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  • THE AMR CHALLENGE SEPTEMBER 23, 2019 7:00 8:30 P.M.

  • [Music]

  • [VIDEO] MORE AND MORE BACTERIA WERE BECOMING RESISTANT SPREADING ACROSS THE GLOBE VERY SOON,

  • WE WILL NOT HAVE ENOUGH ANTIBIOTICS TO TREAT INFECTIONS.

  • THIS IS A MAJOR PUBLIC HEALTH PROBLEM THAT NEEDSTO BE SOLVED.

  • WE NEED TO ASSIST EACH OTHER.

  • WE REALLY NEED TO DO MORE.

  • [Music]

  • AT CDC WE WORK A LOT WITH OUR PARTNERS INTERNATIONALLY TO DETECT AND RESPOND TO THREATS

  • THAT ARE CURRENT HEALTHCARE, LIKE ANTIBIOTIC RESISTANCE.

  • ONE OF THE WAYS TO MAKE A DIFFERENCE IS THROUGH USING EXISTING TECHNOLOGY

  • TO HELP US THINK ABOUT PROBLEMS DIFFERENTLY.

  • ONE OF THE WAYS WE'RE DOING THIS IS THROUGH AN APP CALLED ACUMEN

  • THAT WE ARE PILOTING IN COLOMBIA.

  • WITH THE ACUMEN APPLICATION, YOU HAVE THE GUIDELINES OF ALL THE ANTIBIOTIC USE

  • IN THE HOSPITAL, AND THE GUIDELINES OF INFECTION PREVENTION AND CONTROL.

  • THE CONTACT PRECAUTIONS, AIRBORNE PRECAUTIONS, ALL THE ISOLATIONS AND THE HAND HYGIENE TOO.

  • FOR THE PATIENTS, THE BEST BENEFIT OF THIS APPLICATION IS

  • TO HAVE THE RIGHT ANTIBIOTIC.KNOWING THE RIGHT ANTIBIOTIC IN THE RIGHT TIME, IN THE RIGHT DOSE,

  • FOR THE RIGHT PATIENTS, I THINK IT MAKES A HUGE IMPACT.

  • THE ECHO MODEL IS ANOTHER WAY THAT WE'RE USING EXISTING TECHNOLOGY, SOMETHING THAT'S AS SIMPLE

  • AS A WEBCAM, AS A WAY TO TEACH LABORATORIANS HOW CAN WE BETTER USE THE MICROSCOPES

  • AND THE EQUIPMENT THAT THEY HAVE TO BOLSTER THEIR TRAINING

  • SO THAT WE CAN BETTER DETECT ANTIBIOTIC-RESISTANT BACTERIA.

  • BECAUSE WE WON'T BE ABLE TO DO ANYTHING ABOUT THE BACTERIA IF WE DON'T KNOW IT'S THERE.

  • BY USING VIRTUAL CONNECTIVITY, 100 IF NOT 150 PARTICIPANTS,

  • CAN CONNECT IN AT ANY ONE GIVEN TIME.

  • WE CAN CREATE A SAFE HAVEN FOR THE PARTICIPANTS WHERE THEY'RE ABLE

  • TO COME IN ON A PEER-TO-PEER LEVEL.

  • WHERE THEY FEEL FREE TO ASK QUESTIONS AMONGST THEMSELVES, TO KNOW HOW TO FIND

  • WHERE THE PROBLEM WAS AND CORRECT IT SO THAT THE NEXT TIME, IT DOESN'T HAPPEN AGAIN.

  • WHAT CDC HAS RECOGNIZED IS THAT TECHNOLOGY IS REALLY CRITICAL.

  • BUT WHAT'S ALSO REALLY IMPORTANT IS HAVING THAT HUMAN INTERACTION,

  • HAVING THAT MENTORSHIP AND THAT TRAINING.

  • WE WERE CALLED TO ASSIST THIS REALLY LARGE PUBLIC HOSPITAL

  • BECAUSE THEY WERE SEEING HIGH RATES OF RESISTANT BACTERIA.

  • WE WERE ABLE TO IDENTIFY WHAT ARE THE MAJOR GAPS THAT COULD BE ADDRESSED,

  • AND IMPORTANTLY HOW CAN WE MAKE THOSE CHANGES LAST OVER A LONG PERIOD OF TIME?

  • WE FOCUSED AT THREE AREAS.

  • ONE AREA WAS SAFE PREPARATION OF MEDICATION.

  • THE OTHER PART WE LOOKED AT WAS TO HAVE THE EXPERT

  • IN INFECTION CONTROL VISITING OUR UNIT REGULARLY TO ASSIST THAT IPC NURSE

  • IN TERMS OF TRAINING AND SUPERVISING.

  • BUT TO ME EVEN MUCH MORE IMPORTANT IS THE PHARMACIST IS MONITORING MEDICATION ERRORS,

  • CHECKING AS TO THE USAGE OF ANTIBIOTICS.

  • THE ROLE OF A CLINICAL PHARMACIST IS HIGHLY, HIGHLY, HIGHLY IMPORTANT.

  • TO LOOK AFTER OUR ANTIBIOTICS, TO PRESCRIBE CORRECTLY,

  • O CONTROL ANTIBIOTIC USAGE IN THE HOSPITAL.

  • AND OUR GOAL IS THAT NO MOTHER WOULD TAKE HER BABY HOME AS A CORPSE FROM THIS UNIT.

  • BECAUSE THESE ANTIBIOTIC- RESISTANT BACTERIA ARE ACTUALLY SPREADING FROM ONE PERSON

  • TO ANOTHER PERSON, TO COMMUNITIES AND EVEN ACROSS BORDERS, WE ALL HAVE A ROLE TO PLAY

  • BECAUSE WE ALL HAVE A STAKE IN THE OUTCOME.

  • WE REALLY NEED MORE COMMITMENTS AND WE REALLY NEED MORE ACTION.

  • WHETHER YOU'RE THE HEAD OF A COUNTRY, THE HEAD OF A HOSPITAL, OR EVEN JUST THE HEAD

  • OF A HOUSEHOLD, I THINK THERE ARE A LOT OF THINGS THAT YOU CAN DO TOGETHER

  • TO EFFECTIVELY IMPACT THIS EPIDEMIC.

  • [MUSIC]

  • [Applause]

  • >> MADLEN DAVIES: HELLO AND WELCOME.

  • THANK YOU FOR COMING HERE TONIGHT.

  • I KNOW A LOT OF YOU HAVE COME FROM FAR AND WIDE

  • AND EVEN BRAVED THE STICKY NEW YORK SUBWAY TO BE HERE.

  • SO THANK YOU VERY MUCH.

  • DR. REDFIELD, THE CDC DIRECTOR, WAS DUE TO BE HERE TONIGHT,

  • BUT HE HAS BEEN CALLED AWAY URGENTLY TO THE WHITE HOUSE SO HE SENDS HIS APOLOGIES.

  • MY NAME IS MADLEN DAVIES.

  • I LEAD THE GLOBAL HEALTH TEAM OF THE BUREAU OF INVESTIGATIVE JOURNALISM IN LONDON.

  • THE BUREAU IS BRITAIN'S BIGGEST NON PROFIT MAJOR ORGANIZATION.

  • AND WE WRITE STORIES AND MAKE FILMS THAT ARE IN THE PUBLIC INTEREST.

  • SO FOR THE PAST THREE YEARS, WE HAVE BEEN WORKING

  • ON AN INVESTIGATIVE JOURNALISM PROJECT ABOUT DRUG RESISTANCE.

  • MY TEAM TRAVELED ALL OVER THE WORLD MEETING PEOPLE AFFECTED BY DRUG RESISTANT INFECTIONS.

  • THIS TIME LAST YEAR, I WAS IN A HOSPITAL IN NORTHERN INDIA.

  • THERE, I MET PINKY, A YOUNG WOMAN IN A BEAUTIFUL GREEN SARI.

  • SHE WAS PAINTING HER NAILED A PURPLE GLITTERY POLISH WHEN I MET HER AND ONCE THE POLISH DRIED,

  • SHE TOOK ME THROUGH A CLOSED DOOR AND SAID THAT IS WHERE MY BABY IS BEING KEPT.

  • THERE WAS NO WINDOW INTO THE ROOM AND I COULDN'T SEE HIM.

  • HE HAD BEEN IN THE HOSPITAL FOR MORE THAN TWO WEEKS.

  • SHE HAD AN INFECTION THAT WAS RESISTANT TO NEARLY ANTIBIOTIC,

  • EXCEPT ONE WHICH WAS BEING GIVEN INTRAVENOUSLY.

  • THIS IS THE TIME WHEN I'M SUPPOSED TO BE HOLDING AND FEEDING MY DAUGHTER,

  • PINKY SAID, BUT I CAN'T EVEN TOUCH HER.

  • WHEN I LEFT INDIA, PINKY WAS PRAYING THAT HER DAUGHTER MIGHT LIVE.

  • IN ANOTHER PART OF INDIA, WE MET A FATHER WITH MULTI DRUG RESISTANT TB.

  • HE HAD TO TAKE A COCKTAIL OF DRUGS WHICH HAD SEVERE SIDE EFFECTS AND HE WAS VERY DEPRESSED.

  • THIS, COUPLED WITH THE FACT THAT NONE OF HIS FAMILY WOULD VISIT HIM FOR FEAR

  • OF CATCHING THE DISEASE, LEFT HIM SUICIDAL.

  • IN MALAWI, WE MET A YOUNG WOMAN WHO JUST LOST HER CHILD DURING CHILDBIRTH.

  • THE WOUND FROM HER C SECTION HAD BECOME INFECTED WITH RESISTANT BACTERIA.

  • DOCTORS COULDN'T CRUSH IT WITH ANTIBIOTICS SO THEY WERE FORCED TO SURGICALLY REMOVE HER WOMB.

  • IN THE U.K., WE MET EMILY, SHE SUFFERED A RESISTANT INFECTION WHILE PREGNANT

  • AND WAS FORCED TO MAKE A FRIGHTENING DECISION ABOUT WHETHER TO TAKE ANTIBIOTICS

  • THAT NEVER HAD BEEN CHILD ON PREGNANT WOMEN BEFORE.

  • THESE PEOPLE ARE JUST A FEW OF THE HUNDREDS OF THOUSANDS AFFECTED BY AMR

  • THAT NUMBER IS SET TO INCREASE IF WE DON'T ACT.

  • BUT WHILE THE PROBLEM IS VAST, LOTS OF ACTION IS HAPPENING TO STEM ITS RISE.

  • THE BUREAU RAN A SERIES OF STORIES LAST YEAR ABOUT ONE OF OUR MOST PRECIOUS ANTIBIOTICS,

  • WHICH IS USED AS A LAST HOPE TO SAVE PATIENT'S LIVES WHEN ALL OTHER DRUGS FAILED.

  • IN INDIA, AS IN MANY OTHER COUNTRIES, IT WAS BEING GIVEN EN MASS TO LIVESTOCK

  • TO MAKE THEM GROW FATTER, A PRACTICE WHICH BREEDS THE RESISTANT BACTERIA

  • WHICH CAN GO ON AND INFECT HUMANS.

  • EARLIER THIS YEAR, WE HAD SOME GREAT NEWS.

  • THE INDIAN GOVERNMENT ANNOUNCED IT WILL BAN THE USE OF THIS DRUG IN VETERINARY MEDICINE,

  • JOINING MANY OTHER COUNTRIES AROUND THE WORLD.

  • THIS WAS A FORMIDABLE STEP AND IT WAS MADE POSSIBLE BY A RANGE OF PEOPLE WORKING TOGETHER;

  • JOURNALISTS, CAMPAIGNERS, LAWYERS, GOVERNMENT OFFICIALS, POLITICIANS AND THE INDUSTRY ITSELF.

  • MORE AND MORE STEPS ARE BEING TAKEN.

  • THE CDC LAUNCHED ITS AMR CHALLENGE PROGRAM LAST YEAR ASKING COMPANIES AND ORGANIZATIONS

  • TO MAKE A PRACTICAL PLEDGE, WHICH WOULD HELP TACKLE AMR.

  • AND I WAS REALLY IMPRESSED WITH HOW SPECIFIC THESE PLEDGES WERE.

  • AND TONIGHT, I'M VERY EXCITED TO SHARE SOME OF THE EARLY SUCCESSES WITH YOU.

  • IN JUST ONE YEAR, NEARLY 350 COMMITMENTS HAVE BEEN MADE

  • FROM ORGANIZATIONS ACROSS 32 COUNTRIES.

  • THIS INCLUDES PLEDGES FROM 50 U.S. STATES AND WASHINGTON, D.C. TO TAKE ACTION AGAINST AMR.

  • ALMOST HALF OF THE COMMITMENTS FOCUS ON IMPROVING INFECTION PREVENTION AND CONTROL.

  • THAT'S MORE THAN 10,000 HEALTH CARE FACILITIES WORKING

  • TO PREVENT RESISTANT INFECTIONS OCCURRING IN THE FIRST PLACE.

  • IF YOU'RE A PATIENT YOU WOULD JUST PREFER NOT

  • TO CATCH THE INFECTION RATHER THAN BEING TREATED FOR IT.

  • MORE THAN 45 ORGANIZATIONS HAVE COMMITTED TO IMPROVING SAFE DRINKING WATER, SANITATION

  • AND HYGIENE ACROSS THE WORLD, AND THAT INCLUDES 100 MILLION DOLLAR COMMITMENT FROM WORLD VISION

  • TO IMPROVE WATER AND SANITATION IN RURAL HEALTH CARE FACILITIES ACROSS AFRICA.

  • NEARLY HALF OF THE COMMITMENT MAKERS FOCUS ON IMPROVING ANTIBIOTIC USE,

  • WHICH HELPS SLOW THE DEVELOPMENT OF RESISTANCE AND PROTECTS PATIENTS

  • FROM THE UNNECESSARY SIDE EFFECTS OF THE DRUGS.

  • LASTLY, MORE THAN 55 PHARMACEUTICAL AND BIOTECH GROUPS HAVE COMMITTED TO DEVELOP

  • OR PROVIDE ACCESS TO PRODUCTS THAT WILL PREVENT AND TREAT RESISTANT INFECTIONS.

  • BUT WE STILL NEED MORE ACTION.

  • TO TACKLE THE PROBLEM, AND TO DRIVE POLICY CHANGE, WE NEED POLITICIANS AND THE PUBLIC

  • TO TRULY BELIEVE IT SHOULD BE A PRIORITY.

  • AND FOR THAT, WE NEED BETTER COMMUNICATION ABOUT AMR.

  • THE WORLD INTERESTS HAD CARRIED OUT SOME RESEARCH ON HOW TO COMMUNICATE THIS ISSUE

  • TO THE PUBLIC IN WAYS THAT IT REALLY CUTS THROUGH.

  • IT'S ABSOLUTELY FANTASTIC TO HAVE SOLID EVIDENCE TO INFORM THE WAY WE TALK ABOUT THIS TOPIC,

  • AND I'M PLEASED THAT LATER I'LL BE ABLE TO SHARE SOME OF THE PRACTICAL RECOMMENDATIONS WITH YOU;

  • BUT FIRST, HERE TO SHOWCASE MORE OF THE SUCCESSFUL PLEDGES

  • FROM THE PAST YEAR IS ALEX AZAR, SECRETARY OF HEALTH AND HUMAN SERVICES.

  • Mr. AZAR WAS SWORN IN LAST JANUARY.

  • HE SPENT THE MAJORITY OF HIS CAREER WORKING IN SENIOR HEALTH CARE LEADERSHIP ROLES

  • IN THE PUBLIC AND PRIVATE SECTORS.

  • NO STRANGER TO THE DEPARTMENT OF HEALTH AND HUMAN SERVICES,

  • HAVING SERVED AS ITS GENERAL COUNSEL AND THEN DEPUTY SECRETARY IN THE EARLY 90s.

  • DURING HIS TIME AS DEPUTY SECRETARY,

  • HE WAS INVOLVED IN IMPROVING THE DEPARTMENT'S OPERATIONS, ADVANCING ITS EMERGENCY PREPAREDNESS

  • AND RESPONSE CAPABILITIES, ADVANCING ITS GLOBAL HEALTH AFFAIRS ACTIVITIES

  • AND HELPING OVERSEE THE ROLL OUTS OF MEDICARE PART D PRESCRIPTION DRUG PROGRAM.

  • IN 2007, AZAR REJOINED THE PRIVATE SECTOR AT ELI LILLY

  • AND WAS PRESIDENT OF LILLY USA FROM 2012 2017.

  • I'D LIKE TO WELCOME HIM TO THE STAGE.

  • [ APPLAUSE ]

  • >> SECRETARY AZAR: MADLEN, THANK YOU VERY MUCH AND GOOD EVENING, EVERYONE.

  • ON BEHALF OF THE UNITED STATES GOVERNMENT, THANK YOU ALL FOR JOINING ME HERE TONIGHT TO REFLECT

  • ON AND HIGHLIGHT THE REAL PROGRESS THAT WE HAVE MADE IN THE FIGHT

  • AGAINST ANTIMICROBIAL RESISTANCE IN THE PAST YEAR.

  • THE YEAR LONG INITIATIVE WE LAUNCHED LAST YEAR AROUND THIS TIME,

  • THE AMR CHALLENGE, SETS A PROMISING PRECEDENT.

  • THE SUCCESS OF THE CHALLENGE OVER THE PAST YEAR, DEMONSTRATES WHAT IS POSSIBLE

  • IN THE RELATIVELY SHORT TERM WHEN WE HAVE A REAL COMMITMENT TO FIGHT

  • AGAINST THIS PRESSING PUBLIC HEALTH THREAT.

  • SINCE THE LAUNCH OF THE AMR CHALLENGE UNDER THE LEADERSHIP OF THE CDC LAST YEAR,

  • GOVERNMENTS FROM THE GLOBE, PRIVATE SECTOR BUSINESSES AND NGOs AROUND THE GLOBE,

  • MADE 350 COMMITMENTS TO FIGHT AMR.

  • I KNOW MANY ARE HERE TONIGHT.

  • SO I WANT TO PERSONALLY THANK YOU FOR STEPPING UP TO THE PLATE.

  • AS ALL OF YOU KNOW, THE UNITED STATES HAS EAGERLY ENGAGED ON ANTIMICROBIAL RESISTANCE BOTH

  • IN PUBLIC AND THE PRIVATE SECTOR.

  • THE TRUMP ADMINISTRATION HAS MADE AMR A TOP PRIORITY IN OUR GLOBAL AND DOMESTIC WORK

  • AND THE RESPONSE HAS BEEN ENCOURAGING.

  • WE SAW OVER 225 COMMITMENTS TO THE AMR CHALLENGE MADE

  • IN THE UNITED STATES ALONE SPANNING ORGANIZATIONS ACROSS ALL 50 STATES.

  • I WANT TO HIGHLIGHT A FEW NOTABLE EXAMPLES.

  • OF THE 10,000 HEALTH CARE FACILITIES REPRESENTED BY ORGANIZATIONS COMMITTED TO THE CHALLENGE,

  • I WANT TO MENTION ONE BY WAY OF EXAMPLE.

  • PREMIER, INC., A LARGE HEALTH CARE ALLIANCE OF 4000 U.S. HOSPITALS

  • AND 175,000 MEDICAL PROVIDERS, THEY HAVE REDUCED THE RATE

  • OF A PARTICULAR HEALTH CARE ASSOCIATED INFECTION BY 46% IN 500 HOSPITALS SINCE 2015

  • THROUGH COACHING CALLS, SITE VISITS, WEBINARS AND A NEW WEBSITE FOCUSED ON AMR.

  • THAT'S JUST ONE OF THE MANY HEALTH CARE PROVIDERS THAT HAVE TAKEN THESE KINDS OF STEPS.

  • WE HAVE ALSO SEEN COMMITMENTS FROM MAJOR FOOD AND ANIMAL ORGANIZATIONS.

  • McDONALD'S AND YUM!

  • BRANDS SPECIFICALLY ARE COMMITTING TO REDUCING ANTIBIOTIC USE IN THE POULTRY

  • AND BEEF THEY USE FOR THEIR PRODUCTS.

  • McDONALD'S COMMITTED TO USE ITS MARKET SHARE POWER TO REDUCE ANTIBIOTIC USE

  • IN THE LIVESTOCK IT USES FOR BEEF PRODUCTS AND YUM!

  • AIMS TO CUT ITS ANTIBIOTIC USE IN BEEF BY 25% BY 2025, HAVING ALREADY MADE HUGE STRIDES

  • IN THE POULTRY PRODUCTS INDUSTRY.

  • FOR THOSE OF YOU WHO HAVE NOT GOTTEN DEEPLY INTO WHAT IT TAKES TO CURB ANTIBIOTIC USE

  • IN LIVESTOCK, I KNOW SOME OF YOU HERE THIS EVENING HAVE.

  • EXTENDING THESE POLICIES TO BEEF IS A PARTICULAR CHALLENGE.

  • SO WE APPRECIATE THESE ELEVATED AND AMBITIOUS COMMITMENTS.

  • WE HAVE ALSO SEEN COMMITMENTS FROM NGOs LIKE WORLD VISION, COMMITTING 100 MILLION DOLLARS

  • BY 2021 AND 35 COUNTRIES IN AFRICA TO HELP TO CURB THE SPREAD

  • OF ANTIMICROBIAL RESISTANT BACTERIA AND FUNGI.

  • FINALLY WE SEEN WORK FROM GOVERNMENTS AND THE PRIVATE SECTOR TOGETHER.

  • THE FDA RECENTLY APPROVED A CRITICAL DRUG REGIMEN TO TREAT DRUG RESISTANT TB,

  • AN EFFORT THAT HAS BEEN SUPPORTED BY THE TB ALLIANCE, ADVANCED BY NIH WORK AND BENEFITED

  • FROM THE FDA'S LIMITED POPULATION PATHWAY PROCESS.

  • WHILE THESE ARE CERTAINLY STEPS IN THE RIGHT DIRECTION, OUR WORK IS ONLY BEGINNING.

  • THAT'S WHY LATER THIS YEAR, THE CDC WILL RELEASE THE AMR THREATS REPORT GIVING US A CLEAR PICTURE

  • OF THE SIGNIFICANT WORK THAT IS STILL NEEDED

  • TO PREVENT RESISTANT INFECTIONS AND STOP THE SPREAD OF GERMS.

  • CONTINUING OUR FIGHT AGAINST AMR WITH THE SAME VIGOR WE HAVE SEEN OVER THE LAST YEAR,

  • WILL LEAD TO LOWER RATES OF INFECTION, LOWER HEALTH CARE COSTS,

  • REDUCE HUMAN SUFFERING AND LIVES SAVED.

  • SO THIS YEAR, COMPONENTS OF HHS, THE DEPARTMENT I RUN, ROLLED OUT A NUMBER OF NEW INITIATIVES

  • TO HELP REVITALIZE THE ANTIBIOTIC MARKET, INCREASE STEWARDSHIP PRACTICES,

  • INNOCENT VICE RESEARCH AND DEVELOPMENT AND USE RISK BASED ASSESSMENT

  • TO INFORM ALL ANTIMICROBIAL USE IN HUMAN AND ANIMAL HEALTH.

  • THE CENTERS FOR MEDICARE AND MEDICAID SERVICES OR CMS, HAS DEVELOPED A BUNDLE OF REFORMS

  • TO SECURE MEDICARE BENEFICIARIES ACCESS TO ANTIMICROBIALS IN THE SHORT TERM WHILE SEEKING

  • TO REALIGN FINANCIAL INCENTIVES TO SUSTAIN INNOVATION IN THIS SPACE FOR THE LONG TERM.

  • CMS IS ALSO NOW EXPLORING IMPLEMENTING CDC RECOMMENDATIONS

  • FOR HOSPITAL BASED ANTIBIOTIC STORAGE PROGRAMS AND THE REGULATIONS

  • THAT GOVERN HOSPITAL'S PARTICIPATION IN THE MEDICARE PROGRAM.

  • I'M ENCOURAGED BY THE PROGRESS WE ARE MAKING BUT AS NOTED EARLIER, OUR WORK HAS ONLY JUST BEGUN.

  • THE REAL WORK BEGINS AGAIN WHEN WE DEPART AND RETURN BACK TO OUR HOME COUNTRIES,

  • WHETHER TO JOBS IN GOVERNMENT OR THE PRIVATE SECTOR.

  • I'M COMMITTED TO CONTINUING THIS WORK IN THE COMING YEARS AT HHS.

  • ONE OF THE KEY ELEMENTS OF THE VISION THAT PRESIDENT TRUMP HAS

  • FOR OUR HEALTH CARE SYSTEM INCLUDES TACKLING IMPACTABLE PUBLIC HEALTH CHALLENGES.

  • AMR IS CERTAINLY A CHALLENGE WHERE WE CAN MAKE AN IMPACT

  • AND FURTHER DEVELOPMENT OF ANTIMICROBIALS.

  • BUT IT'S ALSO THE KIND OF ISSUE WHERE IF WE DON'T MAKE AN IMPACT,

  • A LOT OF OTHER HEALTH CHALLENGES GET EVEN HARDER.

  • WE NEED COMMITMENTS FROM ALL SECTORS TO CONTINUE FIGHTING THIS THREAT AND SO,

  • IN THE SPIRIT OF THE AMR CHALLENGE I WANT TO OFFER A FURTHER CHALLENGE.

  • I CHALLENGE EVERYONE HERE TO RENEW YOUR EFFORTS IN YOUR OWN WORLD

  • AND CONSIDER WHAT YOU CAN DO TO COMBAT AMR.

  • ON TOP OF THAT, CONSIDER HOW YOU CAN BETTER COLLABORATE WITH OTHER COUNTRIES IN THIS EFFORT.

  • WE NEED BOTH INDIVIDUAL AND COLLECTIVE ACTION TO COMBAT THE LOOMING THREAT OF AMR

  • AND MAKE A LASTING DIFFERENCE FOR THE CITIZENS WE REPRESENT AND SERVE.

  • TOGETHER, WE CAN PROTECT FUTURE GENERATIONS FROM SERIOUS

  • BUT AVOIDABLE LOSSES TO OUR HEALTH AND PROSPERITY.

  • THANK YOU AGAIN FOR HAVING ME HERE TONIGHT.

  • THANK YOU ALL FOR YOUR DEEP COMMITMENT TO ENDING THE SCOURGE OF AMR AND I LOOK FORWARD

  • TO CELEBRATING MORE SUCCESSES AND ACHIEVEMENTS WITH YOU IN THE YEARS TO COME.

  • THANK YOU.

  • [ APPLAUSE ]

  • [Missing Text]

  • YOU HAVE A 90% CHANCE OF SURVIVAL OR A 10% CHANCE OF DEATH.

  • IT'S A PROBABILITY YET NOT MANY CHOOSE THE LATTER.

  • SO THE QUESTION BECOMES, WHEN WE TALK ABOUT ANTIBIOTIC RESISTANCE,

  • HOW CAN WE ENSURE THE LANGUAGE WE USE IS EFFECTIVE AND DRIVES ACTION?

  • WE TESTED DIFFERENT WAYS OF COMMUNICATING ABOUT ANTIBIOTIC RESISTANCE

  • IN SEVEN COUNTRIES AND THREE THEMES EMERGED.

  • ONE, MAKE IT HUMAN AND RELEVANT.

  • WHEN WE TALK ABOUT WHO IS AFFECTED AND HOW IT EFFECTS THEM,

  • PEOPLE ARE MUCH MORE LIKELY TO ACT.

  • FOR EXAMPLE, SAY EVERYONE IS AFFECTED, INCLUDING YOU, AND EXPLAIN THE IMPACT

  • ON ROUTINE OPERATIONS OR CANCER CHEMOTHERAPY.

  • TWO, MAKE IT SERIOUS BUT SOLVABLE.

  • PEOPLE ARE MUCH MORE LIKELY TO TAKE ACTION

  • WHEN THEY FEEL THE ISSUE IS URGENT BUT THERE IS SOME HOPE.

  • FOR EXAMPLE, HIGHLIGHT HOW ANTIBIOTIC RESISTANCE WORKS IN RECENT PROGRESS AND HEALTH

  • BUT CAN BE COUNTERED BY DEVELOPING NEW TREATMENTS.

  • THREE, USE SIMPLE SCIENTIFIC EXPLANATIONS.

  • PEOPLE DON'T WANT TO BE TOLD WHAT TO THINK.

  • THEY WANT TO UNDERSTAND THE ISSUE.

  • FOR EXAMPLE, USE SIMPLE, CLEAR LANGUAGE TO EXPLAIN THE SCIENCE.

  • FOR TIPS ON HOW TO EFFECTIVELY COMMUNICATE ANTIBIOTIC RESISTANCE, VISIT:

  • [Missing Text]

  • [ APPLAUSE ]

  • >> MADLEN DAVIES: SO THE WELCOME TRUST CARRIED OUT THIS NEW RESEARCH

  • ON HOW WE CAN COMMUNICATE AMR SO THAT IT CUTS THROUGH, AND THE THAT RESEARCH WILL BE PUBLISHED

  • IN FULL IN OCTOBER AND IT WILL BE SENT TO YOU VIA E MAIL SHORTLY.

  • BUT I JUST LIKE TO GO INTO MORE DEPTH ON THE FIRST RECOMMENDATION.

  • IT'S TO MAKE THE PROBLEM SOUND SERIOUS BUT SOLVABLE.

  • THE RESEARCH SHOWS THAT TO PAY ATTENTION, PEOPLE DO NEED TO FEEL THAT AMR A SERIOUS PROBLEM

  • BUT TO BE MOST EFFECTIVE, DESCRIPTIONS OF THE PROBLEM MUST BE COMBINED WITH SOLUTIONS,

  • OTHERWISE PEOPLE JUST LOSE HOPE AND SWITCH OFF.

  • GIVING A CLEAR CALL TO ACTION TO YOUR AUDIENCE HELPS MAKE IT A PRIORITY FOR THEM.

  • YOU MIGHT WANT TO COMMUNICATE ACTIONS AND SOLUTIONS SUCH AS THAT WE CAN GET AHEAD

  • OF THE PROBLEM OF AMR TO INCREASE BEST PRACTICES AROUND APPROPRIATE ANTIBIOTIC USE.

  • THE CDC HAS SEEN A GREAT EXAMPLE OF WORK IN COLUMBIA TO BETTER CONTROL ANTIBIOTIC USE.

  • A PARTNERSHIP WITH THE TECHNOLOGY COMPANY SAW THE DEVELOPMENT OF THE APP.

  • THE APP PROVIDES THE GUIDELINES FOR COMPLEX INFECTION CONTROL LIKE THE STEPS NEEDED

  • TO STOP AIRBORNE SPREAD OF MICROBES.

  • ADDITIONALLY, HEALTH CARE WORKERS CAN USE THE APP

  • WHEN THEY MAKE DECISION BUSY PRESCRIBING ANTIBIOTICS AND MAKING SURE THE RIGHT ANTICIPATE

  • BY ON THETIC IS USED AT THE RIGHT TIME AND AT THE RIGHT DOSE.

  • NEXT WE HAVE THE COLUMBIA MINISTER OF HEALTH WHO CAN SPEAK TO OTHER SOLUTIONS IN THE COUNTRY.

  • HE IS AN ACCOMPLISHED SURGEON AND HAS A LONG HISTORY OF WORK BOTH

  • IN THE PUBLIC AND PRIVATE SECTOR.

  • PREVIOUSLY, HE SERVED AS HEALTH DIRECTOR FOR THE WORLD'S BANK AND A PRIVATE NGO DEDICATED

  • TO STRENGTHENING EQUITY AND SOCIAL DEVELOPMENT IN COLUMBIA.

  • HE ALSO LED THE HOSPITAL IN BOGOTA, ONE OF THE MOST PRESTIGIOUS HOSPITALS IN COLUMBIA.

  • SO WELCOME TO THE STAGE!

  • [ APPLAUSE ]

  • >> SO, GOOD NIGHT AND THE THANKS SO MUCH FOR INVITING ME HERE AND HOSTING ME HERE.

  • SECRETARY AZAR, VERY NICE SEEING YOU AGAIN.

  • LAST YEAR IT WAS BETWEEN COLUMBIA AND VENEZUELA AND I WANT

  • TO APPRECIATE ALL YOUR SUPPORT TO OUR COUNTRY.

  • SALLY, DAVID, EXTREMELY NICE TO MEET YOU.

  • MICHAEL, VERY NICE SEEING YOU AS WELL.

  • I WANT TO EXPRESS ALSO MY APPRECIATION TO ALL THE ARTISTS

  • WHICH DID SUCH A GREAT JOB AROUND US.

  • I HAD TIME TO LOOK AT THEIR PAINTINGS AND MESSAGES ARE EXTREMELY IMPORTANT.

  • PLEASE EXCUSE MY ENGLISH.

  • I'M THINKING IN SPANISH AND SPEAKING IN ENGLISH.

  • AS YOU WILL ALL SEE.

  • SO, ANTIMICROBIAL RESISTANCE IS WHAT I WOULD CALL A PUBLIC ANTI GOOD.

  • WE HAVE PUBLIC GOODS AS YOU KNOW BUT HERE WE HAVE A PUBLIC ANTI GOOD.

  • IT REALLY HURTS ALL OF US AND IT'S EXACTLY THE OPPOSITE OF VACCINE.

  • AND BECAUSE OF THAT, BECAUSE OF THAT VERY SIMPLE FACT, IT IS REALLY A GLOBAL CHALLENGE

  • AND IT SHOULD TAKE THE BEST OF US OUT THERE.

  • IT GOES BEYOND THE HEALTH SECRETARY, AS WE WERE TALKING ABOUT.

  • IT REMINDS US OF HOW RIGHT THAT ONE HEALTH CONCEPT IS AND HOW DIFFICULT

  • AT THE SAME TIME IT IS TO BE IMPLEMENTED.

  • IT GOES FAR BEYOND THE HEALTH SECTOR WHERE I SPENT ALL OF MY LIFE.

  • IN COLUMBIA, WHICH IS A MIDDLE INCOME COUNTRY, 50 MILLION PEOPLE, WE HAVE A NATIONAL PLAN

  • TO RESPOND TO ANTIMICROBIAL RESISTANCE.

  • IT FOLLOWED A LOT OF INTERNATIONAL GUIDELINES AND WE PUT IT OUT TWO YEARS AGO,

  • BUT WE HAD MANY YEARS OF PRIOR WORK WITH ANTIBIOTICS AND THEIR CORRECT USE.

  • THIS NATIONAL PLAN INVOLVES THE MINISTRY OF AGRICULTURE.

  • IT INVOLVES OUR NATIONAL INSTITUTE OF HEALTH.

  • IT INVOLVES OUR FDA LIKE INSTITUTIONS.

  • AND WE TRY TO PUT ALL OF THIS TO WORK TOGETHER IN THIS BIG CHALLENGE.

  • THE NATIONAL PLAN HAS FIVE LEVELS OF INTERVENTION.

  • THE FIRST ONE IS THE SAME GOVERNANCE OF THE PLAN.

  • IT'S NOT A MINOR ONE.

  • AGAIN, HAVING THE HEALTH MINISTRY SPEAKING WITH THE MINISTRY OF AGRICULTURE,

  • IT DOESN'T HAPPEN EVERY DAY TO BE VERY FRANK.

  • SO IT NEEDS GOVERNANCE FOR SURE.

  • WE NEED TO BE SERIOUS.

  • IF YOU DON'T HAVE THAT FIRST DIMENSION AND ALL THAT OTHER ONES, VERY STRAIGHTFORWARD

  • AND VERY TECHNICAL, IT WILL NOT WORK.

  • SO GOVERNANCE AND MANAGEMENT OF THE PLAN.

  • THE OTHER HAS TO DO WITH COMMUNICATION AND EDUCATION.

  • I WAS IMPRESSED WITH THE CLARITY AND THE IMPACT OF THIS MESSAGES.

  • THE THIRD ONE HAS TO DO WITH SURVEILLANCE AND RESEARCH AND I'M GOING

  • TO SPEAK QUICKLY ABOUT IT A LITTLE BIT MORE.

  • THE FOURTH ONE HAS TO DO WITH HYGIENE AND PREVENTION, AND FINALLY,

  • WE HAVE THE OPTIMAL UTILIZATION OF ANTIBIOTICS.

  • OUT OF THOSE FOUR, WE HAVE BEEN ABLE TO MAKE, I WOULD SAY, A FAIR PROGRESS IN SURVEILLANCE

  • AND RESEARCH AND IN THE UTILIZATION OF ANTIBIOTICS.

  • WE WORK CLOSELY WITH CDC, BY THE WAY, AND ALL OUR APPRECIATION AND RECOGNITION

  • TO THEIR CONTRIBUTION TO THIS PROGRESS.

  • SURVEILLANCE AND RESEARCH.

  • WE HAVE OUR REPORT SYSTEM.

  • WE HAVE AN INFORMATION SYSTEM THAT CAPTURES EVERYTHING HAPPENS IN PUBLIC HEALTH IN COLUMBIA

  • AND IT IS REALLY GOOD BY THE WAY.

  • AND ANTIMICROBIAL RESISTANCE IS ONE

  • OF THE FACTORS WE ARE CAPTURING IN OUR INFORMATION SYSTEM.

  • AND THAT MEANS A LOT FOR EPIDEMIOLOGICAL RESEARCH

  • AND FOR PROPER PUBLIC POLICY IN THE FUTURE.

  • SECOND, AND AS YOU SAW IN THE VIDEO, WE ARE WORKING IN RESISTANCE IN HOSPITAL SETTINGS.

  • SO WE GO TO THE INTENSIVE CARE UNITS, THE NICUs, THOSE SPACES IN HIGH COMPLEXITY HOSPITALS

  • WHERE THIS CAN BE ONE OF THE BIGGEST CHALLENGES NOT THE BIGGEST

  • AND WE DO RESEARCH IN WHAT IS HAPPENING TO US.

  • I'M NOT AN EXPERT ON MICROBIOLOGY OR ANTIBIOTICS.

  • BUT WE CAN CLEARLY IDENTIFY WHICH ARE THE ELEMENTS THAT ARE POSING THE BIGGEST THREAT

  • TO US, WHICH ARE THE ANTIBIOTICS WHICH ARE IN A WAY, SHOWING RESISTANCE OR SHOWING EFFECT.

  • AND WE CAN KNOW IN A PRETTY GOOD WAY IN THOSE HOSPITAL SETTINGS WHAT OUR CHALLENGING ARE.

  • WE ALSO HAVE SOFTWARE THAT HELPS US KEEP ALL THIS INFORMATION PUT TOGETHER AND WE INVESTED

  • IN IMPROVING OUR PUBLIC HEALTH LABS, WHICH IS EXTREMELY IMPORTANT.

  • WE HAVE A VERY SOLID PUBLIC HEALTH LAB.

  • WE NEED THE LAB'S CAPACITY AT THE NATIONAL LEVEL.

  • IN A BIG LEVEL WITH A LOT OF CITIES, A LOT OF THINGS GOING ON IN THE SAME TIME,

  • IT'S THE WHOLE SYSTEM THAT NEEDS TO BE STRENGTHENED.

  • MOVING FROM THE SURVEILLANCE AND RESEARCH TO THE OPTIMAL UTILIZATION OF ANTIBIOTICS,

  • WE FOLLOW THE BEST PRACTICES AND THE BEST EVIDENCE IN TERMS OF DIAGNOSIS AND TREATMENT

  • AND WHAT THE PROPER GUIDELINES ARE OF UTILIZATION OF ANTIBIOTICS ARE.

  • WE HAVE AN INDUSTRY THAT HAS AGREED ON A SELF REGULATION WHICH HELPS AND PUSHES US

  • IN THE RIGHT WAY AND MORE IMPORTANT, WE TRY TO ENFORCE CONTROLS ON THE SALES OF ANTIBIOTICS.

  • THEY ARE NOT OUT OF THE SHELF.

  • YOU NEED TO HAVE A FORMULA.

  • THE FORMULA NEEDS TO BE OFFICIAL.

  • THEY CAN TRACK BACK WHO IS SELLING WHAT ANTIBIOTICS TO WHOM.

  • THAT IS SOMETHING THAT HAPPENS AND THAT IS AGAIN, PROPER.

  • HOWEVER, AND THIS IS MY SECOND HALF OF THIS SHORT WORDS AND QUICKLY.

  • I WAS AGAIN TALKING TO DAVID AND HE WAS TELLING ME HOW DOES IT HAPPEN IN COLUMBIA?

  • I WAS TELLING HIM, WHEN YOU GO TO BOGOTA, OR WHEN LIMA OR BUENOS AIRES OR SAN PAULO

  • OR MEXICO CITY, AND YOU GO TO SOLID INSTITUTIONS TO BIG HOSPITALS,

  • I WOULD SAY A LOT OF SO FIRST INDICATION.

  • ANTIBIOTIC USE IS REALLY SOLID AND PROPER GOVERNANCE.

  • THERE IS CLINICAL GOVERNANCE.

  • THE PHYSICIANS HAVE SELF CONTROL.

  • THEY ARE ACCOUNTABLE.

  • THERE IS REVIEW.

  • THERE IS PEER REVIEW.

  • SO IT WORKS PRETTY WELL.

  • HOWEVER, WHEN YOU LOOK AT THIS CHALLENGE, YOU NEED TO CONSIDER THE MIDDLE INCOME COUNTRIES

  • AND LOW INCOME COUNTRIES ARE EXTREMELY DESPAIRED.

  • THEIR PERFORMS HAS A GREAT VARIABILITY.

  • YOU WILL FIND INSTITUTIONS AND THEN PLACES OF INEQUALITY AND POVERTY CONCENTRATIONS

  • WHERE THERE IS REALLY VERY LIMITED PRESENCE OF THE STATE

  • AND VERY LIMITED ORGANIZATIONAL CAPACITY.

  • SO FOR ME, WHEN WE ARE TALKING GLOBALLY, SALLY, WHEN WE ARE TALKING

  • ABOUT ANTIMICROBIAL RESISTANCE GLOBALLY, IT'S THOSE POCKETS WHERE WE NEED TO FOCUS A LOT

  • OF OUR EFFORT AND A LOT OF OUR COLLABORATION.

  • THESE ARE PLACES WHERE THE MOST BASIC INPUTS AND RESOURCES ARE NEEDED,

  • WHERE INFRASTRUCTURE IS NOT YET THERE.

  • WHERE HUMAN RESOURCES ARE STRUGGLING DOING THEIR BEST EFFORT WITH BEAR HANDS.

  • WHERE MANY TIMES KNOWLEDGE IS NOT AVAILABLE IN THE RIGHT TIME.

  • WHERE COMMITMENT MAY NOT BE IN PLACE FOR MANY RIGHT REASONS.

  • THERE IS MANY OTHER NEEDS.

  • WHERE POLICIES DO NOT EXIST AND WHERE LEADERSHIP IS STRUGGLING.

  • I DO BELIEVE THAT IT'S FOR THOSE PLACES, FOR THOSE POCKETS, AGAIN IN THIS ANTI PUBLIC GOOD,

  • THAT WE NEED TO PUT THE BEST OF OUR EFFORTS.

  • I WILL JUST CONCLUDE, RECOGNIZING AND APPRECIATING THE EFFORT OF ALL OF YOU FIGHTERS

  • AGAINST THE ANTIMICROBIAL RESISTANCE.

  • THANK YOU VERY MUCH.

  • [ APPLAUSE ]

  • [Silence]

  • [Music]

  • ANTIMICROBIAL RESISTANCE IS ONE OF THE MOST SERIOUS THREATS GLOBALLY FOR PUBLIC HEALTH.

  • EVERYBODY OUT THERE NEEDS TO BE CONCERNED ABOUT THIS ISSUE.

  • THIS IS A ONE HEALTH ISSUE.

  • ONE HEALTH IS THE IDEA THAT HUMANS, ANIMALS, AND THE ENVIRONMENT ARE ALL CONNECTED TO EACH OTHER.

  • WE'RE WITHIN THE ENVIRONMENT EVERY DAY.

  • WE ALL INTERACT WITH EACH OTHER.

  • WE GO HOME AND INTERACT WITH OTHER PETS.

  • WE'RE EATING FOOD FROM THE ANIMALS THAT ARE BEING PRODUCED ON THE FARM.

  • ANTIMICROBIAL-RESISTANT INFECTIONS CAN SPREAD BETWEEN PEOPLE AND ANIMALS.

  • THAT TO US EXACTLY WHY IT'S IMPORTANT THAT WE WORK WITH STAKEHOLDERS AND PARTNERS

  • ACROSS THE PET CARE COMMUNITY ON ANTIMICROBIAL RESISTANCE.

  • WE ALL NEED TO MOVE THE NEEDLE FORWARD TOGETHER THROUGH COLLABORATIONS.

  • THAT'S WHY OUR PARTNERSHIPS ARE SO IMPORTANT.

  • WE AT PIJAC ARE PROUD TO WORK WITH THE CENTERS FOR DISEASE CONTROL ON ALL ASPECTS

  • OF THE PET CARE COMMUNITY.FROM BREEDERS AND DISTRIBUTORS OF ANIMALS TO FOOD

  • AND PRODUCT MANUFACTURERS SERVICE PROVIDERS AND RETAILERS.

  • WE LOOK AT THE SANITATION THAT'S USED TO KEEP CLEAN ENVIRONMENTS.

  • WE LOOK AT TRANSPORTATION PROTOCOLS.

  • AND WE ALSO MAKE SURE THAT PEOPLE WORKING WITH ANIMALS TAKE STEPS TO PREVENT THE SPREAD

  • OF POTENTIALLY RESISTANT DISEASES BEFORE THEY EVEN ENTER INTO THE EQUATION

  • TO MINIMIZE THE RISK OF ANTIMICROBIAL RESISTANCE DEVELOPING.

  • PETCO WORKS HAND-IN-HAND WITH THE CDC BOTH TO MAKE SURE THAT WE HAVE STRONG POLICIES

  • TO PREVENT ANTIMICROBIAL RESISTANCE,

  • BUT ALSO TO ENSURE WE HAVE THE RIGHT EDUCATION

  • AROUND THAT RELATIONSHIP BETWEEN PETS AND PEOPLE.

  • NOT ONLY DO WE NOT SELL ANY ANTIBIOTICS OVER THE COUNTER,

  • WE ALSO DO NOT ALLOW ANY PROPHYLACTIC USE BOTH IN OUR STORES OR FROM ANIMALS THAT ARE COMING

  • FROM ANY SORT OF VENDOR.WE PUT THOSE INTO PLACE NOT ONLY BECAUSE OF CONCERNS

  • FOR OUR OWN ANIMAL HEALTH IN OUR STORES AND FROM THE SUPPLY CHAIN,

  • BUT MAKING SURE THAT AS A COMPANY WE ARE BEING AS PROACTIVE AS POSSIBLE

  • TO PROTECT HUMAN HEALTH AND PUBLIC HEALTH.

  • BECAUSE WE CAN NEVER FORGET THAT THESE ARE GOING TO BE FOLKS PETS LIVING IN THE HOUSE

  • WITH THEIR FAMILY, AND WE WANT EVERYBODY IN THAT ENTIRE FAMILY VERY HEALTHY.

  • WE ALL LIVE IN ONE WORLD TOGETHER.

  • WHAT WE DO IMPACTS THE ANIMALS AROUND US.

  • WHAT THE ANIMALS AROUND US DO IMPACT US.

  • IF YOU MAKE GREAT STRIDES FOR INSTANCE ON THE HUMAN SIDE IN HEALTHCARE

  • IF THOSE SAME STRIDES AREN'T MADE ON THE ANIMAL SIDE, THEN IT'S GOING TO SET US BACK.

  • THE BIGGEST STRIDES WE'RE GONNA MAKE IS THE ENTIRE INDUSTRY COMING TOGETHER

  • TO ADDRESS THESE ISSUES.SO THAT PETS CAN CONTINUE TO BE AN IMPORTANT PART OF OUR LIVES

  • AND ENRICH EVERYTHING THAT WE DO.

  • [Music]

  • [ APPLAUSE ]

  • >> MADLEN DAVIES: NOW I'D LIKE TO SHARE THE SECOND RECOMMENDATION

  • FOR EFFECTIVE COMMUNICATION AROUND AMR, WHICH IS TO USE SIMPLE, SCIENTIFIC EXPLANATIONS.

  • THE WELCOME TRUST RESEARCH SHOWED THAT PEOPLE DON'T WANT TO BE TOLD WHAT TO THINK

  • BUT THEY DO WANT THE FACTS AROUND AMR.

  • SO THEY ARE ABLE TO UNDERSTAND THE ISSUE FOR THEMSELVES AND COME TO THEIR OWN CONCLUSIONS.

  • SO PROVIDING A BASIC UNDERSTANDING OF AMR IS NECESSARY TO MAKE PEOPLE PRIORITIZE THE ISSUE,

  • WHILE ALSO PREVENTING MISCONCEPTIONS ABOUT HOW RESISTANCE OCCURS

  • AND THE NEED FOR A COLLECTIVE RESPONSE.

  • SO WE NEED TO MAKE SURE THAT OUR EXPLANATIONS ARE SUFFICIENTLY CLEAR

  • AND ACCESSIBLE FOR OUR AUDIENCE.

  • WE REALLY DON'T JUST WANT THESE PEOPLE TO BE ALREADY INTERESTED IN SCIENCE HERE.

  • THE RESEARCH SHOWS YOU MIGHT WANT TO DESCRIBE IT LIKE THIS:

  • THE BACTERIA THAT CAUSE ILLNESSES ADAPT AND CHANGE OVER TIME,

  • MEANING THEY CAN DEVELOP THE ABILITY TO DEFEAT THE ANTIBIOTICS DESIGNED TO KILL THEM.

  • OUR OVERUSE OF ANTIBIOTICS IS SPEEDING UP THIS PROCESS.

  • THE RESULT IS THAT ANTIBIOTICS ARE BECOMING LESS EFFECTIVE IN TREATING ILLNESSES.

  • THE VIDEOS YOU WILL SEE TONIGHT

  • AND THE ART AROUND THE ROOM FROM CDC, WELCOME TRUST, AMERICAN SOCIETY FOR MICROBIOLOGY

  • AND THE AMR FIGHTER COALITION, ARE GREAT EXAMPLES

  • OF MAKING IMPORTANT TECHNICAL WORK MORE RELATABLE WITHOUT COMPLETELY LOSING THE SCIENCE.

  • SO TO HELP US SHOW THE HUMAN FACE OF AMR,

  • WE DESPERATELY NEED MORE PATIENTS TO TELL THEIR STORIES.

  • I HAVE INTERVIEWED OUR NEXT SPEAKER BEFORE AND I KNOW FIRSTHAND HIS STORY

  • AND BRAVERY AND DRIVE ARE QUITE REMARKABLE.

  • I'LL SOON BE WELCOMING TO THE STAGE Mr. DAVID RICCI.

  • Mr. DAVID RICCI AND A SURVIVOR OF A INFECTION THAT NEARLY TO GO HIS LIFE.

  • HE TRAVELED TO WASHINGTON, D.C. TO LOBBY FOR STRONGER REGULATIONS TO COMBAT THE PROBLEM.

  • HE NOW WORKS FOR THE INSTITUTE FOR SYSTEMS BIOLOGY

  • AND THE AMR 350 CAMPAIGN TO EDUCATE YOUTH ABOUT AMR.

  • WELCOME TO THE STAGE Mr. RICCI.

  • [ APPLAUSE ]

  • >> DAVID RICCI: HELLO.

  • EXCUSE ME.

  • MY THROAT IS A LITTLE STIFF TONIGHT.

  • SO, MY NAME IS DAVID RICCI.

  • MY UNCLE SAYS THE SAME THING.

  • NO WORRIES ABOUT IT.

  • IN 2011, I WAS WORKING AT AN HIV CLINIC IN CALL CUT, INDIA,

  • ONE OF THE BEST THINGS I EVER DONE IN MY LIFE.

  • I REALLY GOT TO SEE THE HUMAN IMPACT OF WHAT HEALTH IS LIKE FOR THE POOREST PEOPLE

  • IN THE WORLD AND ONE MORNING, I WAS WALKING TO THE ORPHANAGE I WAS WORKING AT

  • AND I WAS HIT BY A TRAIN AND RUN OVER.

  • SO THAT RESULTED IN THE BRUTAL AMPUTATION OF MY RIGHT LEG ABOVE THE KNEE

  • WITHOUT ANESTHETIC I WATCHED AS THEY CHOPPED IT OFF AND IT WAS VERY TRAUMATIC.

  • WOULD YOU LIKE TO SEE IT?

  • THAT'S THE HUMAN ASPECT OF THIS, RIGHT?

  • BECAUSE I'M HERE TO SHOW YOU WHAT HAPPENS WHEN AMR AFFECTS US PERSONALLY.

  • AND I WAS ON AND OFF ANTIBIOTICS FOR SIX MONTHS, WHICH IS THE LAST RESORT ANTIBIOTIC WE HAVE.

  • AND WITHOUT THAT, THERE IS REALLY NOTHING LEFT.

  • AND MICROBES ARE EVOLVING RESISTANCE EVEN TO THIS.

  • THE FIRST DOCUMENTED CASE WAS THE SAME YEAR I WAS HIT IN THE 2011.

  • BEING ON THIS ANTIBIOTIC IS THE WORST THING THAT EVER HAPPENED TO ME,

  • WORST THAN GETTING HIT BY A TRAIN.

  • WHEN YOU'RE ON IT, THEY HAVE TO GIVE IT TO YOU INTERMITTENTLY FOR TWO WEEKS AT A TIME

  • BECAUSE IT IS SO LETHAL AND TOXIC.

  • IT'S FROM THE 50s AND WE SHELVED IT BECAUSE IT WAS KILLING PATIENTS FASTER THAN THE INFECTION.

  • IT WIPES OUT YOUR IMMUNE SYSTEM.

  • IT KILLS YOUR KIDNEYS.

  • AND EVERY SINGLE DAY I WAS THROWING UP AND I LOST OVER 80 POUNDS.

  • IT FEELS LIKE YOUR ORGANS ARE DISINTEGRATING AND RUBBING AGAINST EACH OTHER.

  • I WAS IN CONSTANT PAIN.

  • AFTER I WAS SENT HOME FROM THE HOSPITAL AFTER A MONTH,

  • I CONTINUED USING THIS IV ANTIBIOTICS FOR SIX MONTHS.

  • AND IT IS A PRIVILEGE FOR ME TO BE HERE BECAUSE NOT ONLY BECAUSE OF THE COLOR OF MY SKIN

  • AND THE COUNTRY OF WHERE I'M FROM, BUT MOST PEOPLE WHO SUFFER

  • FROM THIS GO UNDIAGNOSED IN CHINA AND INDIA.

  • THEY ARE LEFT OUT OF THIS ENTIRE DISCUSSION.

  • THEY ARE NOT HERE ON THE STAGE AND MOST OF THEM, AS I SAID, THE HOSPITAL REPORTS THEY DIE

  • OF LIVER INFECTION OR SOMETHING ELSE.

  • AND I THINK THE GREATEST THING WE NEED TO DO IS SAY, HOW IS THIS HAPPENING?

  • WHY IS THIS HAPPENING?

  • IT ISN'T BECAUSE DOCTORS ARE IRRESPONSIBLE WITH ANTIBIOTICS, ALTHOUGH THAT IS PART OF IT.

  • SOME STATISTICS PUT IT AT OVER 30% OF ANTIBIOTICS ARE UNNECESSARILY PRESCRIBED.

  • OTHER COUNTRIES PUT THAT MUCH HIGHER.

  • BUT I THINK MOST IMPORTANTLY, IT'S IN AGRICULTURE.

  • AND THAT'S A HOT TOPIC FOR PEOPLE NOT TO MENTION.

  • OVER 70% OF THE ANTIBIOTICS THAT ARE DEVELOPED GO TO AGRICULTURE.

  • AND THE WAY THAT WE EAT MEAT IN THIS COUNTRY IS DISGUSTING.

  • IT REALLY IS.

  • IT'S UNNATURAL AND HASN'T BEEN DONE FOR 10,000 YEARS BUT JUST IN THIS CENTURY,

  • WE CONGREGATE ANIMALS INTO BILLIONS ABOUT THIS SIZE, THOUSANDS OF ANIMALS, NO SUNLIGHT,

  • AND WE GIVE THEM PROPHYLACTIC ANTIBIOTICS HOPING THAT BECAUSE OF THEIR RETCHED CONDITIONS,

  • LIVING IN THEIR OWN FECAL MATTER, BITING EACH OTHER AND OPEN WOUNDS,

  • AND WE HAVE TO GIVE THEM ANTIBIOTICS JUST TO SURVIVE.

  • AN AVERAGE COW'S LIFESPAN IS 20 YEARS BUT HERE IT IS FOUR.

  • AND THESE ARE MAMMALS JUST LIKE US.

  • THEY HAVE MEMORIES AND PAIN JUST LIKE US.

  • AND MANY COUNTRIES LIKE IN INDIA AND CHILE, THEY USE THE ANTIBIOTIC ON ANIMALS.

  • THAT'S THE LAST RESORT ANTIBIOTIC WE HAVE.

  • AND COLISTIN IS DISGUSTING.

  • IT KILLS YOU FROM THE INSIDE.

  • TO IMAGINE BECAUSE OF THE RETCHED CONDITIONS

  • OF THESE ANIMALS USING THIS ANTIBIOTIC BEFORE THERE IS ANY INFECTION.

  • THAT IS WHAT CAUSES AMR TO EVOLVE.

  • THAT'S WHAT CREATES IT.

  • WE ARE ACTIVELY CREATING IT WHILE WE PROFESS OURSELVES GRANDIOSE SCHEMES

  • FOR COMBATING RESISTANCE.

  • WE PROLIFERATE IT, RIGHT?

  • SO THAT'S HYPOCRISY.

  • ALL OF YOU HAVE MUCH MORE INFLUENCE AND KNOWLEDGE ABOUT THIS THAN I SO I URGE YOU

  • TO PLEASE, RE EVALUATE THE WAY THAT YOU CONSUME YOUR FOOD.

  • AND IF YOU'RE VEGAN, YOU'RE NOT SPARED FROM THIS AS WELL BECAUSE WHERE IS ALL THAT MANURE GOING

  • FROM ALL THESE ANIMALS THAT ARE PUMPED FULL OF ANTIBIOTICS?

  • WE PROPAGATE CROPS TO GROW CORN AND THE REST OF OUR FOOD.

  • ANTIBIOTICS ARE FOUND EVERY NOW.

  • IT'S IN OUR WATER AND EVERYWHERE.

  • AND I DON'T WANT TO SCARE EVERYONE AND JUST TALK

  • ABOUT NEGATIVE THINGS BECAUSE THERE IS A LOT OF HOPE.

  • THAT'S WHY I'M HERE.

  • I'M GRATEFUL.

  • AND THE SUBJECT IS SO INCLUSIVE TO SO MANY ISSUES, THAT'S WHY I DEDICATED THE REST

  • OF MY LIFE TO COMBATING THIS AND SPEEDING AWARENESS.

  • IT'S TRICKY.

  • THERE IS A LOT OF SUBJECTS THAT THE GENERAL PUBLIC CAN WRAP THEIR HEAD

  • AROUND BUT THIS ISN'T ONE OF THEM.

  • AS SOON AS YOU TALK ABOUT ENZYMES AND EVOLUTION AND MUTATIONS, YOU LOSE MOST OF THE PUBLIC.

  • AND FOR ME, I FIND JUST BEING HONEST IS THE BEST WAY TO START, NOT JUST TO GIVE ALL

  • OF THESE HAPPY CONNOTATIONS TO WHAT WE ARE DOING,

  • BUT TO REALLY ADDRESS WHAT IS WRONG WITH WHAT WE HAVE BEEN DOING.

  • AND YOU KNOW, DIVERSIFYING OUR USE OF ANTIBIOTICS AS WELL.

  • THERE HADN'T REALLY BEEN A NEW CLASS OF ANTIBIOTICS SINCE THE 80s.

  • THAT'S BECAUSE THERE IS NOT REALLY AN INCENTIVE.

  • THERE ARE ENORMOUSLY POWERFUL INTERESTS THAT ARE NOT WANTING TO INVEST 3 BILLION DOLLARS

  • INTO AN ANTIBIOTIC BECAUSE BY DEFINITION,

  • YOU'RE ONLY HOPEFULLY GOING TO USE IT ONCE FOR THREE WEEKS

  • AND WHEREAS THERE IS MUCH MORE PROFIT TO BE MADE IN CANCER AND IN CHRONIC ILLNESSES

  • THAT REQUIRE DRUG COMPANIES TO MAKE A REVENUE ON A MONTHLY BASIS OFF OF PATIENTS.

  • AND I'M BLESSED BECAUSE MY PARENTS WERE INSURED WHERE THERE ARE MANY PEOPLE

  • THAT THEY MIGHT NOT HAVE FOUND OUT THEY HAVE AN INFECTION.

  • I DON'T ALSO WANT THIS TO BE A DISCOURAGEMENT FROM PEOPLE TRAVELING THE WORLD.

  • PEOPLE ARE LIKE, YOU WENT TO INDIA.

  • WHAT DO YOU EXPECT?

  • OF COURSE THERE IS LOTS OF INFECTIONS THERE.

  • AND MASSIVE POVERTY.

  • BUT THIS ISN'T SOMETHING TO DISSUADE US FROM TRAVELING.

  • IF ANYTHING IT'S TO SHOW THAT IT HAPPENS HERE TOO.

  • IT HAPPENS ANYWHERE.

  • IT'S HAPPENED IN HOSPITALS HERE.

  • IF WE DON'T STOP THIS, IT WILL GET WORSE AND OUR FUTURES ARE AT RISK.

  • OUR CHILDREN'S FUTURES ARE AT RISK.

  • MY LIFE IS AT RISK BECAUSE OF THIS.

  • THIS ISN'T BECAUSE BACTERIA RANDOMLY MUTATED,

  • IT'S BECAUSE THERE IS A PRESSURE FOR SELECTION AGAINST THIS.

  • AND SO, I CHALLENGE ALL OF YOU TO, IN YOUR DAILY LIVES, BE MORE CONSCIOUS OF WHAT YOU EAT,

  • WHETHER IT IS PLANTS OR MEAT, JUST TO BE AWARE THAT IT'S NOT RAISED WITH ANTIBIOTICS.

  • AND SECRETARY AZAR MENTIONED THAT McDONALD'S HAS COMMITTED FOR THEIR CHICKEN NUGGETS

  • AND OTHER THINGS NOT TO BE USED WITH ANTIBIOTICS BUT THAT'S ONLY IN AMERICA.

  • RIGHT? McDONALD'S SERVES THE REST OF THE WORLD AS WELL AND THAT IS NOT THE CASE

  • IN MOST SOUTH AMERICAN COUNTRIES.

  • AND SO, EDUCATING OUR YOUTH IS REALLY IMPORTANT TO ME AND SO I HAVE BEEN WORKING

  • WITH THE INSTITUTE FOR SYSTEMS BIOLOGY TO EDUCATE PEOPLE BEFORE THEY GET TO THE GRADUATE

  • AND UNDERGRADUATE LEVELS SO THAT WAY HIGH SCHOOLERS AND YOUNGER CAN UNDERSTAND AMR

  • BECAUSE IT'S NOT A COMPLICATED SUBJECT.

  • IT'S THE WAY THAT A LOT OF TIMES PROFESSIONALS HAVE TALKED ABOUT IT, IT COMPLICATES THE ISSUE.

  • SO I ENCOURAGE ALL OF YOU TO READ UP ON THIS AND TO,

  • IF YOU KNOW ABOUT IT, EDUCATE YOUR FAMILY MEMBERS.

  • EVEN IF THEY ARE NOT INTERESTED.

  • TRY AND TAKE A MOMENT OF THEIR TIME BECAUSE ALL OF OUR LIVES ARE IN DANGER.

  • NOT JUST THE WESTERN WORLD THAT HAS TO TAKE PRECAUTIONS, IT'S ALL OF US.

  • JUST LIKE CLIMATE CHANGE.

  • THOSE THAT ARE WELL OFF WON'T SEE THE EFFECT IMMEDIATELY.

  • SO, BUT IT WILL HAPPEN.

  • IT WILL HAPPEN HERE TOO, IN ALL OF OUR HOSPITALS.

  • JIM O'NEIL, THE U.K. BRITISH COLUMNIST MENTIONED THAT POTENTIALLY BY 2050

  • OVER 10 MILLION PEOPLE A YEAR WILL DIE FROM AMR.

  • THAT'S MORE THAN CANCER AND THE COST WILL BE OVER 100 TRILLION DOLLARS.

  • SO THAT SHOULD BE AN ECONOMIC INCENTIVE ENOUGH FOR US TO MAKE A CHANGE.

  • SOME PEOPLE DISPUTED THAT FIGURE.

  • I WOULD SAY PROBABLY LIKELY A LOT HIGHER BECAUSE THE STATISTICS AREN'T THERE.

  • I MET WITH THE DEPUTY COMMISSIONER OF THE FDA

  • AND THEIR BIGGEST THING IS THEY DON'T HAVE ENOUGH DATA TO MAKE IMPLEMENTATION AND CHANGES.

  • THE FDA ASKS PERMISSION FOR THESE FACTORY FARMS BEFORE THEY CAN GO IN MONTHS IN ADVANCE.

  • SO THEY CHANGE THE PROCEDURES AND CHANGE THE QUALITY OF THEIR PROPHYLACTIC ANTIBIOTIC USE.

  • A LOT OF TIMES VETERINARIANS DON'T NEED PRESCRIPTIONS

  • TO GIVE THE ANIMALS MASS ANTIBIOTICS.

  • SO THAT'S WHY I'M MOST PASSIONATE ABOUT IT AND SO THANK YOU FOR YOUR TIME.

  • [ APPLAUSE ]

  • [Music]

  • [VIDEO] I HAD NEVER HEARD OF A YOUNG, HEALTHY PERSON GETTING C. DIFF.

  • I'VE BEEN A NURSE FOR 20 YEARS - I HAVE HEARD OF THAT.

  • SHE JUST GOT SICK SO FAST AND SHE WAS GONE.

  • I DID NOT KNOW I HAD XDR TB FOR THE FIRST SIX MONTHS.

  • I WAS POPPING OVER 20 PILLS A DAY FOR OVER TWO AND HALF YEARS, SIX MONTHS OF DAILY INJECTIONS.

  • I CAN'T EVEN COUNT WHAT HAPPENED TO ME.

  • THERE WAS JAUNDICE; I LOST MY EYESIGHT FOR A WHILE.

  • [Music]

  • I HAD JUST TURNED 26; AND THIS HAPPENED TWO WEEKS AFTER MY WEDDING AS WELL.

  • IT WAS INFECTIONS AFTER INFECTION, AFTER INFECTION.

  • I WAS DIAGNOSED WITH MRSA.

  • [Music]

  • WE ARE COLLECTIVELY, I THINK, FAILING THIS WORLD, IN TERMS OF RESISTANCE

  • TO ANTIBIOTICS AND IN TERMS OF DRUG RESISTANCE.

  • WE NEED TO GET INTO OUR COMMUNITIES.

  • WE NEED TO GO TO THE GRASSROOTS AND TALK TO THE COMMUNITY AND TELL THEM, LET THEM KNOW.

  • [Music]

  • WE HAVE TO MOVE PEOPLE INTO PREVENTING INFECTIONS, DIAGNOSING BETTER

  • AND ACTUALLY LOOKING AFTER OUR ANTIBIOTICS.

  • AND TO DO THAT, WE NEED A FACE.

  • [Music]

  • MY NAME IS B FLOW - SUPER-FANTASTIC-BIBBITY-BIBBITY-BIBBITY-B FLOW!

  • I AM A MUSIC ARTIST AND I USE MUSIC TO ADVOCATE FOR POSITIVE SOCIAL CHANGE.

  • SO I HAVE DECIDED TO TAKE ACTION AND TO SING ABOUT RESISTANCE,

  • BECAUSE IT HAS MADE MY FAMILY SMALLER THAN IT USED TO BE.

  • AND I DON'T WANT TO LOSE ANY MORE PEOPLE IN MY FAMILY, IN MY NEIGHBORHOOD, IN MY COUNTRY,

  • IN MY CONTINENT, OR ANYWHERE IN THE WORLD.

  • YEAH, MAN.

  • AND THAT'S EXACTLY WHAT WE DO.

  • [ APPLAUSE ]

  • >> MADLEN DAVIES: SO I JUST LIKE TO SHARE

  • WITH YOU THE THIRD RECOMMENDATION FOR EFFECTIVE AMR COMMUNICATION.

  • AS WE SAW WITH Mr. DAVID RICCI'S SPEECH, MAKE IT HUMAN AND MAKE IT RELEVANT.

  • THE WELCOME TRUST RESEARCH SHOWED FOR COMMUNICATIONS TO BE EFFECTIVE,

  • WE NEED TO SHOW THE HUMAN IMPACT OF AMR, EXPLAINING HOW PEOPLE ARE AFFECTED RATHER

  • THAN RELYING ON NUMBERS AND STATISTICS.

  • WE SHOULD LINK TO DISEASES AND PROCEDURES THAT WILL RESONATE WITH OUR AUDIENCE.

  • FOR EXAMPLE, THE RESEARCH SHOWED IN INDIA THIS MIGHT BE ABOUT HOW AMR WILL AFFECT TB.

  • IN KENYA, IT WAS UNDERSTOOD THROUGH THE IMPACT ON MALARIA ERADICATION.

  • AND IN THE U.K., PEOPLE RESPONDED BEST TO HOW IT COULD IMPACT CANCER TREATMENT.

  • TO STRENGTHEN OUR COMMUNICATION EVEN FURTHER,

  • WE SHOULD EXPLAIN HOW AMR COULD DIRECTLY AFFECT EVERYONE BUT THIS IS ENHANCED

  • IF WE COMBINE THE IDEA OF EVERYONE WITH A PERSONAL ANGLE.

  • AMR WILL AFFECT YOU, WE NEED TO SAY, YOU, YOUR FRIENDS, YOUR FAMILY.

  • THIS HAS THE POTENTIAL TO TRANSFORM PERCEPTIONS OF AMR FROM AN ISSUE THAT IS IMPORTANT

  • BUT FAR AWAY TO ONE THAT REQUIRES YOU TO MAKE IT A PRIORITY.

  • THE WORLD HEALTH ORGANIZATION HAS REALLY LED THE WAY ON RAISING THE PROFILE OF AMR.

  • MAKING THIS THE FIRST PILLAR OF EACH COUNTRY'S GLOBAL ACTION PLAN

  • AND HOSTING A WORLD ANTIBIOTIC AWARENESS WEEK EVERY YEAR.

  • WE HAVE A WORLD HEALTH ORGANIZATION SPEAKER NEXT WHO CAN TELL US MORE.

  • I'LL SOON BE WELCOMING TO THE STAGE DR. POONAM KHETRAPAL SINGH.

  • WORLD HEALTH ORGANIZATION REGIONAL DIRECTOR FOR SOUTHEAST ASIA.

  • DR. POONAM KHETRAPAL SINGH BECAME THE REGIONAL DIRECTOR IN 2014

  • AND SHE WAS THE FIRST EVER WOMAN TO HOLD THAT ROLE.

  • PREVIOUSLY, SHE WAS THE HEALTH SECRETARY FOR THE STATE OF PUN JAB, A POPULATION OF 27 MILLION.

  • SHE ALSO WORKED IN HEALTH CARE FOCUSED ROLES FOR THE WORLD'S BANK

  • AND INTERNATIONAL HEALTH ADVISOR TO THE INDIAN GOVERNMENT.

  • DURING HER TIME AT WORLD HEALTH ORGANIZATION, SHE HAS BEEN COMMITTED

  • TO COMBATING THE RESISTANCE SO THE PROGRESS MADE

  • ON PREVALENT DISEASES LIKE TB, IS NOT UNDERMINED.

  • WELCOME DR. POONAM KHETRAPAL SINGH.

  • [ APPLAUSE ]

  • >> POONAM KHETRAPAL SINGH: AS WE GATHERED HERE IN NEW YORK THIS TIME TO TALK

  • ABOUT UNIVERSAL HEALTH COVERAGE, AND I COME FROM A MEETING WHERE WE WERE DISCUSSING THAT,

  • I WONDERED REALLY WHY AMR WAS NOT ON THE AGENDA THERE?

  • BECAUSE IN VARIOUS PANELS THAT I HAVE BEEN IN, I HAVE NOT SEEN AMR BEING DISCUSSED.

  • SO I FIND THE ORGANIZERS OF THIS EVENT

  • FOR HAVING PROVIDED THIS PLATFORM FOR THE DISCUSSION ON AMR.

  • AS FAR AS AMR IS CONCERNED IN THE SOUTHEAST ASIA REGION OF W.H.O.,

  • WE HAVE BEEN GIVING IT A PRIORITY SINCE 2011,

  • FAR BACK BEFORE THE WORLD STARTED TALKING ABOUT IT.

  • MINISTERS OF OUR REGION MET IN INDIA TO DELIBERATE ON AMR

  • AND THERE WAS A MINISTERIAL DECLARATION.

  • THAT BECAME THE BASIS OF BIRTH ON AMR IN OUR REGION.

  • AFTER THAT, WE HAD A FOLLOW UP ACTION ON THE MINISTERIAL DECLARATION.

  • VERY OFTEN WE ARE CRITICIZED AND WE ARE TOLD THAT WE ARE EASY WITH DECLARATIONS,

  • WE ADOPT SOLUTIONS IN THE WORLD ASSEMBLY BUT THERE IS NO FOLLOW UP, REALLY.

  • DO WE REALLY SEE THERE IS PROGRESS ON WHAT WE HAVE DECIDED?

  • THERE IS ACTION TAKEN ON WHAT HAS REALLY BEEN ADOPTED

  • BY THE MEMBER STATES OF THE WORLD HEALTH ASSEMBLY?

  • IN 2014 WE AGAIN HAD A MEETING IN INDIA TO SEE WHERE WE WERE WITH AMR.

  • IN 2015, THE WORLD HEALTH ASSEMBLY ADOPTED A GLOBAL ACTION PLAN ON AMR AND MEMBER STATES

  • OF THE SOUTHEAST ASIA REGION WERE IN THE FOREFRONT TO HAVE NATIONAL ACTION PLANS ON AMR

  • AND NOT ONLY THAT, WE ARE REVIEWING THAT CONTINUOUSLY TO SEE WHAT IS THE PROGRESS ON AMR?

  • WE DO FIND THAT YES, THE ANIMAL SECTOR, THE AGRICULTURE SECTOR AND THE HUMAN SECTOR,

  • HAVE COME TOGETHER, BUT OF COURSE NOT THE WAY WE WOULD HAVE LIKED TO.

  • WE DO HAVE THE ONE HEALTH APPROACH.

  • MEMBER COUNTRIES OF OUR REGION ARE LOOKING AT IT.

  • WE IN THE SOUTHEAST ASIA REGION ARE ADVOCATING FOR IT.

  • CONSTANTLY MONITORING IT TO SEE WHERE THE DAMAGE IS THE MOST.

  • AS HAS BEEN SAID BY MANY SPEAKERS BEFORE ME, IT'S THE ANIMAL SECTOR,

  • THE ECOSYSTEM THAT WE REALLY NEED TO BE LOOKING AT.

  • A FEW DAYS AGO, A PATIENT WAS DETECTED IN INDIA WITH BACTERIA

  • WHICH WE ONLY FIND IN THE ICUs OF HOSPITALS.

  • AND THAT GOT US THINKING THAT HOW WAS IT THAT THIS ANTIBIOTIC WOULD BE FOUND IN A PATIENT,

  • IN A CITIZEN WHO NEVER REALLY BEEN TO A HOSPITAL?

  • WE DISCOVERED THAT THAT WAS BECAUSE OF WASTE DISPOSAL HAPPENING IN THE HOSPITALS.

  • WASTE DISPOSAL REALLY HASN'T BEEN ADDRESSED THE WAY IT OUGHT TO BE ADDRESSED.

  • SO TODAY LADIES AND GENTLEMEN, THE THREAT FOR AMR IS FAR MORE THAN WE WOULD LIKE TO BELIEVE.

  • TODAY, WHAT WAS IN THE ICUs OR HOSPITALS IS OUT IN THE OPEN

  • AND WE ARE HAVING VEGETABLES GROWN IN THAT SOIL.

  • WE ARE HAVING FRUITS GROWN IN THAT SOIL.

  • AND THAT IS HOW THE DANGER FROM AMR IS GETTING REALLY SPREAD ALL OVER.

  • WE'VE TRIED TO SEE HOW TO SUPPORT,

  • HOW W.H.O. COULD SUPPORT MEMBER STATES IN TRYING TO DEAL WITH THIS.

  • WE TRIED TO EXPAND OUR LABORATORY NETWORKS.

  • WE TRIED TO PASS THE MEMBER STATES TO BE ABLE TO DETECT AMR AND BE ABLE

  • TO SEE HOW THEY COULD CONTRIBUTE TO THE CONTROL OF THE AMR.

  • NOW WE DO REALIZE THAT THERE ARE MANY COUNTRIES OF OUR REGION

  • WHERE THEY HAVE DRUGS CAN BE OBTAINED OVER THE COUNTER.

  • AND THESE ARE NOT REALLY AGAINST A PRESCRIPTION.

  • SO THE DANGERS THAT ARE PLACED BY THE DEVELOPING WORLD ARE FAR MORE THAN WE FACE HERE

  • BECAUSE THERE, EVEN THOUGH THEY MAY BE LAWS THAT DO PRESCRIBE AND NOW IT IS HAPPENING

  • IN SEVERAL COUNTRIES IN MY REGION WHERE THEY ARE TALKING ABOUT PRESCRIPTION DRUGS

  • AND THERE IS NO REAL ENFORCEMENT OR REGULATION AND EVEN TODAY,

  • WE CAN GO AND GET THESE DRUGS ACROSS THE COUNTER.

  • I ALSO FEEL THAT THERE IS IT A LACK OF AWARENESS AMONG THOSE WHO PRESCRIBE DRUGS.

  • THEY DO PRESCRIBE DRUGS WITHOUT UNDERSTANDING THAT IT IS GOING

  • TO BUILD RESISTANCE IN A PATIENT.

  • WE FIND THAT YES, ANTIBIOTICS WHICH SHOULD BE TAKEN 5 7 DAYS ACTUALLY ARE TAKEN FOR 3 DAYS,

  • EVEN TODAY, AND THE DOCTORS ALSO NEED TO BE MADE AWARE OF THIS

  • WHEN THEY ARE PRESCRIBING THESE ANTIBIOTICS.

  • SO THE PROBLEM IS FAR MORE THAN WE WOULD LIKE TO BELIEVE.

  • IT IS SOMETHING THAT WE ARE AWARE OF, WHICH WE ARE TRYING TO DEAL WITH.

  • WE EVEN IN HOSPITALS, THE BEST OF HOSPITALS TODAY, I FIND THAT IT'S VERY CUSTOMARY

  • TO GIVE DRUGS WHICH REALLY SHOULD NOT BE GIVEN.

  • THE SPEAKER BEFORE ME WAS REFERRING TO COLISTIN AND I SEE THAT BEING PRESCRIBED IN SOME

  • OF THE BEST HOSPITALS IN OUR COUNTRY WHEN THEY SHOULD NOT REALLY BE GIVEN AT THAT STAGE.

  • AND THAT IS HOW WE ARE COMPOUNDING THE PROBLEM AND BUILDING THIS MORE AND MORE.

  • WE THEREFORE NEED TO DO A LOT OF THINGS TO BE ABLE TO HANDLE AMR.

  • WE NEED TO BUILD AWARENESS, NOT ONLY AMONG THE POPULATIONS, SO THAT THEY UNDERSTAND

  • THAT IF SOMETHING HAS WORKED FOR THEM, THEN THEY AT ONE STAGE OF TIME, IT'S NOT NECESSARY

  • THAT THEY SHOULD TAKE THE SAME ANTIBIOTIC WHEN THEY HAVE A PROBLEM THAT THEY HAD BEFORE.

  • AND I FIND THIS A VERY COMMON FEATURE.

  • WE ALSO NEED TO EDUCATE THOSE WHO HAVE TO PRESCRIBE DRUGS.

  • THEY HAVE TO BE VERY CAREFUL ABOUT WHAT THEY PRESCRIBE.

  • THEY HAVE TO BE VERY CAREFUL ABOUT THE LENGTH OF WHICH THEY PRESCRIBE THEM

  • BECAUSE THAT ALSO BECOMES A VERY MAJOR ISSUE.

  • WHEN THEY PRESCRIBE SOMETHING, PATIENTS FEEL THEY CAN TAKE THEM

  • FOR JUST THREE DAYS AND THAT'S ENOUGH.

  • THAT'S A VERY COMMON FEELING, NOT ONLY AMONG THE CITIES OR THE RURAL AREAS BUT ALL OVER.

  • AND WE ALSO NEED TO SEE THAT GOVERNMENTS GET INTO ACTION, THAT GOVERNMENTS SEE.

  • THEY BRING IN REGULATORY FORCES AND THAT THERE IS ENOUGH REGULATION TO SEE THAT THERE IS NOT

  • OVER THE COUNTER SALE OF DRUGS WITHOUT PRESCRIPTION,

  • THAT THERE IS SUFFICIENT AWARENESS AMONG THOSE WHO NEED TO BE AWARE OF AMR DEVELOPING

  • IF THEY TRADE DRUGS THAT ARE NOT NEEDED.

  • AND I DO BELIEVE THAT THE WORLD HEALTH ORGANIZATION IS TRYING

  • TO DO ITS VERY BEST FOR IT.

  • WE HAVE STARTED A LOT OF INITIATIVES WHERE WE THINK WE WOULD BE ABLE

  • TO HELP THE GOVERNMENTS IN HANDLING AMR.

  • THE ONE HEALTH APPROACH IS A SAMPLE WHERE THE ORGANIZATIONS, THE FAO AND THE W.H.O.,

  • HAVE COME TOGETHER TO BE ABLE TO ADVOCATE AGAINST AMR; YET A LOT REMAINS TO BE DONE.

  • AND AS WE CONTINUE TO HELP GOVERNMENTS AND AS WE HELP TO OR START HELPING THE COUNTRIES,

  • THE PEOPLE OF OUR COUNTRIES, WE STILL FIND THAT THERE ARE HUGE GAPS WHICH WE NEED

  • TO FILL BEFORE THE WORLD CAN BE SAFE AND BEFORE WE REALLY CAN SAY

  • THAT THE PROBLEM OF AMR IS HANDLED.

  • WE HAVE A LONG WAY TO GO.

  • AND THERE ARE ALL THE STAKEHOLDERS AND PARTNERS SHOULD BE PLAYING A VERY MAJOR ROLE

  • AND ARE DOING THAT, YET THE PROBLEM IS SO CHALLENGING THAT A LOT

  • OF EFFORT TO BE ABLE TO HANDLE THAT.

  • MY REQUEST REALLY, AND WHAT I REALLY URGE THOSE PRESENT HERE IS TO SEE

  • THAT AMR SHOULDN'T BE JUST IN THE PREAMBLE OF THE STGs.

  • TO THE SHOULD REALLY HAVE A PLACE IN THE STGs.

  • IT SHOULD FIGURE THERE.

  • BECAUSE THE PROBLEM IS SO ACUTE THAT UNLESS IT'S GIVEN THAT KIND OF VISIBILITY

  • AND UNLESS IT'S YEAR AFTER YEAR WHEN WE NEED TO SEE, WE WILL NOT BE ABLE TO HANDLE IT.

  • ONE OF THE MAIN WHEN WE ARE TALKING ABOUT LEAVING NO ONE BEHIND AND TALKING

  • OF REACHING ALL, WHAT IS IT THAT WE ARE REALLY TALKING ABOUT?

  • WE ARE TALKING ABOUT ACCESS TO MEDICINES.

  • WE ARE TALKING ABOUT REACHING ONE AND ALL WHEN THEY NEED HEALTH CARE

  • AND WHEN THEY NEED ASSISTANCE, THEY WILL LEAD TO A BIGGER PROBLEM.

  • THAT IS WHERE WE NEED TO BE CAUTIOUS.

  • WHEN ALEXANDER FLEMMING DISCOVERED PENICILLIN, THE WORLD WENT CRAZY.

  • WE ALL THOUGHT IT WAS A GREAT DISCOVERY.

  • JUST SEE HOW LONG IT HAS BEEN TO DISCUSS RESISTANCE FROM THOSE ANTIBIOTICS.

  • AND WE ARE GETTING TOGETHER AND THINKING, WHAT WAS CONSIDERED TO BE A BULL NOT VERY LONG AGO,

  • IS CONSIDERED TO BE A MAJOR THREAT TODAY.

  • AND THAT, LADIES AND GENTLEMEN, IS IMPORTANT FOR US.

  • FOR US TO GIVE MORE THOUGHT AND FOR US TO THINK,

  • WHAT ARE THE WAYS IN WHICH WE CAN DEAL WITH THIS PROBLEM?

  • THANK YOU.

  • [ APPLAUSE ]

  • [Music]

  • [VIDEO] ALL ALONG FROM THE VERY BEGINNING OF THE ANTIBIOTIC ERA THERE'S BEEN THIS PARALLEL STORY

  • OF MISUSING ANTIBIOTICS IN AGRICULTURE.

  • OF GIVING ANTIBIOTICS TO ANIMALS THAT ARE NOT SICK THAT DO NOT NEED THEM.

  • ANTIMICROBIAL RESISTANCE IS A GLOBAL CRISIS.

  • THE PROBLEM OF ANTIMICROBIAL RESISTANCE HAS REACHED ALARMING LEVELS.

  • THE EXTENSIVELY DRUG-RESISTANT TUBERCULOSIS HAS BEEN IDENTIFIED

  • IN 105 COUNTRIES.THIS IS ARMAGEDDON; THIS IS THE END OF OUR CURRENT REGIME OF ANTIBIOTICS.

  • IF WE DON'T DO SOMETHING ABOUT ANTIMICROBIAL RESISTANCE IN ANOTHER 35 YEARS,

  • THERE COULD BE 10 MILLION PEOPLE A YEAR DYING.

  • THE POLICY MAKERS ONLY MOVE WHEN THE TSUNAMI IS THERE.

  • I DO WORRY ABOUT THAT.

  • I LOSE SLEEP ABOUT IT.

  • IT'S IMPORTANT TO NOT WALK AWAY FROM THE BATTLEFIELD.

  • IF WE TRULY LOST ALL OUR ANTIBIOTICS, IT WOULD BE A BOMB BLOWING

  • UP OUR HEALTHCARE SYSTEMS AROUND THE WORLD.

  • [Music]

  • [ APPLAUSE ]

  • >> MADLEN DAVIES: SO AS I HAVE MENTIONED PREVIOUSLY,

  • THE FULL FINDINGS FROM THE AMR COMMUNICATIONS RESEARCH BITE THE WELCOME TRUST,

  • WILL BE PUBLISHED IN OCTOBER AND IT WILL BE SENT TO YOUR INBOXES.

  • BUT IN THE MEANTIME, I REALLY HOPE YOU TAKE THREE TOP TIPS AWAY WITH YOU TODAY AND START

  • TO ADOPT THEM DURING YOUR COMMUNICATIONS ABOUT SUPERBUGS.

  • ONE, MAKE IT SERIOUS BUT SOLVABLE.

  • TWO, USE SIMPLE, SCIENTIFIC EXPLANATIONS.

  • THREE, MAKE IT HUMAN AND MAKE IT RELEVANT.

  • THE CDC'S AMR CHALLENGE SHOWS US WHAT IS POSSIBLE WHEN WE ALL STEP UP,

  • WHEN WE ALL PARTNER, WHEN WE ALL COMMIT

  • TO TAKING MEANINGFUL ACTION AGAINST ANTIBIOTICS RESISTANCE.

  • WHILE WE CELEBRATE THE END OF A SUCCESSFUL YEAR AND THERE IS A LOT

  • TO CELEBRATE, THE WORK IS NOT DONE.

  • MOST OF YOU IN NEW YORK HERE TO TALK ABOUT UNIVERSAL HEALTH COVERAGE.

  • THE RISE OF EVERY PERSON TO HEALTH CARE WITHOUT FACING FINANCIAL HARDSHIP.

  • THE AMR IS A SHINING EXAMPLE OF HEALTH INEQUALITY.

  • MILLIONS OF PEOPLE EVERY YEAR DIE OF TREATABLE INFECTIONS BECAUSE THEY HAVE NO ACCESS

  • TO THE ANTIBIOTICS THEY NEED OR THEY CAN'T AFFORD THEM.

  • MEANWHILE, OVERUSE OF THE DRUGS HAS FUELED RISING RESISTANCE RATES.

  • SO COUNTRIES NOW FACE A TWO HEADED MONSTER.

  • LACK OF ACCESS TO ANTIBIOTICS AND ANTIBIOTIC RESISTANCE.

  • AMR CREATES A VICIOUS CYCLE BECAUSE AS RESISTANCE RISES, IT LIMITS THE POOL

  • OF EFFECTIVE ANTIBIOTICS AVAILABLE.

  • BY THE TIME WE IMPROVE UNIVERSAL HEALTH COVERAGE, BY THE TIME WE IMPROVE ACCESS

  • TO ANTIBIOTICS FOR THE POOR, THEY MAY NO LONGER WORK.

  • A NEW DRUG IS LIKELY TO BE EXPENSIVE AND OUT OF REACH FOR THE GLOBAL SOUTH UNLESS WE COME

  • UP WITH BETTER WAYS OF FINANCING DRUG DEVELOPMENT.

  • SO I HOPE IN ANY FURTHER MEETINGS YOU HAVE THIS WEEK AND BACK AT HOME, YOU WILL INCLUDE AMR

  • IN YOUR DISCUSSIONS ABOUT UNIVERSAL HEALTH COVERAGE.

  • AND I HOPE TONIGHT WILL INSPIRE YOU TO MAKE A PLEDGE OR CONTINUE

  • WITH A PLEDGE, AND TO CONTINUE FIGHTING.

  • I THINK YOU CAN SEE WHAT WE DO IN THIS ROOM MATTERS AND WE CAN MAKE A DIFFERENCE.

  • SO IT'S WITH GREAT PLEASURE NOW THAT I'M GOING TO INTRODUCE A FELLOW BRITT TO THE STAGE.

  • DAME SALLY DAVIS HAS BEEN ENGLAND'S CHIEF MEDICAL OFFICER FOR NINE YEARS.

  • DURING THAT TIME, SHE HAS BEEN A PASSIONATE AND OUTSPOKEN CAMPAIGNER ON AMR

  • AND MASSIVELY RAISED ITS PROFILE INTERNATIONALLY RESULTING IN A U.N. RESOLUTION

  • IN 2016 WHICH WAS A HUGE ACCOMPLISHMENT.

  • SHE SUBSEQUENTLY BECAME CO CONVENER OF THE UNITED NATIONS INTERAGENCY GROUP ON AMR

  • AND HELPED TO ESTABLISH THE 265 MILLION FLEMMING FUND TO DEVELOP THE LABORATORIES

  • AND SURVEILLANCE FOR AMR ACROSS THE WORLD.

  • THOUGH SHE IS STEPPING DOWN AS ENGLAND CHIEF'S MEDICAL OFFICER AND WILL START HER NEW ROLE

  • AS MASTER OF TRINITY COLLEGE CAMBRIDGE, I KNOW SHE WILL CARRY ON CAMPAIGNING

  • AS U.N. SPECIAL ENVOY ON SUPERBUGS AND I HOPE SHE IS JUST AS OUTSPOKEN.

  • WELCOME TO THE STAGE, DAME SALLY.

  • [Applause]

  • >> DAME SALLY: THANK YOU VERY MUCH, MADLEN.

  • THE STORIES AROUND THE WORLD MADE AMR REAL.

  • DAVID, YOU BROUGHT THE STORY ALIVE IN A WAY THAT ONLY A PERSON WHO SUFFERED HAS.

  • I CAME TO THIS ACTUALLY THROUGH MY MEDICINE AS A DOCTOR, A HEMATOLOGIST, LOOKING AFTER PATIENTS.

  • SICKLE CELL DISEASE CHILDREN, GETTING INFECTION THAT IS WE COULDN'T TREAT.

  • AND I HAVE SEEN PEOPLE SUFFER.

  • I HAVE SEEN PEOPLE DIE.

  • I DON'T LIKE IT.

  • STILL, LET'S TALK ABOUT THE GOOD BIT.

  • WE HAVE MADE LOTS OF PROGRESS AND I THINK THIS EVENING A CELEBRATION OF PROGRESS.

  • I ALSO HAVE A PERSONAL CELEBRATION.

  • WHEN I TALK ABOUT PETS IN ENGLAND, THEY TELL ME TO TALK ABOUT COMPANION ANIMALS.

  • IT WAS LOVELY TO HEAR YOU IN AMERICA TALK ABOUT PETS!

  • THAT, FOR ME, WAS ANOTHER HIGH POINT THIS EVENING.

  • THE FILM THAT YOU JUST SEEN A CLIP FROM, AND I HOPE YOU WILL STAY AND WATCH WITH US,

  • IS THE ANTIMICROBIAL RESISTANCE FIGHTERS FILM.

  • I WAS TALKING WITH GARY FROM THE ANTIMICROBIAL RESISTANT FIGHTERS COALITION

  • WHO DO THIS WONDERFUL PROGRAM YOU SAW SOME OF HIS PICTURES

  • AND SPEAKING ABOUT IT ALL AROUND THE WORLD.

  • IT IS FANTASTIC PROGRAM.

  • I SAID YOU KNOW WHAT?

  • WE NEED TO GET THIS FILM SEEN BY PEOPLE BECAUSE I KNOW A LOT ABOUT THIS SUBJECT.

  • I LEARN THINGS AND ACTUALLY IT REALLY GOT ME.

  • I FELT RENEWED IN MY DETERMINATION TO GO ON WORKING TO MAKE A CHANGE, MAKE IT BETTER.

  • SO HERE WE ARE, AND I WANT YOU TO WATCH IT.

  • BUT LET'S JUST FOR A MOMENT THINK ABOUT THE OTHER ART WORK THAT IS HERE.

  • AND WANDERING AROUND EARLIER I WAS IMPRESSED.

  • I LIKE THE 50 SHADES OF AMR OVER HERE, BECAUSE I THINK WE HAVE SPENT A LOT OF TIME TRYING

  • TO EXPLAIN NOT ONLY TO THE PUBLIC BUT TO DOCTORS, THAT FONDLY ENOUGH,

  • BUGS CAN GET THEIR RESISTANT GENES OVER TO ANOTHER ONE.

  • AND I HAVE DESCRIBED IT IN ALL SORT OF WAYS.

  • EVEN DESCRIBED IT AS PUTTING OUT A PRICK AND PASSING IT ALONG.

  • BUT THAT PICTURE SHOWS IT BEAUTIFULLY.

  • THERE ARE OTHER WONDERFUL ONES AND YOU HAVE ALL BEEN WANDERING AROUND THINKING ABOUT WHICH YOU

  • LIKE MOST, THE SURGEON'S COMIC SET AGAINST AN ANTIBIOTIC APOCALYPSE, OR THE AMR DANCE?

  • ALL OF THESE THINGS WHERE PEOPLE ARE BRINGING THE ISSUES TO LIFE AND IN DOING SO,

  • BRINGING OTHERS INTO THIS FIGHT FOR LIFE, FIGHT FOR WHAT WE NEED TO DO.

  • SO, WHAT WE REALLY WANT YOU TO DO IS SIGN

  • UP TO THE ANTIMICROBIAL RESISTANT FIGHTERS COALITION, AND WATCH THE FILM.

  • AND THEN OF COURSE, WE HAVE GOT TO THINK ABOUT WHAT WE ARE GOING TO DO IN THE NEXT YEAR.

  • WE HAVE GOT TO RENEW OUR PLEDGES.

  • WHEN I CAME LAST YEAR -- AND THANK YOU CDC, HEALTH AND HUMAN SERVICES AND THE REST OF YOU,

  • THE WELCOME TRUST WHO PUT THIS EVENT ON.

  • I PROMISED TO MYSELF I'M NOT VERY GOOD AT WRITING THESE THINGS

  • DOWN THAT I WOULD GO ON WITH RENEWED ENERGY.

  • I CAN SEE I'M GOING TO GO AWAY AGAIN AND REFLECT EVEN MORE STRONGLY

  • ON HOW I CAN USE MY NEW SPECIAL ENVOY ROLE TO HELP THIS FIGHT

  • AGAINST BUGS THAT DO SEEM TO WANT TO WIN.

  • AND REMEMBERING THAT ACTUALLY BUGS ARE OUR BEST FRIENDS AS WELL.

  • A WONDERFUL MICRO BIOLOGIST IN THE AUDIENCE, EXPLAINS IT MUCH BETTER THAN ME.

  • HOW MORE THAN HALF OF OUR CELLS ON OUR BODIES ARE MICROBES AND THEY ARE THERE

  • TO HELP US, TO GO ON LIFE'S JOURNEY WITH US.

  • WE NEED TO FIND A BALANCE TO CONTINUE ON THAT JOURNEY WITH OUR FRIENDS, AS I CALL MINE,

  • AND YET REDUCE THE RESISTANCE AND ILLNESSES AND SUFFERING THAT COMES WITH IT.

  • SO, I FELT INSPIRED BY ALL OF THAT I HAVE SEEN AND ALL I HAVE HEARD.

  • YOU MUST BE AWFULLY BORING IF YOU HAVEN'T BEEN INSPIRED AS WELL.

  • I THINK YOU PROBABLY HAVE.

  • AND I HOPE YOU'RE GOING TO STAY AND WATCH THE FILM, BECAUSE I THOUGHT IT WAS GRIPPING

  • WHEN I WENT AND SAW THE FULL FILM IN COPENHAGEN AND THEY SHORTENED IT ESPECIALLY FOR US.

  • WHAT I NEED TO ASK IS, ARE WE MOVING STRAIGHT ON TO THE FILM

  • OR ARE WE LETTING PEOPLE HAVE A COMFORT BREAK?

  • COMFORT BREAK.

  • A COMFORT BREAK MEANS YOU CAN LOOK AT THIS OR HAVE A PEE.

  • IT DOES NOT MEAN YOU CAN WALK OUT OF THE DOOR.

  • IF YOU DO WALK OUT OF THE DOOR, YOU'RE MISSING A GREAT FILM THAT YOU'LL WANT TO TALK ABOUT.

  • SO SEE YOU IN 10 MINUTES TO WATCH THE FILM.

  • THANK YOU, VERY MUCH.

  • [ APPLAUSE ]

THE AMR CHALLENGE SEPTEMBER 23, 2019 7:00 8:30 P.M.

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