Antibiotic / Antimicrobial Resistance

International Activities to Combat AR

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Global Threat of Antibiotic Resistance

High levels of antibiotic resistance have been found in all regions of the world. New resistance
mechanisms emerge and spread globally threatening our ability to treat common infectious
diseases. Detecting, preventing, and controlling drug resistance requires coordinated efforts from
all countries. To support the US National Strategy to Combat Antibiotic Resistant Bacteria
(CARB), in addition to antibiotic drug research and development, CDC is reinforcing
international collaboration and capacities for antibiotic resistance prevention, surveillance, and
infection control to address the threat of drug resistance.

Global Action to Better Respond

What can we do globally to slow drug resistance and protect people? Every country—regardless
of resources —can take steps to slow antibiotic resistance by preventing infections and
improving antibiotic use within its borders.

1. Awareness and education: Raising public awareness about this threat is an important
first step.
2. Surveillance: Countries need systems to track antimicrobial resistance and share findings
with international partners.
3. Infection, prevention and control: Infection control and hygiene are critical to stopping
spread of resistant germs in healthcare settings.
4. Optimize use: Ensuring that antibiotics are still effective in the future requires that they
be used correctly today.
5. R&D and investment: Research and development of new drugs, diagnostic tools and
vaccines are a global priority.
Awareness and Education

Raising awareness about the threat of resistance and the need to improve use is critical to
tackling the issue. Almost two thirds (64%) of some 10,000 people surveyed by the World
Health Organization (WHO) across 12 countries say they know antibiotic resistance is an issue
that could affect them and their families, but how it affects them and what they can do to address
it are not well understood. For example, 64% of respondents believe antibiotics can be used to
treat colds and flu, despite the fact that antibiotics have no impact on viruses.

In 2015, WHO launched the first World Antibiotic Awareness Week, aimed at raising awareness
of antimicrobial resistance and promoting change through public communication.

Learn more:

 Get Smart In Doctor’s Offices (Outpatient)

 Get Smart In Healthcare (Inpatient)

―There are significant gaps in the information available on the development and global economic
implications of antimicrobial resistance. Stronger networks of information sharing and a global
strategic research agenda would improve global understanding of antimicrobial resistance.‖ –
World Health Organization

Collaborating with Ministries of Health, CDC country offices, and implementing partners, CDC
is providing technical assistance to partners in building AMR laboratory capacity, surveillance
systems, and infection control capacity for countries to detect, track, and respond to
antimicrobial resistance. Data from these surveillance systems will be used to target intervention
strategies from the national to local level as well as develop and promote antibiotic stewardship
programs.

Global Antimicrobial Resistance Surveillance System (GLASS)

GLASS provides a standardized approach to the collection, analysis and sharing of data on
antimicrobial resistance at a global level.

Infection Prevention and Control

CDC programs, in support of U.S. CARB[63 pages] and the Global Health Security Agenda,
work with countries to help build capacity for infection control. Capacities for infection control
prevent the spread of drug resistant infections, along with many other infectious disease threats
—such as Ebola, malaria, and Middle East Respiratory Syndrome (MERS).
However, more work is needed worldwide. Sustainable infection control requires ongoing
investments in healthcare infrastructure, staffing, and knowledge.

Optimize Use

Key driving factors behind drug resistance are the overuse and misuse of antibiotics.

Access to antibiotic drugs varies widely around the world. Some countries rely on physician or
pharmacist orders for antibiotics, in others, antibiotics are freely available over the counter or
access is lacking. Early efforts to improve antibiotic access and use have focused on the
education of both doctors and patients. Strategies to measure antibiotic use, use vaccines to
prevent infections that can promote antibiotic use, and better diagnostics to rapidly determine
whether antibiotics are warranted all contribute to improved antibiotic use.

Learn more about CDC’s antibiotic stewardship programs.

Global Action on AMR

At the Sixty-eighth World Health Assembly in May 2015, the World Health Assembly endorsed
a global action plan to tackle antimicrobial resistance, including antibiotic resistance, the most
urgent drug resistance trend.

The global action plan sets out five strategic objectives:

 to improve awareness and understanding of antimicrobial resistance;

 to strengthen knowledge through surveillance and research;
 to reduce the incidence of infection;
 to optimize the use of antimicrobial agents; and
 develop the economic case for sustainable investment that takes account of the needs of
all countries, and increase investment in new medicines, diagnostic tools, vaccines and
other interventions.

Read the entire action plan here.

What CDC is Doing

CDC continues to combat antimicrobial resistance globally:

 CDC programs are engaged on the ground with partner governments around the world
o Drug-Resistant TB
o Antibiotic-Resistant Gonorrhea
o Foodborne, Waterborne, and Environmental Disease
 CDC is joining with other U.S. government agencies and global partners to advance the
Global Health Security Agenda (GHSA). CDC has multiple roles in shaping and
executing GHSA through:
 o Coordination: CDC works closely with other parts of the U.S. government and
partner nations to prevent epidemics, detect threats early, and respond rapidly
and effectively.
o Technical support: CDC uses existing investments and relationships in global
health to deliver technical expertise and help partner nations meet global health
security goals.
o Read more about the GHS AMR Action Package here.
 The Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) aims to improve
cooperation between the U.S. and the EU on urgent antimicrobial resistance issues. Learn
more about CDC and TATFAR here.
 CDC’s Antibiotic Resistance Solutions Initiative is part of a broader national strategy to
combat antibiotic resistance and aims to facilitate action in every state, accelerate
outbreak detection and prevention innovation, improve antibiotic use, and reduce
antibiotic resistance. The initiative provides a comprehensive approach based on the
National Action Plan for Combating Antibiotic-Resistant Bacteria[63 pages](CARB).

National Action Plan to Combat Antibiotic-Resistant Bacteria (CARB)

The National Action Plan to Combat Antibiotic-Resistant Bacteria emphasizes the importance of
the U.S. government coordinating on AR internationally. Goal 5 of the National Action Plan
focuses on improving international collaboration and capacities for antibiotic-resistance
prevention, surveillance, control, and antibiotic research development. CDC is leading or
involved in the following aspects of Goal 5.

CARB GOAL 5: Improve international collaboration and capacities for

antibiotic-resistance prevention, surveillance, control, and antibiotic research
and development.

5.1 Promote laboratory capability to identify at least three of the seven World Health
Organization (WHO) priority antimicrobial resistant (AMR) pathogens using standardized,
reliable detection assays.

5.2 Collaborate with WHO, the World Organization for Animal Health (OIE), and international
efforts focused on development of lab surveillance to detect/monitor antibiotic-resistant bacteria
in animal/human foodborne pathogens.

5.3 Develop a mechanism for international communication of critical events that may signify
new resistance trends with global public and animal health implications.

5.4 Promote the generation and dissemination of information needed to effectively address
antibiotic-resistance.

United Nations General Assembly

CDC, along with other federal agencies, participated in a UN General Assembly High-Level
Meeting on Antimicrobial Resistance to help combat antibiotic resistance worldwide. This was
only the fourth time a health issue was discussed by the UN General Assembly, demonstrating
the urgency of this threat. The meeting’s objective was to increase awareness of antibiotic
resistance and get strong commitment from the national, regional, and international community.

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 Page last reviewed: January 25, 2017

 Page last updated: June 14, 2018
 Content source:
o Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Division of Healthcare Quality Promotion (DHQP)