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Anti-Microbial Resistance in Leprosy. Report of the virtual consultation
Abstract
Dr Erwin Cooreman, Team Leader, GLP welcomed all participants on behalf of the World Health Organization (WHO). This virtual consultation brings together two main communities, both from countries and at the international level: leprosy programme managers and partners; as well as persons in charge of AMR programmes.
The previous time that WHO convened a (face-to-face) meeting on the same subject was in October 2016 (Kathmandu, Nepal) and before that almost every two or three years. Since that time, several innovations have come into place; but progress has been much less than desired. This meeting may look into ways to move the agenda of addressing AMR in leprosy forward.
The main new opportunity that has occurred is the significant increased attention for AMR globally, in WHO as well as in countries. This was prompted by serious threats in several infectious diseases caused by wide and inappropriate use of antibiotics. Based on available data, such threat is not perceived in leprosy, which fortunately can be benefit from its robust first-line regimen in the form of multidrug therapy and the controlled dispensation of leprosy treatment. This may be a reason also why AMR in leprosy is typically treated as having a lower priority.
In WHO, AMR has been elevated to a cross-cutting, top priority. A division was created in HQ which is headed by an Assistant Director General. Regional Offices are also streamlining AMR as a horizontal platform to support multiple disease control programmes. In the South-East Asia Region, both control of neglected tropical diseases (NTDs) – which include leprosy – and AMR are flagship priorities.
The general objective of the meeting was to contribute to improving surveillance for resistance to antimicrobial drugs used in leprosy.
The specific objectives were:
To review the status of anti-microbial resistance (AMR) surveillance including inclusion in national AMR plans (where applicable) and magnitude of AMR in leprosy;
To review and confirm current technical guidance in light of any recent evidence;
To outline a template for roll-out of AMR surveillance in leprosy endemic countries in line with technical guidance;
To explore development of a network of reference laboratories and experts to support countries;
To discuss alternate regimens used in treating patients with M. leprae strains resistant to multidrug therapy (MDT) and follow-up actions.
The expected outcomes were:
Status of AMR surveillance (including national AMR plans or leprosy AMR plans) and extent of AMR problem in leprosy programmes documented;
Confirmation of current technical guidance and advice on any new tools for AMR in leprosy;
Draft Template for roll-out of AMR surveillance in leprosy agreed;
New leprosy programmes/countries identified interested in developing AMR surveillance for leprosy need for strengthening of existing network identified;
List of reference laboratories, experts for potential linkage with designated national laboratories updated.
The previous time that WHO convened a (face-to-face) meeting on the same subject was in October 2016 (Kathmandu, Nepal) and before that almost every two or three years. Since that time, several innovations have come into place; but progress has been much less than desired. This meeting may look into ways to move the agenda of addressing AMR in leprosy forward.
The main new opportunity that has occurred is the significant increased attention for AMR globally, in WHO as well as in countries. This was prompted by serious threats in several infectious diseases caused by wide and inappropriate use of antibiotics. Based on available data, such threat is not perceived in leprosy, which fortunately can be benefit from its robust first-line regimen in the form of multidrug therapy and the controlled dispensation of leprosy treatment. This may be a reason also why AMR in leprosy is typically treated as having a lower priority.
In WHO, AMR has been elevated to a cross-cutting, top priority. A division was created in HQ which is headed by an Assistant Director General. Regional Offices are also streamlining AMR as a horizontal platform to support multiple disease control programmes. In the South-East Asia Region, both control of neglected tropical diseases (NTDs) – which include leprosy – and AMR are flagship priorities.
The general objective of the meeting was to contribute to improving surveillance for resistance to antimicrobial drugs used in leprosy.
The specific objectives were:
To review the status of anti-microbial resistance (AMR) surveillance including inclusion in national AMR plans (where applicable) and magnitude of AMR in leprosy;
To review and confirm current technical guidance in light of any recent evidence;
To outline a template for roll-out of AMR surveillance in leprosy endemic countries in line with technical guidance;
To explore development of a network of reference laboratories and experts to support countries;
To discuss alternate regimens used in treating patients with M. leprae strains resistant to multidrug therapy (MDT) and follow-up actions.
The expected outcomes were:
Status of AMR surveillance (including national AMR plans or leprosy AMR plans) and extent of AMR problem in leprosy programmes documented;
Confirmation of current technical guidance and advice on any new tools for AMR in leprosy;
Draft Template for roll-out of AMR surveillance in leprosy agreed;
New leprosy programmes/countries identified interested in developing AMR surveillance for leprosy need for strengthening of existing network identified;
List of reference laboratories, experts for potential linkage with designated national laboratories updated.
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