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This bulletin was prepared by the Department of Health Systems and Services (HSS) and the Department of Communicable Diseases and Environmental Determinants of Health (CDE) from PAHO with the support of the Europe Union through the project "Working together to fight antimicrobial resistance." The views expressed herein can in no way be taken to reflect the official opinion of the European Union.

The bulletin includes material published by third parties and compiled by PAHO. PAHO has taken reasonable precautions to verify the information contained in the document. However, this material is distributed without warranty of any kind. The reader is responsible for the interpretation and use they make of this information and in no case can PAHO be held responsible for any damage caused by its use.

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14 May 2021
NEWS
PAHO completes pilot project on malaria pharmacovigilance in Brazil
 The Pan American Health Organization (PAHO) finished the pilot project “Strengthening Pharmacovigilance and Adherence to Malaria Treatment in the Region of the Americas (VigilADMa).” The country was the first to implement and complete the action, developed in the municipality of Manaus, state of Amazonas, from November 2019 to December 2020.
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Latin American countries advance in the surveillance of antimicrobial consumption
PAHO, together with the Centro Universitario de Farmacología de Argentina (known in Spanish as CUFAR), PAHO/WHO Collaborating Center in Argentina, is collaborating with countries in the Region of the Americas to register the national consumption of antimicrobials in the countries, following the World Health Organization (WHO) methodology. The initiative seeks to train professionals from the countries in data collection and install a common methodology for conducting these studies in the Region.
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Countries of the Region begin the development of national plans for pharmaceutical services based on primary health care
PAHO shared with the countries of the Region a model proposal for the development of national work plans to transform pharmaceutical services towards primary health care (PHC). The document provides guidance for the development of the main content sections of the plan and the priority aspects to be adopted or adapted to the context of the country. Among the lines contemplated in the plan is the strengthening of the enforcement procedures of prescription sale of antimicrobials.
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Global shortage of innovative antibiotics fuels emergence and spread of drug-resistance
The world is still failing to develop desperately needed antibacterial treatments, despite growing awareness of the urgent threat of antibiotic resistance, according to report by the World Health Organization. WHO reveals that none of the 43 antibiotics that are currently in clinical development sufficiently address the problem of drug resistance in the world’s most dangerous bacteria.
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Diagnosis of new TB cases in the Americas reduced by 15-20% during 2020 due to the pandemic
The Americas, with 2.9%, and Europe, with 2.5%, are the regions with the lowest TB burden in the world. However, the COVID-19 pandemic has jeopardized the gains made in the fight to end the disease by 2050 globally. The active search for people who have had contact with someone with TB in order to provide them with preventive treatment is also part of the strategy recommended by PAHO/WHO. Ensuring the full implementation of these measures will substantially reduce not only transmission of infection and disease, but also development of drug resistance. Peru and Brazil account for 52% of all multi-drug-resistant TB cases on the continent.
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WHO launches a digital version of its Model list of Essential Medicines (EML)
The World Health Organization has launched a new easy-to-access, digital version of its Model list of Essential Medicines (EML). The move will revolutionize the way this core WHO reference tool is used. More than 150 countries currently use the WHO list to work out which medicines best meet their national health contexts and priorities, so they can compile their own national essential medicines lists. 
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New WHO Guide to help countries expand access to essential medicines
WHO’s new user guide for countries, ‘Selection of medicines at country level’, is based on the WHO Model List of Essential Medicines. It sets out the key actions countries should undertake to develop and update their own national essential medicines lists based on the treatment needs of their populations and their capacity to reimburse payments for medicines.
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The course on the implementation and strengthening of Programs for Optimizing Antimicrobials (PROA) in the Americas finishes
More than 320 managers, leaders and health professionals from Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, Guatemala, Mexico, Nicaragua, Panama, Peru and the Dominican Republic approved the course. They were trained to organize, implement and monitor the development of a PROA in their health institution and interpret the factors that influence behavior related to the prescription of antimicrobials.
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Medical Product Alert N°2/2021: Falsified COVID-19 Vaccine BNT162b2
This WHO Medical Product Alert refers to falsified COVID-19 Vaccine identified as “BNT162b2” detected in Mexico in February 2021 and recently confirmed as falsified to the WHO. The falsified product was supplied and administered to patients outside authorized vaccination programs.
Read more
UPCOMING EVENTS
23rd Expert Committee on Selection and Use of Essential Medicines
The meeting of the 23rd WHO Expert Committee on the Selection and Use of Essential Medicines will be coordinated from WHO Headquarters, Geneva and held virtually on 21 June to 2 July 2021 to revise and update the WHO Model List of Essential Medicines (EML) and the WHO Model List of Essential Medicines for Children (EMLc).
More information
PUBLICATIONS
Brochure: Fighting Antimicrobial Resistance in the Americas
This document summarizes the work of the countries together with PAHO in the response to antimicrobial resistance in the Region of the Americas. It shares statistics, relevant information and progress in the theme. 
Available here
Guidelines for the prevention and control of tuberculosis in the indigenous peoples of the Region of the Americas
PAHO has developed these guidelines as a tool to help implement the End TB Strategy. Among the components presented in the guide are: the treatment of people with tuberculosis and drug-resistant tuberculosis, with patient-centered support; universal health coverage policy and regulatory frameworks for the notification of cases, vital records, the quality and rational use of medicines, and infection control.
Available in Spanish here
WHO integrated global surveillance on ESBL-producing E. coli using a “One Health” approach
WHO developed a standard protocol for integrated multisectoral surveillance. The model targets monitoring one indicator, the extended spectrum beta-lactamases- (ESBL) producing Escherichia coli across the human, animal and environmental sectors, the “Tricycle protocol”. This protocol includes standard methodologies in the human, food chain and environmental sectors to be implemented in low resource settings to facilitate the establishment of the integrated multisectoral surveillance on AMR. 
Available here
Monitoring global progress on antimicrobial resistance: Tripartite AMR country self-assessment survey (TrACSS) 2019-2020
This report analyzes the global responses on the fourth round of TrACSS (2019-2020) and examines the global trends and actions towards addressing AMR in all sectors.
Available here
Antimicrobial resistance in the Western Pacific Region: a review of surveillance and health systems response
This document provides an in-depth situational review and technical discussion in three main areas for the containment of AMR in the Region: (1) surveillance of AMR in the Western Pacific Region; (2) monitoring of antimicrobial use in the Western Pacific Region;  and (3) health systems response to support containment of AMR in the Western Pacific Region.
Available here
COVID-19: DOCUMENTS / TECHNICAL GUIDELINES
The COVID-19 pandemic is exacerbating antimicrobial resistance. Therefore, everything that contributes to reducing the cases of COVID-19 is also helping to reduce the impact of AMR.
Risk Management Plans and Periodic Safety Reports for COVID-19 Vaccines: Recommendations for Their Request, Preparation, Management, and Assessment
This document establishes recommendations and considerations to guide the development of strategies to assess the risk management plans and periodic safety reports required for use authorization of COVID-19 vaccines and for safety monitoring once their use is authorized.
Available here
Guidance for Implementing the Regional COVID-19 Vaccine AEFI/AESI Surveillance System
The purpose of this guidance document is to develop a sensitive, timely, standardized, reliable, and integrated regional AEFI surveillance system with the participation of all actors involved in safe vaccination to maintain trust in vaccination and acceptance of immunization in the Americas. Contribute to the early detection and correct classification of serious AEFIs and risk markers to generate a rapid and appropriate national and regional response.
Available here
VIDEO

Happy anniversary ReLAVRA!
ReLAVRA, a network of microbiology laboratories from 20 countries in the Americas is celebrating its 25th anniversary. Its dedicated efforts to strengthen the surveillance of antimicrobial resistance (AMR) have significantly contributed to improving patient care and informing public health actions to contain AMR in the region. At the heart of the network’s work are values of technical excellence, equity and solidarity.

CAMPAIGN MATERIALS
RADIO SPOT
RADIO SPOT ON ANTIBIOTIC AND COVID-19
EDUCATIONAL VIDEOS
The role of health workers in the fight against antimicrobial resistance
Antimicrobial resistance and the five keys for food safety
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