Promoting collaborative action to accelerate the regional response to antimicrobial resistance in the Eastern Mediterranean Region

Promoting collaborative action to accelerate the regional response to antimicrobial resistance in the Eastern Mediterranean Region

1. Promoting collaborative action to accelerate the regional response to antimicrobial resistance in the Eastern Mediterranean Region Dr Nevin Wilson Acting Director UHC/Communicable Diseases Unit Head, HTM and NTDs (UHC/DCD)

2. Global Action Plan on AMR adopted at WHA68 Antimicrobial resistance (AMR) – the road travelled UN General Assembly Political Declaration on AMR September 2016 . WHO, FAO and WOAH (formerly OIE) sign a tripartite MoU The IACG launched its report with recommendations Interagency Coordination Group (IACG) Global Leaders Group on AMR launched UNGA high level dialogue and call for action UNEP joins FAO, WHO and WOAH Muscat Manifesto People-centred approach 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

3. Where are we with the AMR response in the Region? 3 All countries have developed their first AMR national action plans 1 All countries have enrolled in the WHO global AMR surveillance system 2 17 countries have set-up dedicated infection prevention and control (IPC) units or programmes 3 12 ongoing operational research projects in the Region 4 Supply chain interruptions remain a challenge compromising access 5

4. The Region has the highest and most rapidly rising antibiotic use We also have inequities between countries within the Region (GRAM data, 2000  2018) Fragile conflict-affected and vulnerable countries includes all low-income countries and a few middle-income countries

5. In 2021, there were 1.14 million deaths attributable to bacterial AMR globally Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. GBD 2021 Antimicrobial Resistance Collaborators Global Database for Tracking Antimicrobial Resistance (AMR). Country Self-Assessment Survey ( TrACSS ). World Health Organization; 2024. Proportion of methicillin-resistance among blood stream infections (BSI) due to S. aureus (MRSA) and proportion of resistance to third-generation cephalosporins among BSI due to E. coli (ESBL E. coli ), Eastern Mediterranean Region SDG indicators ESBL E. coli

6. 6 Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. GBD 2021 Antimicrobial Resistance Collaborators. In 2021, AMR was the direct cause of 96 000 deaths in the Eastern Mediterranean Region 1.7 million deaths from sepsis 373 000 AMR associated 580 000 bacterial sepsis 96 000 AMR attributable

7. Strategic priorities for addressing AMR in the human health sector Access to essential health services Prevention of infections Governance Health emergencies and resilience Strategic information through surveillance and research One Health multisectoral approach​ Built into health emergency preparedness and response​ Primary health care approach​ Working with and through established programmes ​

8. Core interventions for the strategic priorities Access to essential health services Governance Health emergencies and resilience Strategic information through surveillance and research Prevention of infections One Health approach Domestic budget Enforce regulations Primary health care model of care Workforce Diagnostics AWaRe antibiotics WASH Waste management Vaccination E mergency stocks Response planning Resistance and antibiotic use data R esearch and innovation

9. 9 Collaboration: AMR across programmes Emergency preparedness and response Health security, One Health, pandemic preparedness, resistant pathogen outbreaks Health systems Access to medicines, workforce, patient safety, finance Health promotion and well-being WASH, food safety, maternal and child health Noncommunicable diseases Cancer care, diabetes, surgeries Research and innovation Operational research, digital health systems Communication and partnerships Communicable diseases Public health laboratories, immunization, HIV/TB/NTDs AMR

10. 2024 – The year of AMR! WHO strategic and operational priorities to address drug-resistant bacterial infections in human health (2025-2035) WHA77 – May 2024 UNGA 79 – Sept 2024 4th Ministerial Summit - Nov 2024 Political Declaration of the High-level Meeting on Antimicrobial Resistance From declaration to implementation – Jeddah Commitments 71st session of the Regional Committee for the WHO Eastern Mediterranean ​