely collected blood or CSF isolates MIC/Zone diameter/etest and SIR interpretations International guidelines (EUCAST/ CLSI) Patient characteristics Gender, Age, ICU Denominator information Patient days to calculate incidences

7 CAESAR collaboration country support WHO EURO Political expertise Country support process Country situation analysis Follow up ac*vi*es National workshops Multi country workshops Consultancy / Mentorships Observerships / Twinning Focus - Laboratory capacity building; Reference labs; QA, ID & AST, EUCAST - CAESAR methodology; Standardized data collection - Diagnostic and antibiotic stewardship ESCMID Laboratory expertise RIVM IT/EPI expertise

8 CAESAR External Quality Assessment 15 countries have participated in 2015 (250 labs) Laboratories providing/planning to provide data to CAESAR Joint initiative with UK-NEQAS (PHE) and ECDC Six strains sent to each laboratory Results reported via secured website Instant feedback on performance

9 CAESAR Annual Report 2014 Data of 5 countries (Turkey, The former Yugoslav Republic of Macedonia, Serbia, Belarus, Switzerland) EQA results 2013 (9 countries) Levels of data quality described Guidance of data interpretation Provide AMR data to support policy decisions Encourage implementation, maintenance and improvement of national AMR surveillance programs

10 Global AMR Action Plan - Strategic Objectives 1. Improve awareness and understanding 2. Strengthen knowledge and evidence base 3. Reduce incidence of infection 4. Optimize use of antimicrobial medicines 5. Develop economic case for sustainable investment

11 Framework for action

12 GLASS objectives Foster national surveillance and global standards Estimate extent and burden of AMR globally Analyse and report global AMR data Detect emerging resistance and its international spread Inform implementation of targeted prevention and control programmes Assess the impact of interventions

13 GLASS specimens and pathogens

14 GLASS Information flow

15 GLASS and CAESAR Virtual platform - GLASS Countries An*microbial consump*on CAESAR / EARS- Net Aggregated global data Animal / food networks Relavra (PAHO) Other AMR networks

16 WHO support for surveillance Access to web-based platform for data sharing, management and reporting Support package, incl implementation tools, software Capacity-building activities and assistance in M&E Exchange and peer support between countries Provide technical support for implementation of GLASS International collaboration among WHO CCs, national and regional networks and other institutions

17 Acknowledgments Division of Communicable Disease, Health Security & Environment Nedret Emiroglu Cristiana Salvi Siff Malue Nielsen AMR Coordination Danilo Lo Fo Wong Nienke van de Sande-Bruinsma Saskia Nahrgang Food Safety Hilde Kruse Health Systems and Public Health Hans Kluge Health Technologies and Pharmaceuticals Hanne Bak Pedersen Guillaume Dedet Influenza & other Respiratory Pathogens Caroline Brown Pamela Hepple Vaccine Preventable Diseases & Immunization Robb Butler Catharina de Kat-Reynen Alert and Response Operations Ana Paula Coutinho

18 Thank you for your aoen*on