GLOBAL CHALLENGES IN AMR - GETTING RESEARCH TO MOVE BEYOND SILOS

GLOBAL CHALLENGES IN AMR - GETTING RESEARCH TO MOVE BEYOND SILOS

Fri, 06/08/2018 - 09:48
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A conference addressing the Global Challenges in Antimicrobial Resistance was held on 22 May in the Graduate institute, Geneva. The main discussion topic was “Getting Research to Move Beyond Silos”. It was also a launch event of the PLOS AMR Channel – which is an online resource for the AMR community.

By Felix Tin

In the Panel discussion session, six speakers were invited for the discussion, which they were Manica Balasegaram, Director of the Global Antibiotic Research & Development Partnership (GARD); Carmem L. Pêssoa-Silva, the team leader of the Infection Prevention and Control in Health Care unit in the World Health Organization; Ursula Theuretzbacher, a microbiologist and an expert in the antibacterial drug R&D; Peter Beyer, senior advisor of the department of Essential Medicines & Health Products in the World Health Organization; Ingrid Smith, technical officer of the Department of Essential Medicines & Health Products in the World Health Organization and Clare Stone, managing director of the PLOS Medicine.

Speakers had addressed a few issues regarding the AMR control, which included the R&D for new drugs, AMR data surveillance, full utilization of old antibiotics, infection prevention & control and the global AMR strategy.

In Balasegaram speech, he first addressed the current scientific challenges for developing the new drugs. Stressing the importance of the prioritization of investment in certain drugs and diseases, he stressed parties to deal with two “how questions”, i.e. how to develop the priorities and how to develop the drugs in suiting the best need for the people. Also, he expressed that AMR surveillance programme could help in targeting the drugs investments and let scientists understand how to do the R&D in different drugs. At the same time, parties should consider issues like the sustainability supply on antibiotics, better utilization of existing antibiotics, drug quality assurance of the antibiotics manufacturers, strategic use of antibiotics as well as the overuse of antibiotics by the healthcare workers. He summed up by recognizing the importance of public awareness and the role of the civil society in tackling against the AMR issue.

For Miss Pêssoa-Silva, she had been mainly focusing the importance of surveillance in AMR control. Through surveillance programs, data could be collected and help us understand the AMR situation in different countries. She also stated that these national data would be crucial for the global strategies in tackling AMR and AMR surveillance could be seen as a public good. Since 2016, there have been 60 countries already participating in the AMR surveillance system. Moreover, Pessoa-Silva had proposed a 3 steps solution in tackling against AMR.

1. Improving the quality of the doctors in terms of AMR surveillance and collecting a comprehensive, accurate and representative data so as to avoid a misleading data on the use of antibiotics.

2. Using the data to analyze what are the most problematic issues of AMR and developing target based solutions.

3. Performing prevention infection control, in which includes the awareness raising programs in public in changing people’s behavior in antibiotics usage, improving the social hygiene level and bridging the linkage of health and economy together.

As a microbiologist, Dr. Theuretzbacher had been viewing the AMR issue mainly from the scientific perspective. She had been stressing the importance of science itself in discovering the new antibiotics. At the same time, she also reminded that old antibiotics maybe even better than the new antibiotics. However, scientists would still need to further investigate on how to make the best use between old and new antibiotics so as to minimize the resistance. Dr. Theuretzbacher also recognized the challenges in working across the silos, especially in language terms. Nevertheless,  Dr. Theuretzbacher stated that it would be important for low-income countries in improving their use of antibiotics, especially in terms of the correct usage such as dosing them correctly.

For Beyer, he mainly addressed the issue of the setting up of the AMR convention and the national action plan in tackling against AMR. While AMR is currently a basket of issues without any unified and mutual agreement, the setting up of a global AMR convention, whether legally binding or not, maybe an option. Of course, details such as the setting of the individual country targets, accountability issues, AMR finance, cooperative and unified action plan remain to be discussed. Beyer also reemphasized the importance on the suitable use of antibiotics and infection prevention and control mechanism. “Will an International AMR Convention change the behavior of countries, doctors, pharmacies and healthcare workers in terms of their behavior on their use of antibiotics ?” This is a question that needed to be answered.

For Smith, she also stressed on the importance on the care handling of antibiotics. Guidance should be set to all the sectors in the society such as agriculture and health sector in monitoring the misuse and overuse of antibiotics. She used Sweden as an example, recognizing their efforts in successfully reducing their AMR prescription by 30 percent. While understanding each country has their different national context, Smith still believed that every country could be able to reduce the Antibiotics use. The most important is to get prescribers in the community to use antibiotics properly.

Lastly, for Stone, she mentioned the need for the crosstalk between the stakeholders. While AMR control has been brought to the national policy level, public engagement is crucial in successfully tackling the issue. Communication channel should be improved and bringing stakeholders together to promote the cross talking discussion.