The problem of antimicrobial resistance and its containment is back on the agenda, both nationally and internationally. With increasing resistance globally, and here in Australia, there is now a major push to address this problem as a matter of urgency. Unfortunately, like many medical problems with a strong societal component, the solution to controlling antimicrobial resistance is complex and requires the introduction of a wide range of interventions. Most important, it is recognised that this is a One Health issue, by which is meant that both the human and non-human sectors need to work together for solutions.
It is important to recognise that while antimicrobials are used, there will always be some level of resistance. Control strategies should be directed at reducing the current resistance burden, and controlling the spread of new resistances as they emerge. With this in mind, the federal Departments of Health and Agriculture have joined forces and produced a National Antimicrobial Resistance Strategy that was released in June 2015. The Strategy was based on the evolving Global Action Plan produced by the World Health Organisation, and has seven listed objectives:
There are a range of educational activities occurring across Australia, the most important of which is that run by NPS MedicineWise for general practitioners and the public. Antimicrobial stewardship programs are now mandated in Australian hospitals as part of hospital accreditation, and work by several organisations, especially the National Centre for Antimicrobial Stewardship, are investigating ways to extend stewardship beyond the hospital sector, including into general practice, aged care and veterinary practice. National surveillance in human health has just completed its phase 1 build and providing very useful data on where to focus control efforts, and pilot programs have commenced in food animal production. Infection control and vaccination are strongly promoted across all sectors. A formal national research agenda has yet to be established, but already positives are emerging through NHRMC centres for research excellence. International collaboration is at an all time high, heavily promoted by the WHO both centrally and in regional offices as well as it’s animal health equivalent, the OIE. Australia is fully engaged all these levels. A governance structure has emerged with a high level interdepartmental Steering Group and a national Scientific and Technical Advisory Group. For all of this, there is still a way to go, and a lot of work to be done.