Archive

This group has published a document summarizing the use of available data sources at the country level to track antibiotic use and inform action [PDF – 10 pages].

This group has published a review of target setting for the reduction of antibiotic use in TATFAR partner countries.

Work is ongoing with good collaboration among TATFAR partners, WHO, and other non-TATFAR countries. Read our latest news story summarizing work for the 2019 World Antibiotic Awareness Week.

This network exchanges information and discusses ongoing and future national and international activities and events related to the consumption of antimicrobials in veterinary medicine. This work contributes to the alignment of methodologies and views on priority topics. The working group is developing a position paper on methodology for measuring and reporting the consumption of antimicrobials per species in veterinary medicine.

The work of this group is focused on aspects of CAC/GL 77-2011 implementation, and sharing ideas and expertise on how to effectively conduct risk analysis for the authorization of antimicrobial drugs for use in veterinary medicine. These discussions around development of a risk profile are based on Canada’s experience implementing the Codex Framework. The working group is currently:

• Refining a table of risk profile elements to inform how to streamline future risk profiles, the time and data needed for those elements, and considerations for which elements would be required depending on the problem the risk analysis is attempting to address.
• Developing an inventory of information that could be warehoused and used in future risk analyses, and determining where the information can be warehoused. Members are currently looking at what kind of models are used for these AMR risk assessments, and what kinds of models might be used for different questions, to make it easier to understand what the options are.

• Linking the work of the risk elements table to Whole Genome Sequencing (WGS) and determining which quantitative models can provide value. As an initial step, the Working Group is making note of where the models exist, including a short description of what they encompass, and linking it to the table of risk profile elements. A separate table has been created for quantitative microbiological risk assessment (QMRA) models.

In 2018, Health Canada, the Canadian Food Inspection Agency, and the Public Health Agency of Canada described the Canadian government’s comprehensive efforts to develop their framework and action plan to address AMR, work being conducted by stakeholders, and challenges they face in implementation. USDA’s Animal and Plant Health Inspection Service, described the collaborative approach the American Veterinary Medical Association took to develop a recently published definition and core principles of antimicrobial stewardship in veterinary settings.

This group is focused on four topics:

• The use of next generation sequencing technologies to conduct genomic surveillance of resistance
• Best practices for conducting surveillance within the One Health paradigm
• Examples where surveillance was able to document success stories to limit or reverse resistance trends
• Sharing of emergent resistances of special public health concern

The new EU regulations on veterinary medicinal products (2019/6) and on medicated feed (2019/4) were adopted in December 2018 and will begin applying on January 28, 2022. They provide for a wide range of concrete measures to fight AMR and to promote a prudent and responsible use of antimicrobials in animals. These include:

• A reinforced ban on the use of antimicrobials in animals for promoting growth and increasing yield
• The possibility to reserve certain antimicrobials for humans only
• A ban on the preventive use of antimicrobials via medicated feed
• A ban on preventive use of antibiotics in groups of animals
• Restrictions on metaphylactic use and the possibility to restrict off-label use of certain antimicrobials

In addition, to better monitor antimicrobial consumption in animals, the regulation foresees compulsory data collection by EU Member States, following a stepwise approach, on sales of antimicrobials and on their use per species.

The working group has ongoing meetings to discuss the following topics:

• Approaches to validation of prevalence survey data
• Best practices for using and sharing prevalence survey data
• Use of prevalence surveys to identify and gather additional information about HAIs that may need more attention, such as pneumonia
• Areas for collaboration between TATFAR objectives

Working group members are currently working on collaborative manuscripts addressing prevalence survey methods and data use and will cover both hospital and long-term care facility prevalence surveys.

The working group is currently addressing the following objectives:

• Map current national and international AMR surveillance systems to identify gaps and unmet public health needs relevant to the use of genomic information that would provide added value across countries and regions
• Identify priority target pathogens of high public health international impact for a pilot data sharing system
• Map available bioinformatics data management platforms and standards for storing and analyzing genomic information relevant for AMR in these pilot pathogens to avoid duplication of effort and explore potential synergies
• Propose a system to facilitate the exchange of information among TATFAR partners on genetic determinants and vectors of AMR patterns

CRE were identified as a priority target to explore the feasibility, potential channels, epidemiological data, and barriers for genomic data sharing. In October 2019, the working group discussed possible approaches to exchange genomic data on CRE. The group agreed that the most feasible solution is to use available platforms, such as the TATFAR communication of critical resistance threats. The use of protected space for data sharing was explored, with potential solutions in the near future, such as the upcoming implementation of a new ECDC epidemic intelligence expected to be launched in 2020.

The working group completed the mapping of available genomic information on CRE across the TATFAR partner countries. They also addressed bioinformatics approaches and the need for availability of microbiological and epidemiological information, with a short-term agreement on essential information such as sample origin and type, date of sample collection. and country.

This group meets regularly to discuss emerging and concerning resistance trends.

This group works with CLSI and EUCAST to harmonize breakpoints with the focus being on bug/drug combinations included in WHO GLASS.

The working group is developing a perspective article that will:

• Address the need for timely detection of emerging resistance threats and the gaps and lessons learned from recent emerging resistance threats (e.g. dissemination of CRE, Candida auris, N. gonorrhoeae)
• Map the currently available relevant systems across TATFAR partner countries
• Make proposals for systems, processes, and methods to facilitate the detection and assessment of threats

This group has published two articles focused on incentives. The most recent in June 2017 (Ardal et al., 2017, Clinical Infectious Diseases), which examined various pull incentives to potentially incentivize antibacterial drug development. At present, there are few pull incentives implemented. Many experts argue that this is the remaining piece that requires action to create an ecosystem of incentives to mobilize industry to re-enter antibacterial drug discovery and development.

The working group is exploring opportunities for collaboration.

The work within this action is ongoing and fruitful with regular communication focused on enhanced collaboration among funders and the research community, facilitating research/product development opportunities, and enabling clinical research.

TATFAR partners regularly discuss antibacterial drug development programs, clinical trial designs for studying new antibacterial drugs, emerging safety issues, and coordinating efforts on scientific meetings to facilitate antibacterial drug development among TATFAR partners.

Action 3.4 encompasses this action.

This working group continues to share information and working jointly on developing future public meetings to describe approaches for developing alternative approaches for treating bacterial diseases.

To date, participants have exchanged information on the approach to authorization of alternatives in their region and the initiatives already underway to promote access to market for such products whilst ensuring appropriate levels of quality, safety, and efficacy.