Post on 05-Jul-2018
8/15/2019 AMR and Rational Use of Antibiotics Workshop Dr Mary Murray ReAct
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Antimicrobial resistance ‐ what are we talking about?
Antimicrobial resistance (AMR)
Antiviral Antiparasitiic
ABR
agen s
(e.g drugs for
HIV)
agents
(e.g drugs for =Antibiotics
(e.g. drugs
for
u ercu os s
and
diseases
…
8/15/2019 AMR and Rational Use of Antibiotics Workshop Dr Mary Murray ReAct
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main focus of the workshop
Compared to other health problems,
we are not talking about a specific disease
Instead, we are talking about a medicalproduct that is no longer working against
bacteria causing many common infectious
diseases
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Common diseases‐ becoming non‐treatable
Blood
n ec ons
Surgical
infections
onorr ea
AntibioticAntibioticResistanceResistance
Pneumonia Typhoid
fever
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In addition, many medical procedures
are affected and threatened b ABR
Care of
pre erm
children
Trans‐
plantations
Major
surgical
procedures
AntibioticAntibioticResistanceResistance
treatment Safe child
deliveries
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Who is affected by ABR?
Ever one !
However ……
→… vulnerable o ulations with the hi hest
infectious disease
burden
pays
the
highest
price
→… these populations are also the ones that have
least
access to
current
and
future
interventions
to manage antibiotic resistance
8/15/2019 AMR and Rational Use of Antibiotics Workshop Dr Mary Murray ReAct
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8/15/2019 AMR and Rational Use of Antibiotics Workshop Dr Mary Murray ReAct
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Cost Implications of growing antibiotic resistance ARE
Typhoid fever
Cost of antibiotics for non-resistant cases $3-5
Cost of antibiotics for resistant cases
Azithromycin $35-42
ra cep a ospor ns ce x me -
Parenteral cephalosporins (ceftriaxone) $84-104
Average Treatment Costs for Typhoid (US$)
Child weighing 20 kg using standard treatment guidelines
Source: AKU Pharmindex 2004 & WHO guidelines 2003
8/15/2019 AMR and Rational Use of Antibiotics Workshop Dr Mary Murray ReAct
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We are beginning to sense that the hidden problem is much larger than we imagined
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bacteria and the global spread of resistance
• Poor sanitation and hygiene
• Alarming decline in antibiotics development
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A Global Problem
Worldwide spread of the 23F clone of penicil lin
resistant pneumococci
France
U. K
USA
Japan
Korea
Mexico
Colombia
Taiwan
Singapore
Argentina Brazil S. Africa
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ESBL (CTX-M) producing Enterobacteriaceae
2001-2002
Endemici ty Sporadic reports
2007
Endemic it y Sporad ic repor ts 2005
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The drug development pipeline for
antibiotics has
gone
dry
• T e ast anti iotic c ass was iscovere in
1987 ! No new drugs for:
•
- Typhoid fever - Shigella
ineffective due to antibiotic resistance- Gonorrhoea- Urinary tract infections
• The pharmaceutical industry has
neither the
- oo n ec ons- ..........
-innovative capacity nor the commercialinterest to develop novel antibiotics
........
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Strategies to stop manage antibiotic
res stance
Prolong the lifespan of existing drugs
Rational Usee er agnos cs
Prevent the spread of resistant bacteria
Improved hygieneInfection control
Development of new antibiotics
Controlled distribution and use of new future antibiotic A new global system to preserve the effectiveness of antibiotics
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Antibiotic Resistance
Caused by human activity and by over‐ consumption
of a obal resource
A failure of public policy & global governance, research prioritization and the current market system
,
organizations and individuals to take action
Through our activism, need to inspire people to hold us all
collectively accountable
NasaNasa 1969: Earthrise over the moon from Apollo II1969: Earthrise over the moon from Apollo II
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Encouraging Multisectoral Regional Networks
China
IndiaSouth East
A r ca
America
Australia