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Antibiotics have been a critical public health tool since the discovery of Penicillin in 1928, saving the lives of millions of people around the world. In developing country like ours, where the burden of treatable disease is very high and access to health facilities and laboratories is difficult, a
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ntibiotics have long acted as miracle drugs. Today, however, the emergence of drug
resistance in bacteria is reversing the miracles of the past eighty years, with drug choices for the treatment of many bacterial infections becoming increasingly limited, expensive, and in some cases, nonexistent. Diseases previously regarded as relatively easy to manage are much harder to treat as doctors must use “last-resort” drugs that are more costly, take longer to work
and are often unavailable or unaffordable in developing countries. Moreover, regular prescription of antibiotics, random treatment, over the counter sales, inadequate dosage, inclusion of antibiotics in animal feeds and agriculture has contributed equally to emergence of antibiotics resistance as silent epidemic within the country.
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Maldives has made significant strides in the area of infectious disease prevention and control. This is exemplified by elimination of malaria from Maldives in 2015 and successes in TB control. In addition, Maldives is a front runner in infectious disease prevention through successful water, sanitati
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on, hygiene and vaccination campaigns and coverage. However, given the limited evidence that exists with respect to the occurrence of resistant organisms in the nation, it is hard to estimate the exact antimicrobial resistance (AMR) scenario. Also, it becomes difficult to compare the current situation with other countries in the region. Moreover, limited evidence exists on the trends of use of antimicrobial agents (AMA) in Maldives. Although, recent prescription audits have indicated overuse of antibiotics, especially for common conditions such as flu, cough and fever.
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The issue of Antimicrobial resistance has become one of the most substantial health issues, prompting the World Health Assembly (WHA) to urge Member States to finalise tailor made national action plans by May 2017, aligning them with objectives of the Global Action Plan (GAP). These cover awareness,
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surveillance and research, hygiene infection prevention & control, optimal use of antimicrobial medicines and economic case for sustainable investment. Indonesia, by virtue of its geographical terrain and complex interactions with diverse stakeholders, indicates a higher burden of AMR. Most of the country’s data currently relies on local studies conducted by labs and universities. To get a more accurate estimate of the situation, one has to rely on results from the Regional Resistance Surveillance Programme. By undertaking such measure, Indonesia would acquire data to detect AMR trends at a national level.
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Priority research questions for TB/HIV in HIV-prevalent and resource-limited settings
H. Getahun; R. Granich; C. Lienhardt; et al.
World Health Organization (TBHIV Working Group)
(2010)
C_WHO
Stop TB Partnership
Supporting the food and agriculture sectors in implementing the Global Action Plan on Antimicrobial Resistance to minimize the impact of antimicrobial resistance
As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of the planet. We rely on land and sea for the produc
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tion of safe and quality foods for our daily nourishment. Pests and disease epidemics negatively impact the quality, quantity and safety of our food sources, and cripple economic growth and efficiencies in production. Furthermore, the epidemic and endemic levels of the pathogens and disease vectors can be difficult to control. This is why FAO stresses and promotes the special efforts required for cost-effective preventive measures rather than the more expensive control, disinfestation, treatment and disposal measures. When preventive measures are late or difficult, preparedness and contingency plans must be in place to enable rapid response. Early warning systems, based on close monitoring, surveillance, and timely reporting are fundamental to warn and empower communities to safeguard their livelihoods and assets by enhancing disease and pest prevention measures and for government services to take immediate measures to protect communities and national economies.
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Health care-associated infection (HCAI) places a serious disease burden and has a significant economic impact on patients and health-care systems throughout the world. Yet good hand hygiene, the simple task of cleaning hands at the right times and in the right way, can save lives. World Health O
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rganization (WHO) has developed evidence-based WHO Guidelines on Hand Hygiene in Health Care to support health-care facilities to improve hand hygiene and thus reduce HCAI.
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Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19
recommended
Updated Interim guidance 29 July 2020
The provision of safe water, sanitation and waste management and hygienic conditions is essential for preventing and for protecting human health during all infectious disease outbreaks, including of coronavirus disease 2019 (COVID-19). Ensuring evidenced-based
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and consistently applied WASH and waste management practices in communities, homes, schools, marketplaces, and healthcare facilities will help prevent human-to-human transmission of pathogens including SARS-CoV-2, the virus that causes COVID-19.
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MICROBIAL DRUG RESISTANCEVolume 24, Number 5, 2018ªMary Ann Liebert, Inc.DOI: 10.1089/mdr.2017.0383
Antibiotic resistance (ABR) is a worldwide publichealth concern, with serious health, economic, and so-cietal repercussions. Its emergence is attributed to the se-lective pressure exerted by antib
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iotic use in the community, hospitals, veterinary health, agriculture, aquaculture, and the environment. Additionally aggravating the situation is the fact that very few new antibiotics have recently been produced by pharmaceutical companies. It is widely acknowledged that food animals are key reservoirs of antibiotic-resistant bacteria and that antibiotic usage in this population favors the emergence, selection, and spread of resistance among animals and humans, both through zoonoses (infectious diseases trans-mitted between animals and humans) and the food chain.
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Comprehensive Reviews in Food Science and Food Safety, Vol.12 (2013) pp.234-248
In 2006, the Institute of Food Technologists (IFT) published an Expert Report entitled “Antimicrobial Resistance: Implications for the Food System” (IFT 2006). That report summarized current scientific knowledge pe
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rtaining to the public-health impact of antimicrobial use in the food system and the development and control of antimicrobial resistance. Since that time, intense interest in this topic has continued within the regulatory and scientific communities as well as the general public. This IFT Scientific Status Summary serves to update that 2006 IFT Expert Report by briefly reviewing new scientific evidence relevant to the goals of the initial report and providing a number of key observations and conclusions.
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Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since be
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en applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
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This document provides additional guidance for the responsible and prudent use of antimicrobials in food-producing animals, and should be read in conjunction with the Recommended International Code of Practice for Control of the Use of Veterinary Drugs CAC/RCP 38-1993. Its obj
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ectives are to minimize the potential adverse impact on public health resulting from the use of antimicrobial agents in food-producing animals, in particular the development of antimicrobial resistance. It is also important to provide for the safe and effective use of veterinary antimicrobial drugs in veterinary medicine by maintaining their efficacy. This document defines the respective responsibilities of authorities and groups involved in the authorization, production, control, distribution and use of veterinary antimicrobials such as the national regulatory authorities, the veterinary pharmaceutical industry, veterinarians, distributors and producers of food-producing animals.
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The purpose of this guidance is to assist WHO Member States, and other stakeholders, in the establishment and development of programmes of integrated surveillance of antimicrobial resistance in foodborne bacteria (i.e., bacteria commonly transmitted by food). In this guidance, “integrated surveill
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ance of antimicrobial resistance in foodborne bacteria” is defined as the collection, validation, analyses and reporting of relevant microbiological and epidemiological data on antimicrobial resistance in foodborne bacteria from humans, animals, and food, and on relevant antimicrobial use in humans and animals. Integrated surveillance of antimicrobial resistance in foodborne bacteria therefore includes data from relevant food chain sectors (animals, food and humans) and includes data on both antimicrobial resistance and antimicrobial use. Integrated surveillance of antimicrobial resistance for foodborne bacteria expands on traditional public health surveillance to include multiple elements of the food chain, and to include antimicrobial use data, to better understand the sources of infection and transmission routes.
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A conceptual framework for the environmental surveillance of antibiotics and antibiotic resistance
Patricia M.C. Huijbers, Carl-Fredrik Flach, D.G. Joakim Larsson
Centre for Antibiotic Resistance Research (CARe), University of Gothenburg
(2019)
C2
The systematic surveillance of antibiotic use and antibiotic re-sistance prevalence in humans and animals is imperative for managingbacterial infectious disease (JPIAMR, 2019;WHO, 2015). Many low-income countries currently face substantial challenges in building national surveillance systems due to
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a lack of infrastructure and resources,resulting in a shortage of systematic data (FAO/OIE/WHO, 2018)
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Handbook of COVID-19 Prevention and Treatment
recommended
Handbook of COVID-19 Prevention and Treatment, expecting to share their invaluable practical advice and references with medical staff around the world. This handbook compared and analyzed the experience of other experts in China, and provides good reference to key departments such as hospital infect
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ion management, nursing, and outpatient clinics. This handbook provides comprehensive guidelines and best practices by China's top experts for coping with COVID-19.
This handbook, provided by the First Affiliated Hospital of Zhejiang University, describes how organizations can minimize the cost while maximizing the effect of measures to manage and control the coronavirus outbreak. The handbook also discusses why hospitals and other healthcare institutions should have command centers when encountering a large-scale emergency in the context of COVID-19. This handbook also includes the following：
- Technical strategies for addressing issues during emergencies.
- Treatment methods to treat the critically ill.
- Efficient clinical decision-making support.
- Best practices for key departments like inflection management and outpatient clinics.
more
Interim Version 24, February 2020
This checklist has been prepared with the aim of supporting hospital managers and emergency planners in achieving the above by defining and initiating actions needed to ensure a rapid response to the COVID-19 outbreak. The checklist is structured on eleven key co
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mponents; under each component, there is a list of questions regarding the status of implementation of the recommended action specific to that component. Hospitals at risk of increased health service demand should be prepared to initiate the implementation of each action promptly. The section on “Recommended reading” lists selected tools, guidelines and strategies relevant to each component, as well as other supporting documentation.
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This survey is part of a series of eight country surveys conducted in the context of the People that Deliver Initiative (peoplethatdeliver.org). This global initiative, which brings together the world’s largest organizations, aims to improve health services performance through the professionalizat
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ion of logistics managers.
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In 1998 the Swedish Veterinary Association decided to adopt a general policy for the use of antibiotics in animals. Since then specifi c policies for the use of antibiotics in dogs and cats have been adopted and in 2011 Guidelines for the use of Antibiotics in Production animals – Cattle and Pigs,
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were accepted. By decision of the board of the Swedish Veterinary Society (SVS) these guidelines have been updated. Th e over-arching goal of SVS is to achieve a low and controlled use of antibiotics in Swedish animal production so that the fi rst-hand choices of treatment remain effi cient and that the spread of antimicrobial resistance – among animals and herds as well as in the food chain – is kept at a minimum. Keeping antimicrobial resistance in animals low is important also for human health, since we are all part of the same ecosystem. Th e authors of these guidelines hope that they may be useful for veteri-narians in clinical practice when deciding on treatments for common diseases and ailments caused by bacteria. Sometimes the decision may even be to refrain from use of antibiotics and chose other ways of improving herd health.
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The era of effective antibiotics is coming to a close. In just a few generations, many “miracle medicines”have been beaten into ineffectiveness by the bacteria they were intended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order
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to survive. The misuse of antibiotics,which is an international problem, only exacerbates the steady evolution of resistance. In August 2010, the journal Lancet Infectious Diseases posed the question "Is this the end of antibiotics?" documentingthe rapid spread of multidrug-resistant bacteriaand predicting that 10 years remain in the useful life of many agents.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro
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bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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