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Can the Application of the International Health Regulations to Antimicrobial Resistance Events Help to Preserve Antimicrobials? AMR 1, abstract N° 406 Didier Wernli, Thomas Haustein, John Conly, Stephan Harbarth Service prévention et contrôle de l‘infection Hôpitaux Universitaires de Genève
Background (1) • Legal framework for international effortsto contain the risk from public health threats that may spread between countries • scope not limited to a list of diseases, but covering “illness or medical condition, irrespective of origin or source, that presents or could present significant harm to humans” • Adopted by WHA in 2005, entered into force 2007 • 194 states parties + WHO as “hub” .
Background (2) • States Parties to develop certain minimum core public health capacities • States Parties to notify WHO of significantpublic health events • At the request of a State Party, WHO shall collaborate in the response […] by providing technical guidance and assistance (Art. 13.3) .
Background (3) – Notification • All events which may constitute a public health emergency of international concern (PHEIC) within its territory (≥2 x yes to the following questions) • Is the public health impact of the event serious? • Is the event unusual or unexpected? • Is there a significant risk of international spread? • Is there a significant risk of international travel or trade restrictions? • DG to determine whether event constitutes a PHEIC[this has happened once so far: H1N1 2009] .
Are AMR events notifiableunder the IHR? Example: International spread of“new” types of resistancecarbapenem-resistantEnterobacteriaceae .
Are AMR events notifiableunder the IHR? • At least 3 of the 4 criteriacouldbeaffirmed • If theycould, shouldthey? .
Why should the IHR be applied to the global AMR threat? • AMR requires a coordinated international response. • “wake-up call” to strengthen global AMR surveillance and response • early warning system: allow early implementation of screening measures and prevent the establishment of new resistant strains • societalinvestment in core surveillance and response capacities at different levels by setting minimum standards .
Outlook • IHR ultimately “owned” by the States Parties • WHO to provide leadership on the role of the IHR for combating AMR • Many practical obstacles for realizing the full potential of the IHR • Window of opportunity for an open debate about the applicability of the IHR to AMR. .
Thank you! PLoS Med. 2011 Apr;8(4):e1001022. .