1. Strategy and Policy Cohesion: “The One Health Agenda: will it deliver”
Elizabeth J. Phillips, MD, FRCPC,FRACP, FACTM
Professor & Director, Centre for Clinical Pharmacology & Infectious Diseases
Institute for Immunology & Infectious Diseases, Murdoch University
John A. Oates Chair in Clinical Research
Professor of Medicine & Pharmacology
Director of Personalized Immunology
Oates Institute for Experimental Therapeutics
Vanderbilt University School of Medicine

2. “Drugs Don’t Work” Allan Roses, December 2003 VP of Genetics (GSK)
>90% of drugs have efficacy in 30-50% of people

3. Overview of Global and National Response
Social, financial and environmental depth
Education and communication
National antimicrobial resistance response documents supporting commitment
Global antimicrobial response
Implementation – what are the measurable outcomes

4. The AMR One Health Policy Toolkit: Animal-Human Interface
Awareness
Surveillance (obstacles to data collection) and antimicrobial stewardship in agriculture
Education and Communication
Evidence base (decreased AMR after voluntary withdrawal) and ongoing effectiveness monitoring
Broad agricultural implications and complexity of the “AMR web” (aquaculture, the plant connection)
Alternatives to antimicrobials in agriculture
Industry and regulatory issues

5. Globalisation & Governance of AMR
Challenges in developing world parallel those in developed world – political & cultural considerations
Defining extent of problem, educational compaigns
Conservation of antibiotics and promote stewardship and infection control
Challenges of global demand for animal protein (antimicrobial consumption in agriculture) – need incentives to change practice, non-antibiotic approaches, infection control
AMR shows no boundaries

7. One Health Approach Broadly engage Consistent approaches
Doctors, veterinarians, farmers, industry and community
Consistent approaches
Infection prevention, optimize antibiotic utilization in human and animal sectors, new treatments and diagnostic methods
Simple messages
What can be done now?
Reinforce positive achievements, raise awareness of risk, attention to health science, social, environmental and economic issues and uncertainties surrounding all
Australian Colloquium 2013

9. Driver’s and Consequences of Antimicrobial Resistance

11. Multidisciplinary Toolkit
System change
Training and education
Evaluation
Reminders (eg workplace)
Safety climate
Adapt to culture
Dr. Didier Pittet

12. Partnership, Leadership & Innovation
The Human health and social care sector
Livestock, food retail and veterinary sectors
Research councils, other research funders and academics
Pharmaceutical industry
Local governments, professional boards, scentific and other advisory committees
UK 5 year antimicrobial resistance strategy

13. WHO Global Action Plan Building Block 1: AWARENESS
Building Block 2: IDENTIFYING and OPERATIONALIZING INFECTION PREVENTION APPROACHES
Building Block 3: OPTIMIZING ANTIMICROBIAL USE IN HUMAN & ANIMAL HEALTH & AGRICULTURE
Building Block 4: CLOSING KNOWLEDGE GAPS
Building Block 5: INNOVATION
Building Block 6: COSTS AND INVESTMENT

14. US National Goals, Sept 2014 1. Slow Emergence of AMR
2. Strengthen National One-Health Surveillance Efforts
3. Advance development of rapid diagnostic tests to identify and characterize AMR.
4. New Antibiotics, therapeutics and vaccines
5. Global effort on AMR prevention, surveillance, control and antibiotic R&D.

15. Canadian AMR Response
ACTION 1: establish and increase surveillance in both animal and human settings
ACTION 2: promote appropriate antibiotic use in animal and human settings
ACTION 3: work with animal agriculture sector (antibiotic stewardship in veterinary medicine)
ACTION 4: promote innovation
October 2014

16. Where to go from here?
Definition and measurement of problem, awareness and broad and global engagement
Build on existing success and models that have a proven track record
What can we do now and defining priorities
What are the short and long-term measurable outcomes
Diagnostic test development
Antibiotic pipeline (a lengthy process that will not modify behavior or attack root of the problem)
Other approaches (vaccine, non-antimicrobial)