Introduction to Antimicrobial Resistance and the Maternal Sepsis Intervention

Abstract Non-communicable diseases (NCDs) are the leading cause of death and disability in the world with the majority of deaths occurring in low- and middle-income countries (LMICs). The financial implications of disease and disability due to NCDs, combined with the costs of long-term management, are major causes of impoverishment and serve as barriers to socio-economic development. The transition from infectious diseases to NCDs as leading causes of mortality in LMICs is driven by several factors, primarily increasing globalization, urbanization, ageing of populations and economic development. Responding to these challenges will require local and comprehensive primary and secondary prevention efforts. The World Health Organization’s Global Action Plan provides a road map and an array of policy options to achieve nine voluntary global targets by 2025. The primary responsibility of governments in responding to the challenge of NCDs includes international scientific cooperation to support national and local efforts. The implementation of such efforts to prioritize the prevention of NCDs will create an environment in which the rising trend of the NCD burden could be potentially halted and reversed. When developing NCD policies, stakeholders should consider evidence-based strategies which can be implemented by multidisciplinary teams that are led or have the participation of behavioral medicine scientists. Behavioral medicine strategies should be incorporated into the policy and intervention framework developed to target NCDs in LMICs.

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Antimicrobial Resistance as a Global Health Crisis

Oxford Research Encyclopedia of Politics ◽

10.1093/acrefore/9780190228637.013.1626 ◽

2020 ◽

Author(s):

Erik Baekkeskov ◽

Olivier Rubin ◽

Louise Munkholm ◽

Wesal Zaman

Keyword(s):

Antimicrobial Resistance ◽

Global Health ◽

Action Plan ◽

World Health ◽

Political Commitment ◽

Health Crisis ◽

Entry Points ◽

Global Action ◽

Global Initiatives ◽

Global Action Plan

Antimicrobial resistance (AMR) is a global health crisis estimated to be responsible for 700,000 yearly deaths worldwide. Since the World Health Assembly adopted a Global Action Plan on AMR in 2015, national governments in more than 120 countries have developed national action plans. Notwithstanding this progress, AMR still has limited political commitment, and existing global efforts may be too slow to counter its rise. The article presents five characteristics of the global AMR health crisis that complicate the translation from global attention to effective global initiatives. AMR is (a) a transboundary crisis that suffers from collective action problems, (b) a super wicked and creeping crisis, (c) the product of trying to solve other global threats, (d) suffering from lack of advocacy, and (e) producing distributional and ethical dilemmas. Applying these five different crisis lenses, the article reviews central global initiatives, including the Global Action Plan on AMR and the recommendations of the Interagency Coordination Group on AMR. It argues that the five crisis lenses offer useful entry points for social science analyses that further nuance the existing global governance debate of AMR as a global health crisis.

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Microbiological aspects of ozone: bactericidal activity and antibiotic/antimicrobial resistance in bacterial strains treated with ozone

Ozone Therapy ◽

10.4081/ozone.2018.7971 ◽

2018 ◽

Vol 3 (3) ◽

Author(s):

Giuseppe Giuliani ◽

Giovanni Ricevuti ◽

Antonio Galoforo ◽

Marianno Franzini

Keyword(s):

Antimicrobial Resistance ◽

Global Health ◽

Action Plan ◽

Animal Health ◽

Resistant Bacteria ◽

General Assembly ◽

The World ◽

Global Action ◽

New Antibiotics ◽

Global Action Plan

Antimicrobial resistance is one of the most complex global health challenges today. The world has long ignored warnings that antibiotics and other medicines are losing their effectiveness after decades of overuse and misuse in human medicine, animal health and agriculture. Common illnesses like pneumonia, postoperative infections, diarrhoeal and sexually transmitted diseases, as well as the world’s largest infectious disease killers – tuberculosis (TB), HIV and malaria – are increasingly becoming untreatable because of the emergence and spread of drug resistance. Worsening antimicrobial resistance could have serious public health, economic and social implications. The threat of antimicrobial resistance is also becoming a key consideration for programmes addressing maternal and child health, sexual and reproductive health, foodborne diseases, water and sanitation, and infection prevention and control. Although the 21st century is being shaped by technology and innovation, humans could soon find themselves in an era where simple infections once again kill millions every year. The past three years have seen unprecedented global political momentum to address antimicrobial resistance: in 2015, governments adopted a global action plan at the World Health Assembly and in 2016 passed a political declaration at the United Nations General Assembly. Antimicrobial resistance has made it onto the agendas of the G7 and G20 groups and is a core component of the Global Health Security Agenda. WHO is working closely with the Food and Agriculture Organization of the United Nations and the World Organization for Animal Health in leading global efforts against antimicrobial resistance and ensuring that the necessary momentum is consolidated and sustained. These efforts are guided by an ad-hoc interagency coordination group established in 2017. A global development and stewardship framework to combat antimicrobial resistance is being drafted to support the development of new antimicrobial medicines, diagnostics, vaccines and other tools. One of the gravest global concerns about antimicrobial resistance currently is that antibiotic resistance has emerged in so many pathogens, including TB. In 2016, at the high-level meeting of the UN General Assembly on antimicrobial resistance, Heads of State directed an unprecedented level of attention to curbing the spread of infections that are resistant to antimicrobial medicines. They reaffirmed their commitment to stopping the misuse of antimicrobial medicines in human health, animal health and agriculture, and recognized the need for stronger systems to monitor drug-resistant infections and the amounts of antimicrobials used in humans and animals. In the wake of the increasing global awareness of the need for new antibiotics, Member States highlighted market failures, and called for new incentives for investment in research and development of new, effective and affordable medicines, rapid diagnostic tests, and other important therapies to replace those that are losing their effectiveness. In response to this and in line with the Global Action Plan on Antimicrobial Resistance to support the identification of pathogens of greatest concern, WHO developed a priority list of antibiotic resistant bacteria to underpin renewed efforts for the research and development of new antibiotics. The only possible defence against the threat of antimicrobial resistance and the (very real) possibility of a post-antibiotic era is a global and coordinated effort by all stakeholders to support other important therapies such as the Oxygen-Ozone (O2O3) therapy. As a result, the scope and focus of the work underlying this dissertation was to study the application of O2O3 therapy towards several resistant bacteria. Moreover, we evaluated three different framework for gut bacteria, skin and soft tissue infections and mucosal infections.

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A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00873-9 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Sanjeev Singh ◽

Esmita Charani ◽

Sarada Devi ◽

Anuj Sharma ◽

Fabia Edathadathil ◽

...

Keyword(s):

Public Health ◽

Antimicrobial Resistance ◽

Antimicrobial Stewardship ◽

Infection Prevention ◽

The State ◽

Action Plans ◽

Public And Private ◽

Middle Income ◽

Middle Income Countries ◽

Public Health Threat

Abstract Background The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. Strategies Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. Conclusion Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.

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Policy Evaluation Network (PEN): Protocol for systematic literature review examining the evidence for impact of school policies on physical activity

HRB Open Research ◽

10.12688/hrbopenres.13089.1 ◽

2020 ◽

Vol 3 ◽

pp. 62

Author(s):

Kevin Volf ◽

Liam Kelly ◽

Enrique García Bengoechea ◽

Blathin Casey ◽

Anna Gobis ◽

...

Keyword(s):

Physical Activity ◽

Literature Review ◽

Systematic Literature Review ◽

Policy Evaluation ◽

Physical Inactivity ◽

Action Plan ◽

Relative Reduction ◽

Global Action ◽

The Impact ◽

Global Action Plan

Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity attributes an estimated 9% to this figure. Global responses have included the sustainable development goals and the global action plan on physical activity. Both point to policy action in physical activity (PA) to address change, yet the impact of policy is unknown. The protocol described outlines a systematic literature review that will be undertaken by the Policy Evaluation Network to address this knowledge gap. Protocol: This review of school PA policies is the first of seven planned reviews. The seven best investments for promotion of population PA identified in the Toronto Charter (whole-of-school programmes, transport policy, urban design policy, primary health care policy, public education policy, community programmes and sport programmes) will form the basis of these reviews. Seven individual scientific literature searches across six electronic databases, using key concepts of policy, PA, evaluation and a distinct concept for each area will be conducted. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined categories. Conclusions: The review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, this review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by the ‘Global Action Plan on Physical Activity’. Registration: PROSPERO CRD42020156630 (10/07/2020).

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The global governance of antimicrobial resistance: a cross-country study of alignment between the global action plan and national action plans

Globalization and Health ◽

10.1186/s12992-020-00639-3 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Louise Munkholm ◽

Olivier Rubin

Keyword(s):

Antimicrobial Resistance ◽

Global Governance ◽

Action Plan ◽

World Health ◽

Action Plans ◽

Vertical Alignment ◽

Member States ◽

Horizontal Alignment ◽

Global Action ◽

Global Action Plan

Abstract Background Antimicrobial resistance (AMR) is a growing problem worldwide in need of global coordinated action. With the endorsement of the Global Action Plan (GAP) on AMR in 2015, the 194 member states of the World Health Organization committed to integrating the five objectives and corresponding actions of the GAP into national action plans (NAPs) on AMR. The article analyzes patterns of alignment between existing NAPs and the GAP, bringing to the fore new methodologies for exploring the relationship between globally driven health policies and activities at the national level, taking income, geography and governance factors into account. Methods The article investigates the global governance of AMR. Concretely, two proxies are devised to measure vertical and horizontal alignment between the GAP and existing NAPs: (i) a syntactic indicator measuring the degree of verbatim overlap between the GAP and the NAPs; and (ii) a content indicator measuring the extent to which the objectives and corresponding actions outlined in the GAP are addressed in the NAPs. Vertical alignment is measured by the extent to which each NAP overlaps with the GAP. Horizontal alignment is explored by measuring the degree to which NAPs overlap with other NAPs across regions and income groups. In addition, NAP implementation is explored using the Global Database for Antimicrobial Resistance Country Self-Assessment. Findings We find strong evidence of vertical alignment, particularly among low-income countries and lower-middle-income countries but weaker evidence of horizontal alignment within regions. In general, we find the NAPs in our sample to be mostly aligned with the GAP’s five overarching objectives while only moderately aligned with the recommended corresponding actions. Furthermore, we see several cases of what can be termed ‘isomorphic mimicry’, characterized by strong alignment in the policies outlined but much lower levels of alignment in terms of actual implemented policies. Conclusion To strengthen the alignment of national AMR policies, we recommend global governance initiatives based on individualized responsibilities some of which should be legally binding. Our study provides limited evidence of horizontal alignment within regions, which implies that regional governance institutions (e.g., WHO regional offices) should primarily act as mediators between global and local demands to strengthen a global governance regime that minimizes policy fragmentation and mimicry behavior across member states.

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Global Action Plan on Antimicrobial Resistance

Microbe Magazine ◽

10.1128/microbe.10.354.1 ◽

2015 ◽

Vol 10 (9) ◽

pp. 354-355 ◽

Cited By ~ 16

Keyword(s):

Antimicrobial Resistance ◽

Action Plan ◽

Global Action ◽

Global Action Plan

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Opening up ‘fever’, closing down medicines

Medicine Anthropology Theory | An open-access journal in the anthropology of health illness and medicine ◽

10.17157/mat.6.4.676 ◽

2019 ◽

Vol 6 (4) ◽

Cited By ~ 1

Author(s):

Clare Chandler ◽

Justin Dixon

Keyword(s):

Antimicrobial Resistance ◽

Global Health ◽

Integrated Management ◽

Childhood Illness ◽

High Tech ◽

Middle Income ◽

Middle Income Countries ◽

Opening Up ◽

Over Time ◽

Global Algorithm

Rising concerns about antimicrobial resistance have sparked a renewed push to rationalise and ration the use of medicines. This article explores the case of the Integrated Management of Childhood Illness (IMCI) guideline, a periodically updated ‘global’ algorithm that shapes and normalises the centrality of medicines to care in low- and middle-income countries and, increasingly, the imperative to ration them. Using ‘classification work’ as analytic frame, we firstly consider the IMCI algorithm as a blueprint for global health that classifies illnesses, patients, and care in particular ways relative to available medicines. Zooming in on this blueprint, we then offer a classificatory reading of ‘fever’ over time, tracing ‘nonmalarial fever’ from being malaria’s residual ‘other’ category to becoming increasingly legible through attention to diagnostics and antibiotic (over)use. Our reading suggests that an apparent refinement of the ‘fever’ category may concurrently entail the closing down of medicine options. This raises the possibility that an increasingly high-tech but ‘empty’ form of pharmaceuticalised care is being incidentally worked into the infrastructure of weak health systems.

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