Stewardship / Resistance Scan for Oct 22, 2019

Stewardship in low-income nations
G20 health leaders' AMR commitment
Veterinary stewardship progress

WHO issues toolkit for stewardship programs in low-resource countries

The World Health Organization (WHO) yesterday published a roadmap for implementing antimicrobial stewardship programs in healthcare facilities in low- and middle-income countries (LMICs).

The WHO toolkit provides guidance on the core elements and structures that need to be in place at the national and facility level in low-resource countries to establish and support antimicrobial stewardship, along with detailed recommendations on how to plan, perform, and assess stewardship interventions. It also provides an overview of the core competencies that an antimicrobial stewardship team needs to facilitate more responsible antibiotic prescribing, and the education and training required to develop those competencies.

The aim of the toolkit, according to Hanan Balkhy, MD, the WHO's assistant director-general for antimicrobial resistance (AMR), is to offer practical guidance to LMICs to support objective 4 of the Global Action Plan on AMR—optimizing the use of antimicrobial medicines.

"It is my sincerest hope that this toolkit will be helpful to countries in implementing their national action plans on AMR, in particular in optimizing their use of antibiotics," Balkhy writes in the foreword. "Time is running out, but we still have a window of opportunity to turn the tide on AMR and ensure continued effective treatment of bacterial infections for future generations. Let us act now."
Oct 21 WHO toolkit for stewardship in LMICs


G20 health ministers reaffirm commitment to urgent action on AMR

In a statement issued after their recent meeting in Japan, health officials from 19 countries and the European Union have reaffirmed their commitment to take urgent action to address AMR.

The Okayama Declaration, released following the Oct 19-20 meeting of G20 Health Ministers in Okayama, Japan, contains several commitments to address major health issues, which have been a focus of the group since 2017. In addition to AMR, the document reaffirms commitments to universal health coverage, active and healthy aging, and strengthening health systems against infectious disease outbreaks and other global health threats.

On AMR, the ministers say they will strengthen efforts to fund, implement, monitor, and update national and regional AMR action plans; enhance implementation of measures to provide clean water, sanitation, vaccination, and hygiene to improve infection control; promote antimicrobial stewardship and appropriate access to antimicrobials and diagnostics; encourage countries to strengthen AMR surveillance; and encourage investment in research and development of new antibiotics, diagnostics, and vaccines.

The document also acknowledges the need for a coordinated approach to addressing AMR and universal health coverage in order to achieve the 2030 Agenda for Sustainable Development.
Oct 20 Okayama Declaration


FDA details progress made in veterinary antimicrobial stewardship

Yesterday the US Food and Drug Administration (FDA) made public performance measures for tracking the progress of the Center of Veterinary Medicine's (CVM's) Five-Year Plan for Supporting Antimicrobial Stewardship in Veterinary Settings, the FDA said in an update. The information is contained in FDA-TRACK, which monitors progress on FDA projects. 

The CVM 5-year plan contains three goals:

  • Align antimicrobial drug product use with the principles of antimicrobial stewardship
  • Foster stewardship of antimicrobials in veterinary settings
  • Enhance monitoring of AMR and antimicrobial use in animals

The new performance measures pertain to the first goal and include implementing Guidance for Industry #213, which brings 292 medically important antimicrobials under veterinary oversight, defining the duration of use for 70% of medically important antimicrobial drugs used in food animals, assessing antimicrobial risk, and updating the list of medically important antimicrobials. 

Performance measures for the other two goals will be made available in the coming year, the FDA said. 
Oct 21 FDA update
FDA-TRACK progress report

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