Rebranding Antibiotic Resistance as a Disaster Risk Problem - A Necessary Step Towards Integrated Health Risk Management Dale DOMINEY-HOWES
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Presentation at 3rd GRF One Health Summit 2015 Session Integrative Health Risk Management
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Rebranding Antibiotic Resistance as a Disaster Risk Problem - A Necessary Step Towards Integrated Health Risk Management Dale DOMINEY-HOWES
- 1. Rebranding antibiotic resistance as a disaster risk problem – a necessary step towards integrated health risk management Dale Dominey-Howes 1 & Maurizio Labbate 2 1 University of Sydney 2 ithree Institute, UTS
- 2. Outline Goal: See antibiotic resistance rebranded as a disaster risk problem so it aligns with integrated risk management focus of this conference theme Approach today: Reframe AMR as a disaster risk Outline the Risk Management Framework as a useful policy & practice tool to tackle the issue (complimentary to existing approaches) Share some preliminary research findings from an Australian study
- 3. As you know….. Tone = urgent & alarming; Terminology = disaster risk “is now a major threat to public health….” “… risk to communities…’ “Without urgent, coordinated action by many stakeholders…” “antibiotics have been one of the pillars allowing us to live longer and healthier…. Implications are devastating…” “Widespread resistance to ‘last resort’ antibiotics” Dr Keiji Fukuda, WHO Assistant DG, Health Security Disaster = “a serious disruption of the functioning of a community/society… that exceeds the ability of affected community to cope using own resources” AMR = “beyond business as usual”
- 4. One Health within a ‘risk’ construct
- 5. Dominey-Howes, Labbate et al., (2015): Frontiers in Microbiology The Risk Management Framework Problem recognition Problem recognition
- 6. Media Public/Communit y Pharmaceutical companies Medical GPs, Dentists etc NGO’s. Community Groups (e.g. anti-vaccination) Food industry Agriculture, Distribution (e.g. Woolworths) Pharmacists Antibiotic use/Antibiotic resistance Medical Hospitals • Network • Each box can produce it’s own network • Complex Researchers Microbiologists, Social Scientists, Chemists etc Government Politicians, Emergency Management etc Internet/Hoarding/Inappro priate use etc Wastewater treatment? – spread of resistance genes Stakeholders & selection pressure
- 7. Surveying community about knowledge & perceptions “… I’ve got the flu Doc and I WANT my antibiotic!....” Psychometric/b ehavioral Cultural Theory Social Amplification of Risk Experience Awareness Sense of place Peer pressure Media coverage Message signals Voluntary/involuntary Trust Knowledge ‘Scales’ of events/processes Culture Faith Length of residence Geography of place Confidence Benefit
- 8. 02 Preliminary data from Sydney survey 1,000+ participants
- 9. Preliminary results Current education messages not getting through The public think the responsibility is everyone else’s rather than theirs (& farmers have a lesser role)
- 11. Poor politicians! TRUST in SELF as high as trust in medical & health officials Preliminary results
- 12. 02 On management options…… Preliminary results
- 13. Preliminary results On management options……
- 14. 02 Take Home Messages for ‘One Health’ Strengths of this type of work: •Integrated systems approach •Stakeholder oriented Weaknesses & challenges: •Breaking through existing silos •Convincing funding agencies Other issues: •Need interdisciplinary teams Thank you
- 15. 02 Thanks & Questions? NSW Ministry of Health – Emergency Management Unit for support & advice Dale acknowledges (1) ARC DP130100877; (2) NDRP CRIP & SEMP grants Brittany Betteridge & Annie Zhou (RA’s), Jon Iredell, Beata Bajorek, Carolyn Michael Dominey-Howes, D., Michael, C. & Labbate, M. (2014). Why emergency management should be interested in the emergence of antibiotic resistance. Australian Journal of Emergency Management, 29 (3), 11-15. Michael, C., Dominey-Howes, D. & Labbate, M. (2014). The antimicrobial resistance crisis: causes, consequences and management. Frontiers in Public Health. Doi: 10.3389/fpubh.2014.00145. Dominey-Howes, D., Bajorek, B., Michael, C., Betteridge, B., Iredell, J. & Labbate, M. (2015). A novel approach to tackling the global antibiotic resistance crisis. Frontiers in Microbiology. QUESTIONS?
Hinweis der Redaktion
- Interestingly, if you pay close attention to the language and terminology being deployed by experts at the highest levels domestically and internationally, it becomes very clear experts are already using the language of DRR Such experts are using the language of DRR without realising they are describing an increasingly rapidly developing disaster Under UN and international legislation, a disaster is defined as: “a serious disruption of the functioning of a community or a society…..… which exceeds the ability of the affected community or society to cope using its own resources ”
- This forum explores ‘One Health’ as an ‘integrated risk management’ concept It advocates for a ‘systems approach’ to managing risk associated with complex problems like AMR Uses language and approach of DRR The forum (and us) are agitating for a rethinking of humanities relationship with the microbial world
- An approach more commonly applied to natural disasters such as volcanic eruptions, epidemics, tsunamis and bushfires BUT may be applied just as well to the ‘risk of AMR”….. Bottom up, complimentary to existing health and medical ‘top down’ approaches
- The Risk Management Framework is good because it forces us to engage with the many ‘stakeholders’ in the complex system that AMR has emerged within (and again aligns with concept of ‘One Health’)
- Understanding socio-cultural and behavioural contexts is critical
- So – just for you guys – HOT OFF THE PRESS – Maurizio and I have been working with an Honours student in Geography Survey administered by households, in pharmacies, on Facebook and via social media blog sites We asked 49 separate questions (including many compound questions) – most comprehensive survey yet undertaken in Australia We built upon previous Australian and international AMR knowledge studies to ensure we mirrored best practice and can bench mark our data We are targeting surburbs that are ‘disadvantaged’ and ‘advantaged’ – according to ABS classification Over 850 completed surveys There are very clear policy oriented messages in the data we are getting and some surprises Data show such things as…….
- And the good news is that the public thinks microbiologists should be getting more research funding to tackle this issue and they TRUST you! Logistic regression analysis shows people married or in relationships more likely to see AMR as presenting a risk to them in the future Ethnicity also statistically related to NOT recognising the risk
- More worried about terrorism