1. Global Surveillance of Human Pathogens Resistant to Antimicrobial Agents: Introduction to the Proposed Global Platform Monica M Lahra WHO Collaborating Centre for STD South Eastern Area Laboratory Services Sydney NSW Australia SOUTH EASTERN AREA LABORATORY SERVICES 1800 0 SEALS 1800 0 73257 Surveillance of Antimicrobial Resistance for Local and Global Action Stockholm, 2-3 December 2014

2. Antimicrobial Resistance (AMR) A threat to global health security. Associated increased morbidity, mortality, costs to health systems Calls for urgent action: develop, improve, enhance surveillance

3. WHO AMR Global Report on Surveillance 2014 Identified Key Gaps in: coordinated global AMR surveillance population-based AMR surveillance methodology and integrated surveillance coordination amongst existing networks to support collaboration

4. 5 http://www.who.int/drugresistance/documents/surveillancereport/en/

5. Moving towards Global AMR Surveillance: establishing Standards and a Collaborative Platform http://bmdp.org/wp-content/uploads/2013/12/164-moving-forward-389.jpg

6. General Functions of AMR Surveillance:  determine the burden of AMR  monitor trends in AMR  inform treatment guidelines  provide evidence to underpin public health strategies  monitor impact of interventions  detect incursion of resistant strains http://michelsonmedical.org/2014/11/13/unique-antibiotic-mechanism-developed/ http://33q47o1cmnk34cvwth15pbvt120l.wpengine.netdna-cdn.com/wp-content/uploads/bottle-of-antibiotics-320x213.jpg 7

7. WHO Global AMR Surveillance A foundation to monitor national, regional and global AMR Based on a Collaborative Platform for Member States To address AMR in a coordinated and cohesive manner Standardised metrics; quality assured, validated data

8. Initial Implementation of Global AMR Surveillance Proposed Framework for Initial Implementation 2015: 1. Identify Member States ready to i. meet laboratories standards requirements ii. participate in initial phase 2. Invitation to participate through an MOU 3. Submission of aggregate data 4. Review, analysis and initial Report of WHO Global AMR Surveillance 5. Review, analysis and expansion of WHO Global AMR Surveillance

9. Building Global Surveillance:

10. Collaboration for Global Surveillance of AMR Principle: to evaluate AMR indicators globally in a standardised manner WHO will coordinate and manage a Global AMR Collaborative Platform  Member States  National and Regional Networks of:  Collaborating Centres  Laboratories  Institutions  Enhanced collaboration with FAO and OIE:  integrated surveillance: human, animal health and agriculture

11. WHO Global AMR Collaborative Platform Aims of the Global AMR Collaborative Platform : collect, analyse comparable, validated AMR data share information for decision making + advocacy + action support capacity building; provide guidance to address gaps overview of available technical and human resources facilitate networking across sectors nationally, internationally

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13. WHO Global Collaboration: IT Platform Collaboration: requires Principles and Processes Information Technology Platform will – be coordinated and managed by WHO – enable international collaboration – foster data management, networking, collaboration

14. Global Surveillance of AMR: IT Platform The Information Technology Platform functions: –multisite data entry –centralised data storage –enable data retrieval, analysis and sharing In the longer term the IT Platform will: –be expanded to form a global AMR repository –include data from the veterinary and agricultural sectors

15. Define Information Needs (Country and Global) Define Core AMR data (pathogen+antibiotic) Laboratory structure and capacity including EQA IT platform Data collection in Health Facilities and Community: Epi data and AMR of pathogens to specific antibiotics Networks: New and ExistingWorld Health Organization Global Repository Surveillance data Special studies Impact studies Drug use AMR IT Platform Regional hubs or WHO CC National Reference Laboratory/ies National AMR Coordinator Country Data: aggregated, analysed, utilized AGISTAR: antimicrobial susceptibility testing of foodborne pathogens WHO/FAO/OIE Drug use: WHO/FAO/OIE Advisory Group on AMR surveillance Flow of reporting Advisory

16. Acknowledgments: Members of the WHO Working Groups for Standards and Collaboration Awa Aidara-Kane Celia Alpuche Aranda Jorge Matheu Alvarez Penelope Andrea Olov Aspevall Carolee Carson Amy Cawthorne Tejinder Chowdhary Sergey ErEmin Hajo Grundmann Liselotta Diaz-Högberg Shashi Khare So Hyun Kim Roman S. Kozlov Tjalling Leenstra Danilo Lo Fo Wong Ali R. Mafi Saskia Nahrgang Christopher Oxenford Jean Patel Charles Penn Carmem Pessoa-Silva Olga Perovic Pilar Ramon-Pardo Jean-Baptiste Ronat Betuel Sigauque Johan Strewe Neinke van de Sande-Bruinsma Nalini Singh Aparna Singh-Shah John Stelling Teodora Wi Yonghong Xiao

17. thank you monicalahra@sesiahs.health.nsw.gov.au