Global Surveillance of Human Pathogens Resistant to Antimicrobial Agents:
Introduction to the Proposed Global Platform
Monica M Lahra
WHO Collaborating Centre for STD
South Eastern Area Laboratory Services
Sydney NSW Australia
SOUTH EASTERN AREA
LABORATORY SERVICES
1800 0 SEALS 1800 0 73257
Surveillance of Antimicrobial Resistance for Local and Global Action
Stockholm, 2-3 December 2014
Antimicrobial Resistance (AMR)
• A threat to global health security.
• Associated increased morbidity, mortality, costs to health systems
• Calls for urgent action: develop, improve, enhance surveillance
WHO AMR Global Report on Surveillance 2014
Identified Key Gaps in:
• coordinated global AMR surveillance
• population-based AMR surveillance
• methodology and integrated surveillance
• coordination amongst existing networks to support collaboration
http://www.who.int/drugresistance/documents/surveillancereport/en/
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Moving towards Global AMR Surveillance:
establishing Standards and a Collaborative Platform
http://bmdp.org/wp-content/uploads/2013/12/164-moving-forward-389.jpg
General Functions of AMR Surveillance:
 determine the burden of AMR
 monitor trends in AMR
 inform treatment guidelines
 provide evidence to underpin public health strategies
 monitor impact of interventions
 detect incursion of resistant strains
http://michelsonmedical.org/2014/11/13/unique-antibiotic-mechanism-developed/
http://33q47o1cmnk34cvwth15pbvt120l.wpengine.netdna-cdn.com/wp-content/uploads/bottle-of-antibiotics-320x213.jpg
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WHO Global AMR Surveillance
• A foundation to monitor national, regional and global AMR
• Based on a Collaborative Platform for Member States
• To address AMR in a coordinated and cohesive manner
• Standardised metrics; quality assured, validated data
Initial Implementation of Global AMR Surveillance
Proposed Framework for Initial Implementation 2015:
1. Identify Member States ready to
i.
meet laboratories standards requirements
ii.
participate in initial phase
2. Invitation to participate through an MOU
3. Submission of aggregate data
4. Review, analysis and initial Report of WHO Global AMR Surveillance
5. Review, analysis and expansion of WHO Global AMR Surveillance
Building
Global
Surveillance:
Collaboration for Global Surveillance of AMR
Principle: to evaluate AMR indicators globally in a standardised manner
WHO will coordinate and manage a Global AMR Collaborative Platform
 Member States
 National and Regional Networks of:
 Collaborating Centres
 Laboratories
 Institutions
 Enhanced collaboration with FAO and OIE:
 integrated surveillance: human, animal health and agriculture
WHO Global AMR Collaborative Platform
Aims of the Global AMR Collaborative Platform :
• collect, analyse comparable, validated AMR data
• share information for decision making + advocacy + action
• support capacity building; provide guidance to address gaps
• overview of available technical and human resources
• facilitate networking across sectors nationally, internationally
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WHO Global Collaboration: IT Platform
Collaboration: requires Principles and Processes
Information Technology Platform will
– be coordinated and managed by WHO
– enable international collaboration
– foster data management, networking, collaboration
Global Surveillance of AMR: IT Platform
The Information Technology Platform functions:
– multisite data entry
– centralised data storage
– enable data retrieval, analysis and sharing
In the longer term the IT Platform will:
– be expanded to form a global AMR repository
– include data from the veterinary and agricultural sectors
•
•
•
•
Define Information Needs (Country and Global)
Define Core AMR data (pathogen+antibiotic)
Laboratory structure and capacity including EQA
IT platform
Data collection in Health Facilities and Community:
Epi data and AMR of pathogens to specific antibiotics
National Reference Laboratory/ies
National AMR Coordinator
Country Data: aggregated, analysed, utilized
Networks: New and Existing
Flow of reporting
Advisory
AGISTAR: antimicrobial
susceptibility testing of
foodborne pathogens
WHO/FAO/OIE
AMR IT Platform
Regional hubs or WHO CC
World Health Organization
Global Repository
•Surveillance data
•Special studies
•Impact studies
•Drug use
Advisory Group on
AMR surveillance
Drug use:
WHO/FAO/OIE
Acknowledgments:
Members of the WHO Working Groups
for Standards and Collaboration
Awa Aidara-Kane
Saskia Nahrgang
Celia Alpuche Aranda
Christopher Oxenford
Jorge Matheu Alvarez
Jean Patel
Penelope Andrea
Charles Penn
Olov Aspevall
Carmem Pessoa-Silva
Carolee Carson
Olga Perovic
Amy Cawthorne
Pilar Ramon-Pardo
Tejinder Chowdhary
Jean-Baptiste Ronat
Sergey ErEmin
Betuel Sigauque
Hajo Grundmann
Johan Strewe
Liselotta Diaz-Högberg
Neinke van de Sande-Bruinsma
Shashi Khare
Nalini Singh
So Hyun Kim
Aparna Singh-Shah
Roman S. Kozlov
John Stelling
Tjalling Leenstra
Teodora Wi
Danilo Lo Fo Wong
Yonghong Xiao
Ali R. Mafi
thank you
monicalahra@sesiahs.health.nsw.gov.au