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The World Alliance Against Antibiotic Resistance (WAAAR): A major player in the global drive to protect human health 2017

“Our Alliance has several important strengths: A multidisciplinary and multi-professional structure including veterinary medicine, strong involvement of consumers, participation of several parliamentarians (deputies), global programmes including antibiotic stewardship, infection control, use of old and recent diagnostic tools, research, and upgrades of vaccination programmes, official support from many professional societies, from many different countries or various bodies.“ Dr Jean Carlet, President, www.waaar.org The non-governmental organization ACdeBMR (L’Alliance contre le Développement des Bactéries Multirésistantes aux Antibiotiques) was constituted on 2 December 2011. Subsequently, its internationally adopted name in English became: “The World Alliance Against Antibiotic Resistance” (WAAAR). Actions in 2015–2016  WAAAR has joined the network of international not-for-profit civil society organizations initiated by CDDEP (Center for Disease Dynamics, Economics, and Policy) and which was launched on the occasion of the United Nations General Assembly, 21 September 2016 in New York City, United States. WAAAR President Dr Jean Carlet attended, as well as Garance Upham, Deputy Executive Secretary of WAAAR and member of Medicus Mundi International, and Tim Probart, CEO of Global Health Dynamics. WAAAR in France Founded in Paris, ACdeBMR/WAAAR is the major player in France itself and in the French speaking world on antibiotic resistance issues. Dr Carlet and the WAAAR team campaigned for decisive action, and in early 2015 Dr Carlet was selected to put together and chair France’s National Task Force on the Preservation of Antibiotics for 2015...

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The Economics of reducing antibiotic use to reduce antimicrobial resistance

Dr Edward I Broughton Director of Research and Evaluation, Q&P Institute, USAID ASSIST URC, USA Human consumption of antibiotics is only beneficial to societal welfare when the correct antibiotics are used and they are given at the right dose for the optimal length of time and only to those who need them. There are many cases in which these circumstances do not occur, thereby increasing the risk of adverse outcomes. One of the most important for public consideration is antimicrobial resistance (AMR). Therefore, the discussion of the economics of efforts to control AMR will be considered in terms of the cost of managing production and consumption of antibiotics because this factor is so intimately and inextricably  related to the development of AMR. Shortly after the first widespread use of antibiotics for human health in the 1940s, there was already evidence that targeted pathogenic agents could develop resistance to an antibiotic and the realization that further use of any antibiotic agent would cause antimicrobial resistance (AMR) as a natural part of the Darwinian evolution of living organisms (1, 2). Economic theory predicts that, without market distortions and if given accurate information, we would be compelled to stop using antibiotics in the current way they are being used when the adverse consequences of AMR are considered too great to accept the status quo. However, we know of many distortions that exist...

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Research in essential oils: the case of Oregano

Nora Mahfouf Faculty of Science, University of Chadly Ben Djedid, Algeria Of the 250,000 species of flowering plants in the world, more than 20,000 – nearly 10% of the total – are classified as herbs. Herbs picked by people from the wild have been an essential factor in healthcare all over the world throughout the ages and in all cultures. Nowadays, some 80% of the world’s people rely on traditional, plant-based medicines for their primary healthcare (1). Actually, there exists a tendency to use natural products for the treatment of several illnesses. With use of medicinal plants, investigations have been performed all over the world in order to find more productive and economical medicines (2). Medications used to cure disorders require continuous changing to improve their effectiveness. However, few of the many claims of therapeutic efficacy have been validated adequately by clinical trials. Even though these claims have been substantiated scientifically, complementary medicines are unlikely to secure a place in conventional healthcare (3). Research in essential (volatile) oils has attracted increased attention from both academic and commercial circles due to a growing interest in green consumerism, worldwide reduction in the composition of salt in food (health reasons), and the need for alternative techniques to assure quality and safety of perishable foods (4, 5). The essential oils of aromatic and medicinal plants present a great potential for application as antimicrobial...

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The role of the biomedical advanced research and development authority (BARDA) in promoting innovation in antibacterial product development

Dr Christopher Houchens, Branch Chief, Antibacterial Program and Dr Joe Larsen Deputy Director, Division of CBRN Medical Countermeasures, Biomedical Advanced Research and Development Authority, Office of Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington DC, USA The Biomedical Advanced Research and Development Authority (BARDA) initiated a program in 2010 to address antimicrobial-resistant bacterial infections. Since then, BARDA has established several public-private partnerships aimed at the development of new antibacterial drugs and diagnostic platforms.    The Biomedical Advanced Research and Development Authority (BARDA) is a component of the United States Department of Health and Human Services tasked with preparing for and responding to mass public health emergencies. BARDA has an organizational remit to address chemical, biological, radiological, and nuclear (CBRN) threats, pandemic influenza and emerging infectious diseases. BARDA supports public-private partnerships with industry to develop medical countermeasures (vaccines, therapeutics, diagnostics) to respond to public health emergencies. BARDA exists to address or correct market failures or challenges in public health emergency preparedness and response.  An early example was the United States’ lack of preparedness to effectively respond to a public health emergency that occurred during the anthrax attacks of 2001.  At the time, there were very few companies developing medical countermeasures for bioterrorism agents and indications. To address the perceived market failure inhibiting the development of such countermeasures and to demonstrate the government’s long-term commitment to biodefence,...

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Socioeconomics, antimicrobial use and antimicrobial resistance

Molly Miller-Petrie Research Associate, CDDEP and Hellen Gelband, Associate Director for Policy, CDDEP Global patterns of health and disease vary by national economic status, and individual health and healthcare are also heavily influenced by family social and economic status within countries. It is no surprise that the levels and patterns of antimicrobial resistance – which reflect disease incidence and antimicrobial use patterns – also vary around the globe (1-4). Because socioeconomic factors have been directly linked to antimicrobial use, and use drives antimicrobial resistance (AMR), socioeconomic factors can be considered indirect drivers of AMR. At a societal level, disease burden, health system development, pharmaceutical regulations and enforcement, health insurance or national healthcare coverage, and access to and quality of medicines all affect antimicrobial use and are affected by socioeconomic factors. Individuals, both high- and low-income, operate in their own societal conditions, and their individual behaviour also impacts patterns of antimicrobial use and ultimately, resistance. Drug-resistant infections also affect patients’ social and economic status by increasing healthcare costs, mortality and morbidity, and decreasing productivity.  In this article, we review the evidence for socioeconomic effects on antimicrobial use and AMR at global, national, and individual levels. We consider human health, animal health and agriculture, and the environment – following the One Health concept. Global-level economic correlates of AMR and antimicrobial use  Low- and many middle-income countries (LMICs) face relatively higher rates...

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