Drug resistance

WHO Global Strategy Recommendations

Fundamental priority recommendations are underlined and highlighted in bold
Other first priority recommendations are highlighted in bold.


National Governments and Health Systems

Advocacy and intersectoral action

5.1 Make the containment of antimicrobial resistance a national priority.

  • Create a national intersectoral task force (membership to include health care professionals, veterinarians, agriculturalists, pharmaceutical manufacturers, government, media representatives, consumers and other interested parties) to raise awareness about antimicrobial resistance, organize data collection and oversee local task forces. For practical purposes such a task force may need to be a government task force which receives input from multiple sectors.
  • Allocate resources to promote the implementation of interventions to contain resistance. These interventions should include the appropriate utilization of antimicrobial drugs, the control and prevention of infection, and research activities.
  • Develop indicators to monitor and evaluate the impact of the antimicrobial resistance containment strategy.

Regulations

5.2 Establish an effective registration scheme for dispensing outlets. o:p>

5.3 Limit the availability of antimicrobials to prescription-only status, except in special circumstances when they may be dispensed on the advice of a trained health care professional.

5.4 Link prescription-only status to regulations regarding the sale, supply, dispensing and allowable promotional activities of antimicrobial agents; institute mechanisms to facilitate compliance by practitioners and systems to monitor compliance.

5.5 Ensure that only antimicrobials meeting international standards of quality, safety and efficacy are granted marketing authorization.

5.6 Introduce legal requirements for manufacturers to collect and report data on antimicrobial distribution (including import/export).

5.7 Create economic incentives for appropriate use of antimicrobials.

Policies and guidelines

5.8 Establish and maintain updated national Standard Treatment Guidelines (STGs) and encourage their implementation.

5.9 Establish an Essential Drugs List (EDL) consistent with national STGs and ensure the accessibility and quality of these drugs.

5.10 Enhance immunization coverage and other disease preventive measures, thereby reducing the need for antimicrobials. Education

Education

5.11 Maximize and maintain the effectiveness of the EDL and STGs by conducting appropriate undergraduate and postgraduate education programmes of health care professionals on the importance of appropriate antimicrobial use and containment of antimicrobial resistance.

5.12 Ensure that prescribers have access to approved prescribing literature on individual drugs. Surveillance of resistance, antimicrobial usage and disease burden

5.13 Designate or develop reference microbiology laboratory facilities to coordinate effective epidemiologically sound surveillance of antimicrobial resistance among common pathogens in the community, hospitals and other health care facilities. The standard of these laboratory facilities should be at least at the level of recommendation 3.6

5.14 Adapt and apply WHO model systems for antimicrobial resistance surveillance and ensure data flow to the national intersectoral task force, to authorities responsible for the national STGs and drug policy, and to prescribers.

5.15 Establish systems for monitoring antimicrobial use in hospitals and the community, and link these findings to resistance and disease surveillance data.

5.16 Establish surveillance for key infectious diseases and syndromes according to country priorities, and link this information to other surveillance data.

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