TACKLING DRUG-RESISTANT INFECTIONS GLOBALLY FINAL REPORT AND RECOMMENDATIONS

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HOW SURVEILLANCE CAN IMPROVE HEALTH OUTCOMES 33 Globally Provide early warnings of emerging threats and data to identify and act on long-term trends Nationally Guide policy and ensure appropriate and timely public health interventions Locally Allow healthcare professionals to make better informed clinical decisions to ensure better patient outcomes
34 data’ that will be generated as diagnostic tools are modernised and cloud computing is embraced. These new tools are just around the corner, and even less developed countries may be able to ‘leapfrog’ into using them. So questions about how data are owned, used and shared need to be answered now if the full potential of this information revolution is to be harnessed in our battle against AMR. Additionally, governments need to examine regulations and incentives for private players such as private laboratories, hospitals and pharmaceutical companies to encourage them to enter the field of surveillance and share the data that they collect, both on consumption and resistance rates. This presents a rich potential source of information that would generate more representative data. enhancements to emergency response capabilities64. We support the recommendations of the report and believe that a global commitment to investing on this scale is crucial to enable health systems to better respond to the threat of infectious diseases as a whole. The work of the WHO in setting up the GLASS, the work of the Fleming Fund in the UK, and the surveillance-focused strands of the GHSA, will play important roles in providing financial and technical support for building laboratory and surveillance capabilities in low and middle-income countries. How much would it cost? It is exceptionally challenging to establish a firm estimate of the costs of implementing a comprehensive, global surveillance system tracking antibiotic use and rising drug resistance across both the human and animal populations, and in the environment. First, there is a lack of data on current surveillance capabilities across the world, which are extremely variable with some countries and regions having advanced systems in place, some with insufficient laboratory capability for participating in surveillance, and some regions where there is simply no infrastructure or routine testing being carried out. Second, there is very little information to set out what type of system we would need to provide good quality data for surveillance that would also benefit the patient. Third, in the regions where resistance testing is conducted, it is often part of larger surveillance systems that are intrinsic parts of the wider healthcare infrastructure. Fourth, AMR is not limited to a single pathogen or case definition, unlike diseases such as polio, gonorrhoea or influenza, for which surveillance systems have existed for a while. It is therefore challenging to extrapolate the costs of AMR surveillance from the cost of already existing surveillance networks. However, we believe that improving the surveillance of AMR is vital. The recent GHRF report, recommended a total investment of 4.5 billion USD per year to improve national pandemic preparedness capabilities, including significant improvements to global disease surveillance capabilities as part of wider 64 GHRF Commission (Commission on a Global Health Risk Framework for the Future). The neglected dimension of global security: A framework to counter infectious disease crises, 2016.
Page 1 and 2: TACKLING DRUG-RESISTANT INFECTIONS
Page 3 and 4: ACRONYMS AND ABBREVIATIONS AMC Adva
Page 5 and 6: 2 time focusing on this over the la
Page 7 and 8: 4 EXECUTIVE SUMMARY Following 19 mo
Page 9 and 10: 6 7. Improve the numbers, pay and r
Page 11 and 12: 8 Review on Antimicrobial Resistanc
Page 13 and 14: 10 1. THE PROBLEM: WHY TACKLING AMR
Page 15 and 16: 12 This challenge will only get wor
Page 17 and 18: 14 AMR-related research between 200
Page 19 and 20: 16 An outline of the market failure
Page 21 and 22: 18 LOWERING DEMAND FOR ANTIMICROBIA
Page 23 and 24: 20 Labelling of medicines and food:
Page 25 and 26: 22 BETTER WATER AND SANITATION REDU
Page 27 and 28: 24 Intervention 3: Reduce unnecessa
Page 29 and 30: 26 is an issue that the G20 must ta
Page 31 and 32: 28 HOW COUNTRIES COULD ACHIEVE TARG
Page 33 and 34: 30 Reduce Environmental pollution W
Page 35: 32 Intervention 4: Improve global s
Page 39 and 40: 36 RAPID DIAGNOSTICS WOULD REDUCE U
Page 41 and 42: 38 NEW RAPID DIAGNOSTICS WOULD OPTI
Page 43 and 44: 40 Intervention 6: Promote developm
Page 45 and 46: 42 ALTERNATIVE PRODUCTS TO TACKLE I
Page 47 and 48: 44 Intervention 7: Improve the numb
Page 49 and 50: 46 rising drug resistance as poorer
Page 51 and 52: 48 INCREASING THE SUPPLY OF ANTIMIC
Page 53 and 54: 50 critical to ensure that efforts
Page 55 and 56: 52 Intervention 9: Better incentive
Page 57 and 58: 54 to emerge more quickly than comm
Page 59 and 60: 56 investment decisions by companie
Page 61 and 62: 58 need to sit on top of and fit wi
Page 63 and 64: 60 Tuberculosis: a cornerstone of t
Page 65 and 66: 62 of a new diagnostic (with no new
Page 67 and 68: 64 4. HOW TO PAY FOR IT: TACKLING A
Page 69 and 70: 66 level, agreements between compan
Page 71 and 72: 68 3. Exchangeable ‘vouchers’ t
Page 73 and 74: 70 antimicrobials and do not incent
Page 75 and 76: IF NOT TACKLED, RISING AMR COULD HA
Page 77 and 78: 74 3.5 3.6 3.7 In 2018, defined tar
Page 79 and 80: 76 ACKNOWLEDGEMENTS The views and o
Page 81 and 82: 78 Dr. Lloyd Czaplewski, Director,
Page 83 and 84: 80 Dr. John Stelling, Co-Director o

TACKLING DRUG-RESISTANT INFECTIONS GLOBALLY FINAL REPORT AND RECOMMENDATIONS

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