BACKGROUND :

Antimicrobial resistance (AMR), one of the greatest health threats of the 21st century,1 causes approximately 700,000 deaths globally per year and failing to tackle AMR will cause 10 million deaths a year and cost up to US$ 100 trillion by 2050. The highest impact will be found in Asia and Africa, accounting for 4.7 and 4.2 million deaths, respectively.2 Ineffectiveness of infection prevention and control as well as failure in curbing and optimizing antimicrobial use in human and non-human sectors are key drivers for the emergence and spread of AMR. Unfortunately, evidence indicates that antibiotic consumption is on the rise worldwide, with a 36% increase between 2000 and 2010. Cephalosporins and broad-spectrum penicillins are the most frequently used antibiotics, representing 55% of the worldwide consumption. Alarming evidence is the increase use of carbapenems and polymixins by 45% and 13%, respectively as they are two last-resort classes of antibiotics to combat highly resistant bacteria.3,4 An equally important area is the antibiotic use in companion animals, agriculture and aquaculture as well as the control of meat production-supply chains that could induce the emergence and spread of resistant bacteria among animals, farm workers, meat products, environment and consumers. A recent study estimates that global consumption of antimicrobials used in agriculture will increase by 67% (from 63,000 to 106,000 tons) between 2010 and 2030.5 While antimicrobial use is on the rise and AMR is increasing, the pipeline of antimicrobials is running dry. This situation is eventually leading to the post-antibiotic era and the apocalypse of modern medicine – a situation in which modern medical procedures such as organ replacement and transplantation as well as chemotherapy that rely on the effectiveness of antibiotics collapse and operations cannot be performed because of the risk of untreatable infection.6 In address this issue, the World Health Assembly resolution on the Global Action Plan on AMR (GAP-AMR) urges member states to develop the national action plan on AMR by May 2017. Aligned itself to GAP-AMR, Thailand’s National Strategic Plan on Antimicrobial Resistance (2017-2021) (NSP-AMR) was endorsed by the cabinet on August 2016. It is the first Thailand’s strategy which addresses AMR specifically. In order to implement the NSP-AMR effectively, the Prime Minister issued an order No. 86/2560 dated 10 March 2017 appointed the National Committee on AMR Policy, chaired by the Deputy Prime Minister. The National Committee on AMR Policy had its first meeting on 13 July 2017 and had a resolution to host the First National Forum on AMR. To align with the resolution of National Committee on AMR and to support Thailand’s global actions in addressing AMR challenges, the First National Forum on AMR is therefore planned to be held at the Prince Mahidol Award Conference (PMAC) 2018.