The Resistance Phenomenon in Microbes and Infectious Disease Vectors Implications for Human Health and Strategies for Containment: Workshop Summary (2003) / Chapter Skim
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Appendix D: Executive Summary: WHO Report
Appendix D: Executive Summary: WHO Report
Pages 256-273
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Appendix D 256
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The designations employed and the presentation of the material in this document, including tables and maps, do not imply the expression of any opinion whatsoever on the part of the secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.
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In particular, WHO would like to acknowledge the important contributions made to the drafting of the strategy by Professor W Stamm, Professor ML Grayson, Professor L Nicolle and Dr M Powell, and the generosity of their respective institutions Infectious Diseases Department, Harborview Medical Center, University of Washington, Seattle, USA; Infectious Diseases and Clinical Epidemiology Department, Monash Medical Centre, Monash University, Melbourne, Australia; Department of Internal Medicine, University of Manitoba, Winnipeg, Canada; Medicines Control Agency, London UK that enabled them to spend time at WHO. WHO also wishes to thank all those who participated and contributed their expertise in the consultations and those individuals and organizations that provided valuable comments on drafts of this document.
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In some instances resistance to second- and third-line agents is seriously compromising treatment outcome. Added to this is the significant global burden of resistant hospital-acquired infections, the emerging problems of antiviral resistance and the increasing problems of drug resistance in the neglected parasitic diseases of poor and marginalized populations.
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Countries were also encouraged to develop sustainable systems to detect resistant pathogens, to monitor volumes and patterns of use of antimicrobials and the impact of control measures. · Since the WHA Resolution, many countries have expressed growing concern about the problem of antimicrobial resistance and some have developed national action plans to address the problem.
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· The strategy highlights aspects of the containment of resistance and the need for further research directed towards filling the existing gaps in knowledge. · The strategy is people-centred, with interventions directed towards the groups of people who are involved in the problem and need to be part of the solution, i.e.
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To assist in this process an implementation approach has been defined together with indicators for monitoring implementation and outcomes. · Recognition that the problem of resistance exists and the creation of effective national intersectoral task forces are considered critical to the success of implementation and moni taring of interventions.
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Although the interventions directed towards providers and patients are presented separately (1 and 2) for clarity, they will require implementation in an integrated fashion.
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264 THE RESISTANCE PHENOMENON rid o o C)
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infections, and linking therapeutic and drug supply decision-making. This will require training of key individuals and the allocation of resources to effective surveillance, infection control and therapeutic support.
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266 THE RESISTANCE PHENOMENON rid o o C)
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The factors affecting such antimicrobial use, whether for therapeutic, prophylactic or growth promotion purposes, are complex and the required interventions need coordinated implementation. The underlying principles of appropriate antimicrobial use and containment of resistance are similar to those applicable to humans.
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APPENDIX D 269 11 Vat x · .: ..
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270 THE RESISTANCE PHENOMENON rid o o C)
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APPENDIX D 271 Vat x · .: ..
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272 THE RESISTANCE PHENOMENON rid o o C)
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