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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.