AMR TDT Meeting Feb 7th at SwissThinkTankHub

ACTIONS and DELIBERATIONS during and after the first meeting Feb 7th at the SwissThinkTankHub, with sincere thanks to the later for the meeting place.

The AMR Think-Do-Tank first meeting on Feb 7 took place just at the time when the WHO Executive Board began to face the mounting coronavirus epidemic, and organized sudden briefings on the situation in China, right prior to the evidence that the epidemic would become a pandemic.

Six weeks later, upon his return from a work trip to the USA, the coronavirus took the life of our inspiration, Prof Jacques Acar, MD, and his loss is a tragedy not just for us, for his close friends and family, but also for the world, as his breath and extent of knowledge on issues is irreplaceable.

He was expert to the OIE and to AGISAR/WHO, founder and former president of ISID and ESCMID, as well as expert to the Fleming Fund in the development of projects for lesser developed countries.

Born in Sénégal from French people of Lebanese origin, he has inherited from there a certain love for people, without any consideration for their rank or function, he loved to think and to listen to thinking, and could spend an evening speaking of opera or religion, medicine or history.

Off hand, quite a few "projects" had been discussed, at the meeting which Jacques Acar attended, and immediately following in discussions, over diner or on the telephone, before lock-downs and confinements came down in France, in the UN Geneva itself, in the US, and so forth. Among whom the following.

I - The publication: “AMR & the Environment, a Global Health Security Issue”, had been already well on its way in collaboration in the fall with experts from Hong Kong notably. We started that back in August, more than 20 contributors lined up from around the world. China, France, Japan, South Korea, USA… In view of the COVID-19’s already visible enhancing and amplifying effect on AMR infections, the issue of the interplay will be an added topic. We may note that reknown experts on AMR from the environment have already proposed to evaluate the local epidemiology of SARS-CoV-2 by waste waters analysis.

However, at this point, news from the WHO, and the governments’ Missions to the UN here, indicate that the World Health Assembly, the WHA, which normally brings several thousand governments and Civil society representatives, might be a shrank to a ‘meeting’ with two representatives per country and no one from civil society, NGO, media or private sector.

In view of that, and the incredible difficulties faced by all of us, we have decided to delay publication launch for the fall, in the hope of better days then. We will publish abstracts on line as they come in the spring.

II – The plan to hold a side event at ESCMID Paris this April on new antibiotics which Jacques Acar, a founder and former president of ESCMID is of course out of the question. ESCMID’s Paris meeting is besides canceled with the lockdown.

III - The preparatory concept for a one day brainstorming seminar: "Climate Change, an Ecology Informed look into AMR", to be organized for late fall-winter or in 2021, depending again on the COVID-19 pandemic, is under discussion.

Contacts with the World Meteorological Organization, where we had the Feb 7th meeting, with the UNEP (UN Environment Program), ITU (International Telecom Union), etc as well as large NGO groups to get the idea across.

IV - The building of global/local Patients for Patient Safety Projects on Women/Child & AMR, and Women educate Women, which, elaborated over several years by experienced field researchers and NGOs, was infused by new enthusiasm from Ouganda and Benin.

-Piggybacking on the WHO newly found interest in promoting IPC internationally - which fits with our Patients for Patient Safety previous work. This project, still ongoing in Benin today will incorporate basics of COVID-19 prevention.

Education of lay persons has never been higher on the global agenda in view of the coronavirus pandemic.

Today the focus will have to go from safe injection, all the way to safe hand hygiene, to undoing practices of hugging, hand shakes and even congregating, involving also contacts and interactions between healthcare providers and patients.

Today a growing number of maternity wards in the EU and USA are preventing husbands or any family member from attending birth, which is dramatic for women in labour. Now is the time to reverse practices of forcing women into maternity wards, may we ask?

Can LMIC countries get inspired from the Netherland’s experience of home birth?

V- The publication of Newsletters, educationals, memorandum and MOOCS

The arrival of this COVID-19 crisis on the Indian and African continents is really a source of extreme worry.

- While the COVID-19 pandemic has overshadowed AMR, the breakdowns in health care systems, even in the ‘advanced’ OECD countries, demonstrated how little is the countries’ preparedness for any disease shock, and fundamentally for AMR.

If countries, humanity, survive this crisis better than the Spanish Flu - at present it is a worse disease because more contagious even – the COVID-19 crisis will multiply antibiotic resistance in many ways: through opportunistic infections necessitating antibiotics, through indiscriminate use of antibiotics, through ruptures in supply chains as well as lack of availability in older antibiotics, through contamination, notably massive use of ventilators which can, especially in LMIC, become vectors of AMR drug-resistant Health System Acquired Infections.

In that context, the development of MOOCSFrom COVID-19 to AMR, The Need Education, for Containment and Preparedness” appears of interest.

But in this sea of info where can we make the difference?

We would suggest, perhaps, a few ideas:

1- A keen interest in ‘inventiveness’ from make-shift solutions to advanced technologies and their use today

2- A penchant for field based projects and implementation research, bringing together people with a wide array of different experience including political economy

3- Curiosity about innovative systemic work practices by health care staff and patients representatives

4- A keen interest in political economy and fundamental research

We ask you, our collaborators and friends for input and suggestions.

So far, we run on volunteer labor and thank Arno Germond (PhD, Researcher, Riken, Japan) for his great input with the creation of this website and his commitment to the overall project.

Garance,

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