86
and prevention against infectious disease with promising results (Hauser et al. 2016;
Marston et al. 2016).
However, mitigations alone are not enough to overcome the threat of antimicrobial resistance being necessary an international commitment. The implementation
of worldwide practices to prevent resistance spreading is urgent and requires drastic
measures. The World Health Organization established a global action plan on antimicrobial resistance in 2015 to feature the ‘one health’ approach to combat antimicrobial resistance and reach a new era of sustainable development (WHO 2015).
This proposal encompasses several international sectors including main stakeholders for example; food and pharmaceutical industry, finance, environment, academia,
and the government, human and veterinary medicine, agriculture, and well-informed
consumers, all together to achieve a common goal. The action plan was set with five
major objectives:
• To improve awareness and understanding of antimicrobial resistance through
effective communication, education, and training;
• To strengthen the knowledge and evidence base through surveillance and
research;
• To reduce the incidence of infection through effective sanitation, hygiene and
infection prevention measures;
• To optimize the use of antimicrobial medicines in human and animal health;
• To develop the economic case for sustainable investment that takes account of
the needs of all countries and to increase investment in new medicines, diagnostic tools, vaccines, and other interventions.
Furthermore, the WHO Advisory Group on Integrated Surveillance of
Antimicrobial Resistance (AGISAR), in conjunction with worldwide experts, published in 2018 an update (6th revision) of medically important antimicrobials for
risk management of resistance due to non-human use (Table 4.1) (WHO 2018a).
The update of the ‘WHO List of Critically Important Antimicrobials for Human
Medicine’ (WHO CIA List) happens regularly to (i) gain knowledge, (ii) provide
guidance on resource allocation and prioritization of risk assessment for both new
and existing drug, (iii) estimate hazard consequences, and (iv) restrict the use of
specific antimicrobial in countries or globally.
The progression of the action plan is available in a database (https://amrcountryprogress.org/) filled by each country (i.e. self-assessment questionnaire) concerning
the development of their national antimicrobial resistance action plans, the work
with multiple sectors, and the implementation of key actions to address antimicrobial resistance. The international gathering and action plans are already generating
outcomes that could improve the antimicrobial problem. For instance, policies were
adopted in European countries to restrict the use of antimicrobial as animal promoters; however, the guidelines do not limit antimicrobial use to either human or animal
to avert the crossover of resistance.
M. Santana et al.
and prevention against infectious disease with promising results (Hauser et al. 2016;
Marston et al. 2016).
However, mitigations alone are not enough to overcome the threat of antimicrobial resistance being necessary an international commitment. The implementation
of worldwide practices to prevent resistance spreading is urgent and requires drastic
measures. The World Health Organization established a global action plan on antimicrobial resistance in 2015 to feature the ‘one health’ approach to combat antimicrobial resistance and reach a new era of sustainable development (WHO 2015).
This proposal encompasses several international sectors including main stakeholders for example; food and pharmaceutical industry, finance, environment, academia,
and the government, human and veterinary medicine, agriculture, and well-informed
consumers, all together to achieve a common goal. The action plan was set with five
major objectives:
• To improve awareness and understanding of antimicrobial resistance through
effective communication, education, and training;
• To strengthen the knowledge and evidence base through surveillance and
research;
• To reduce the incidence of infection through effective sanitation, hygiene and
infection prevention measures;
• To optimize the use of antimicrobial medicines in human and animal health;
• To develop the economic case for sustainable investment that takes account of
the needs of all countries and to increase investment in new medicines, diagnostic tools, vaccines, and other interventions.
Furthermore, the WHO Advisory Group on Integrated Surveillance of
Antimicrobial Resistance (AGISAR), in conjunction with worldwide experts, published in 2018 an update (6th revision) of medically important antimicrobials for
risk management of resistance due to non-human use (Table 4.1) (WHO 2018a).
The update of the ‘WHO List of Critically Important Antimicrobials for Human
Medicine’ (WHO CIA List) happens regularly to (i) gain knowledge, (ii) provide
guidance on resource allocation and prioritization of risk assessment for both new
and existing drug, (iii) estimate hazard consequences, and (iv) restrict the use of
specific antimicrobial in countries or globally.
The progression of the action plan is available in a database (https://amrcountryprogress.org/) filled by each country (i.e. self-assessment questionnaire) concerning
the development of their national antimicrobial resistance action plans, the work
with multiple sectors, and the implementation of key actions to address antimicrobial resistance. The international gathering and action plans are already generating
outcomes that could improve the antimicrobial problem. For instance, policies were
adopted in European countries to restrict the use of antimicrobial as animal promoters; however, the guidelines do not limit antimicrobial use to either human or animal
to avert the crossover of resistance.
M. Santana et al.