Gert van der Hoek
In Memoriam - Editor, Senior Moderator
See also: Ministerial Conference Antibiotic Resistance 25-26 June, 2014
World Alliance Against Antibiotic Resistance
Alliance Contre le développement des Bactéries Multi-Résistantes
The WAAAR declaration against antibiotic resistance
June 2014
The increase in antibiotic resistant bacteria poses a major
healthcare threat. In the face of an almost complete absence of
new antimicrobial drugs in development, antibiotic resistance
(ABR) has become one of the main public health problems of our
time.
Antibiotics are a unique class of medications because of their
potential societal impact; use of an antibiotic in a single patient can
select for ABR that can spread to other people, animals, and the
environment, making an antibacterial used in one patient
ineffective for many others.
Bacterial resistance can evolve rapidly.
As bacteria acquire resistance mechanisms, the altered bacterial
genetic material coding for resistance mechanisms can be
transmitted at times readily between bacteria, broadening the
reach and extent of resistance. Treatment failures because of
multidrug resistant (MDR) bacteria, once rare, notable, and limited
to hospitals, now occur very commonly in hospitals and
increasingly in the community as well.
It is estimated that at a
minimum 25000 patients in Europe and 23000 in the USA die each
year from infections caused by resistant bacteria. The cost of
antibiotic resistance is tremendous, whether measured as the
personal and societal burden of illness, death rates, or healthcare
costs.
Although it is a never-ended phenomenon, antibiotic resistance is
directly related to the volume of antibiotics used. We are using
increasing amounts of antibiotics in health care and agriculture,
and discharging these active drugs into the environment. The
impact of widespread antibiotic use is enormous, promoting the
development and dissemination of antimicrobial resistance.
Safeguarding antibiotics will require a concerted effort by citizens,
patients and prescribers.
The primary goal of WAAAR is to raise
awareness about the urgency and magnitude of the threat and to
promote an international dialogue to assist in effective responses.
The Alliance, in particular through this declaration, is dedicated to
actively promoting antibiotic preservation and to raising awareness
among antibiotic prescribers, politicians and policy-makers, patient
safety and advocacy groups, the pharmaceutical industry,
international health organizations, and the general population.
Individual actions, no matter how well intended, are doomed to
failure unless there is an international dialogue, a common sense of
purpose, and broad consensus on how best to proceed.
WAAAR advocates for the following 10
The WAAAR Proposes 10 Actions:
Awareness of all stakeholders, including the public, the importance of the danger of bacterial resistance.
Close cooperation between the nternational organizations, political and / or economic, which must take the lead in this movement against bacterial resistance.
Organization in each country, ideally by the ministries of health, national plan to fight against bacterial resistance, funded, with participation of all stakeholders, particularly consumer associations.
Permanent access to essential antibiotics of assured quality, particularly in developing countries.
Monitor the consumption of antibiotics and resistance.
Surveillance of bacterial resistance and antibiotic consumption at the institution, region, and country (along the lines of "Centers for Disease Control and Prevention," CDC), with comparative statistics (benchmarking), published in real time, or at least every 12 months. Improvement of laboratory capacity, with application of international standards, technical centralization and coordination of infrastructure and information technology.
Use and development of rapid diagnostic tests.
Development of new rapid diagnostic tests, effective, and inexpensive and use tests available to deal quickly with targeted antibiotics, to avoid unnecessary treatments (differentiating bacterial and non-bacterial infections) and to modulate the duration of treatment.
Careful and controlled use of antibiotics (Antibiotic stewardship).
In hospitals, long-stay facilities, and downtown. In animal husbandry, agriculture, aquaculture and veterinary world, in a philosophy of "One Health".
Abandon antibiotics (systemic and local) as growth and exceptional prophylactic use in animals.
Rational use of antibiotics metaphylactic (prophylaxis if some animals are sick or at high risk of being) and treatment of animals.
Limited use in humans and animals, antibiotics critical to human (eg carbapenems). Gradual elimination of the sale of antibiotics "under the counter" (available without prescription).
Information and education.
Educational programs directed to children / adolescents on antibiotics, bacterial resistance and prevention of infection (model: e-Bug).
Implementation of wide information and awareness campaigns directed to the public for a rational use of antibiotics.
Initial and continuing education for all health professionals, including veterinarians, dentists, nurses (AD) s, pharmacists and other medical schools, bacterial resistance, the rational use of antibiotics, including indications, the dose and duration of treatment.
Education of breeders.
Prevention and control of bacterial transmission.
Efforts to prevent cross-transmission of multi-resistant bacteria in health care, food production, and livestock.
International promotion of hand hygiene and control measures of infection have demonstrated their effectiveness.
Limitation of contamination of drinking water by the multi-resistant bacteria, as well as environmental contamination
Use of available vaccines in humans and animals
Fundamental and applied research and development of new products research.
New business models to support the cost of innovation while safeguarding public health requirements.
Increased resources to reduce bacterial resistance in humans and animals
Use for new antibiotics principles used for orphan drugs
Facilitating the search for new products (antibiotics and other products), and vaccines, regulatory mechanisms for accelerated development
Request for UNESCO to include the “concept of antibiotic” in the list of the
intangible cultural heritage.
Read PDF- document
More: http://www.infectiologie.com/site/waaar.php
WAAAR is a group of 700 individuals from 55 different countries representing all the key stakeholders (physicians, veterinarians,
microbiologists, surgeons, pharmacists, nurses, evolutionary biologists, ecologists, environmentalists, patient advocacy groups). The Alliance
receives support from more than 140 learned societies or professional groups throughout the world. WAAAR is a nonprofit organization
open to professionals and consumers worldwide. WAAAR receives no funding from the pharmaceutical industry
World Alliance Against Antibiotic Resistance
Alliance Contre le développement des Bactéries Multi-Résistantes
The WAAAR declaration against antibiotic resistance
June 2014
The increase in antibiotic resistant bacteria poses a major
healthcare threat. In the face of an almost complete absence of
new antimicrobial drugs in development, antibiotic resistance
(ABR) has become one of the main public health problems of our
time.
Antibiotics are a unique class of medications because of their
potential societal impact; use of an antibiotic in a single patient can
select for ABR that can spread to other people, animals, and the
environment, making an antibacterial used in one patient
ineffective for many others.
Bacterial resistance can evolve rapidly.
As bacteria acquire resistance mechanisms, the altered bacterial
genetic material coding for resistance mechanisms can be
transmitted at times readily between bacteria, broadening the
reach and extent of resistance. Treatment failures because of
multidrug resistant (MDR) bacteria, once rare, notable, and limited
to hospitals, now occur very commonly in hospitals and
increasingly in the community as well.
It is estimated that at a
minimum 25000 patients in Europe and 23000 in the USA die each
year from infections caused by resistant bacteria. The cost of
antibiotic resistance is tremendous, whether measured as the
personal and societal burden of illness, death rates, or healthcare
costs.
Although it is a never-ended phenomenon, antibiotic resistance is
directly related to the volume of antibiotics used. We are using
increasing amounts of antibiotics in health care and agriculture,
and discharging these active drugs into the environment. The
impact of widespread antibiotic use is enormous, promoting the
development and dissemination of antimicrobial resistance.
Safeguarding antibiotics will require a concerted effort by citizens,
patients and prescribers.
The primary goal of WAAAR is to raise
awareness about the urgency and magnitude of the threat and to
promote an international dialogue to assist in effective responses.
The Alliance, in particular through this declaration, is dedicated to
actively promoting antibiotic preservation and to raising awareness
among antibiotic prescribers, politicians and policy-makers, patient
safety and advocacy groups, the pharmaceutical industry,
international health organizations, and the general population.
Individual actions, no matter how well intended, are doomed to
failure unless there is an international dialogue, a common sense of
purpose, and broad consensus on how best to proceed.
WAAAR advocates for the following 10
The WAAAR Proposes 10 Actions:
Awareness of all stakeholders, including the public, the importance of the danger of bacterial resistance.
Close cooperation between the nternational organizations, political and / or economic, which must take the lead in this movement against bacterial resistance.
Organization in each country, ideally by the ministries of health, national plan to fight against bacterial resistance, funded, with participation of all stakeholders, particularly consumer associations.
Permanent access to essential antibiotics of assured quality, particularly in developing countries.
Monitor the consumption of antibiotics and resistance.
Surveillance of bacterial resistance and antibiotic consumption at the institution, region, and country (along the lines of "Centers for Disease Control and Prevention," CDC), with comparative statistics (benchmarking), published in real time, or at least every 12 months. Improvement of laboratory capacity, with application of international standards, technical centralization and coordination of infrastructure and information technology.
Use and development of rapid diagnostic tests.
Development of new rapid diagnostic tests, effective, and inexpensive and use tests available to deal quickly with targeted antibiotics, to avoid unnecessary treatments (differentiating bacterial and non-bacterial infections) and to modulate the duration of treatment.
Careful and controlled use of antibiotics (Antibiotic stewardship).
In hospitals, long-stay facilities, and downtown. In animal husbandry, agriculture, aquaculture and veterinary world, in a philosophy of "One Health".
Abandon antibiotics (systemic and local) as growth and exceptional prophylactic use in animals.
Rational use of antibiotics metaphylactic (prophylaxis if some animals are sick or at high risk of being) and treatment of animals.
Limited use in humans and animals, antibiotics critical to human (eg carbapenems). Gradual elimination of the sale of antibiotics "under the counter" (available without prescription).
Information and education.
Educational programs directed to children / adolescents on antibiotics, bacterial resistance and prevention of infection (model: e-Bug).
Implementation of wide information and awareness campaigns directed to the public for a rational use of antibiotics.
Initial and continuing education for all health professionals, including veterinarians, dentists, nurses (AD) s, pharmacists and other medical schools, bacterial resistance, the rational use of antibiotics, including indications, the dose and duration of treatment.
Education of breeders.
Prevention and control of bacterial transmission.
Efforts to prevent cross-transmission of multi-resistant bacteria in health care, food production, and livestock.
International promotion of hand hygiene and control measures of infection have demonstrated their effectiveness.
Limitation of contamination of drinking water by the multi-resistant bacteria, as well as environmental contamination
Use of available vaccines in humans and animals
Fundamental and applied research and development of new products research.
New business models to support the cost of innovation while safeguarding public health requirements.
Increased resources to reduce bacterial resistance in humans and animals
Use for new antibiotics principles used for orphan drugs
Facilitating the search for new products (antibiotics and other products), and vaccines, regulatory mechanisms for accelerated development
Request for UNESCO to include the “concept of antibiotic” in the list of the
intangible cultural heritage.
Read PDF- document
More: http://www.infectiologie.com/site/waaar.php
WAAAR is a group of 700 individuals from 55 different countries representing all the key stakeholders (physicians, veterinarians,
microbiologists, surgeons, pharmacists, nurses, evolutionary biologists, ecologists, environmentalists, patient advocacy groups). The Alliance
receives support from more than 140 learned societies or professional groups throughout the world. WAAAR is a nonprofit organization
open to professionals and consumers worldwide. WAAAR receives no funding from the pharmaceutical industry