1. European Antibiotic Awareness Day 2013, 18 November 2013 European Antibiotic Awareness Day 2013 * Joining efforts to avoid a post-antibiotic era [Name presenter] *The EAAD is a European health initiative coordinated by the European Centre for Disease Prevention and Control (ECDC) and supported by the European Commission and the WHO Regional Office for Europe

2. European Antibiotic Awareness Day 2013, 18 November 2013 “ Antibiotic overuse, underuse and misuse are the most important drivers of resistance. That is why mapping both the consumption of antibiotics and the resistance patterns of infectious agents is a primary step to spot and tackle this growing public health problem. Decision-makers urgently need this information for appropriate recommendations and regulatory action on provision, prescription and consumption of antibiotics”. Dr Guenael Rodier Director of Communicable Diseases, Health Security and Environment

3. European Antibiotic Awareness Day 2013, 18 November 2013 Antibiotic misuse is the major driver of resistance No national regulation or enforcement on antibiotic usage Antibiotics given to healthy animals as growth promoters or to prevent disease Commercial companies engaged in irresponsible promotion Antibiotics sold over the counter Antibiotics prescribed inappropriately, including to treat viral infections

4. European Antibiotic Awareness Day 2013, 18 November 2013 Antibiotics are a miracle of modern science 20 years added to our life expectancy (together with vaccination) Many millions of lives saved Surgery-related infections prevented Livestock more productive

5. European Antibiotic Awareness Day 2013, 18 November 2013 Increasing antibiotic resistance decreases effective treatment Antibiotic resistance is a natural phenomenon It is accelerated by misuse and overuse of antibiotics It claims lives, costs money, affects livelihoods, undermines health programmes No new antibiotic classes discovered in 25 yrs.

6. European Antibiotic Awareness Day 2013, 18 November 2013 Full picture of the European Region still lacking Current situation in European Union alarming –5-12% hospital patients acquire infection during stay –400.000 patients catch a resistant strain each year –25.000 patients die MRSA & resistant E.coli in 31 European countries* –260.000 bloodstream infections –370.000 extra hospital days –€ 62 million *De Kraker MEA et al., PLoS Medicine, 2011, 8(10) e1001104

7. European Antibiotic Awareness Day 2013, 18 November 2013 Use antibiotics when and as prescribed by a doctor Antibiotics kill bacteria, not viruses. Viruses cause 9 out of 10 sore throats. Taking antibiotics unnecessarily weakens their effectiveness. This enables bacteria develop resistance to antibiotics.

8. European Antibiotic Awareness Day 2013, 18 November 2013 Antibiotic resistance respects no borders For the first time, antimicrobial resistance listed as cross-border threat in Decision No 1082/2013/EU of European Parliament (entered into force 6 November 2013) Resistant pathogens spread everywhere through people and food on the move The success of the Decision relies on regional and global action

9. European Antibiotic Awareness Day 2013, 18 November 2013 WHO addresses the challenge of antibiotic resistance in the European Region Action plan building on momentum created by WHO in 2011 Recognizing –AMR neglected in many countries of the region –no systematic AMR surveillance in large part of the Region –international spread of AMR through trade and travel –need for international standards and data sharing

10. European Antibiotic Awareness Day 2013, 18 November 2013 WHO calls on countries to complete the picture

11. European Antibiotic Awareness Day 2013, 18 November 2013 Progress of CAESAR ( C entral A sian and eastern E uropean S urveillance of A ntimicrobial R esistance) The following countries are now engaged in CAESAR: Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Montenegro, Kyrgyzstan, Russian Federation, Serbia, Switzerland, The former Yugoslav Republic of Macedonia, Turkey, as well as Kosovo (in accordance with UN SCR 1244, 1999) Surveillance forms the basis for evidence-based action

12. European Antibiotic Awareness Day 2013, 18 November 2013 WHO collects region-wide antimicrobial use data WHO and University of Antwerp (Belgium) organise technical workshops for data collection and analysis of national antimicrobial use data Non-EU countries ready to publish data: Armenia, Azerbaijan, Belarus, Bosnia & Herzegovina, Georgia, Kyrgyzstan, Moldova, Montenegro, Serbia, Tajikistan, Turkey, as well as Kosovo (in accordance with UN SCR 1244, 1999)

13. European Antibiotic Awareness Day 2013, 18 November 2013 Antibiotic use and resistance in [COUNTRY]

14. European Antibiotic Awareness Day 2013, 18 November 2013 A coordinated response is urgently needed " As antibiotic resistance is affecting the entire WHO European Region, WHO is working closely with countries in Eastern Europe, Caucasus and Central Asia to complement the data collected by European Union (EU)’ institutions such as the European Centre for Disease Prevention and Control (ECDC) for all countries of the EU and the European Economic Area (EAA)” (Dr Guenael Rodier)