Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine (2022) / Chapter Skim
Currently Skimming:
8 A Role for the United States in Coordinated Global Action
8 A Role for the United States in Coordinated Global Action
Pages 321-340
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 321... ...
The consequences of the spread of SARS-CoV-2 were relatively clear and direct, while resistant pathogens may move around the world undetected until they are established in a population. The global dissemination pathways for antibiotic-resistant bacteria are well documented and include international travelers carrying resistant bacteria on their skin, in their gut, or in their upper respiratory system (Arcilla et al., 2017; Nurjadi et al., 2015; Reuland et al., 2016; Walker et al., 2018; Worby et al., 2020)
|
From page 322... ...
As the previous chapter explained, the implementing agencies are to be commended on their progress in meeting the goals set in the National Action Plan for Combating Antimicrobial Resistance, 2015– 2020. At the same time, meaningful and measurable progress against antimicrobial resistance will hinge on cross-sectoral policies and the balancing of human, animal, and environmental health priorities.
|
From page 323... ...
Key to this engagement would be the strengthening of international surveillance for resistant pathogens through increased support for both national and multilateral surveillance systems, such as the WHO's Global Antimicrobial Resistance and Use Surveillance System (GLASS) , described in Chapter 4, and the coordinated efforts of the tripartite program on antimicrobial resistance of the WHO, the Food and Agriculture Organization of the United Nations (FAO)
|
From page 324... ...
reduc ing need for antimicrobials by broadening agencies' work on infection prevention and antimicrobial stewardship in humans and animals; and (3) ensuring sustained leadership and critical evaluation by creating a Global Coordinator for Antimicrobial Resistance similar to the Global AIDS Coordinator.
|
From page 325... ...
. GLASS also provides implementation guidance specifically tailored to meet the challenges encountered in lowand middle-income countries, such as lack of a national action plan on antimicrobial resistance, the need for an accredited, coordination laboratory at a sentinel surveillance site, and the need for training clinical, laboratory, information technology, and public health personnel about antimicrobial resistance (Seale et al., 2017)
|
From page 326... ...
The FAO also supports countries in developing surveillance for resistant pathogens in food and agriculture. It provides guidelines on data management and susceptibility testing tools for aquaculture, and supports reference centers in eight countries to build tools and knowledge about antimicrobial surveillance in food and food-producing animals (FAO, 2016, 2019, 2021a,b,c; Smith, 2019)
|
From page 327... ...
Similarly, an effort to automate surveillance would mean faster turnaround on information, something valuable in low- and middle-income countries, where the opportunity costs of wasting time or resources are high and good data to guide antimicrobial stewardship activities are scarce. Attention to surveillance would complement U.S.
|
From page 328... ...
A higher burden of infectious disease and problems with infection control in health care contribute to the greater need for antibiotics in low- and middle-income countries. There is also a problem of inappropriate antimicrobial use, often a consequence of limited access to medicines and to quality health services (Das and Horton, 2016)
|
From page 329... ...
. There is also evidence that lack of staff training on infection control and Lack access Lack improved Lack soap for Lack adequate to piped water sanitation handwashing infectious waste disposal FIGURE 8-1 Environmental conditions in health facilities in 78 low- and middleincome countries.
|
From page 330... ...
Expanding programming would serve the dual goals of protecting local communities and mitigating emergence and global spread of resistant pathogens. The problem of unstable supply chains applies to medicines as well.
|
From page 331... ...
provides a voluntary external evaluation of countries' capabilities to comply with the International Health Regulations and respond to a variety of health threats, including antimicrobial resistance. A recent analysis of these evaluations in sub-Saharan Africa found that countries' antimicrobial stewardship was the weakest link in overall response plans for antimicrobial resistance (Elton et al., 2020)
|
From page 332... ...
. Such international partnerships may also be good tools to drive more political will for designing stewardship programs suitable to the challenges and context in low- and middle-income countries (Mathew et al., 2020)
|
From page 333... ...
Given the scope of this investment and the need for coordination with an increasingly large groups of stakeholders both in the United States and abroad, there is a need for a designated national leader on the antimicrobial-resistance effort. This role would be modeled off the Global AIDS Coordinator, with the same responsibility for monitoring and oversight of international response (FBS, 2018)
|
From page 334... ...
But some of the lessons learned from preventing and treating HIV are applicable to other global health crises, including antimicrobial resistance. Because of PEPFAR, there are processes in place for working with multiple government partners, intergovernmental agencies, the pharmaceutical industry, and various private philanthropic organizations.
|
From page 335... ...
. A global program for antimicrobial resistance might be able to build off the lessons learned from other global health initiatives and avoid this pitfall (Atun et al., 2008; Biesma et al., 2009)
|
From page 336... ...
2021. CDC and the global health security agenda.
|
From page 337... ...
:e00048-00019. GCOA and IDSA (Global Coalition on Aging and Infectious Diseases Society of America)
|
From page 338... ...
2019. Improving global health supply chains through traceability.
|
From page 339... ...
2019a. Global health security agenda.
|
From page 340... ...
https://www.who.int/initiatives/glass/glass modules-7 (accessed July 16, 2021)
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.