National Action Plan to Combat Bacterial Resistance (2016-2020)

This action plan is formulated to strengthen the management of antimicrobial drugs, curb bacterial resistance, safeguard the health of the people, and promote coordinated economic and social development., the foreword,
china is a major country in the production and use of antimicrobial drugs. Antibacterial drugs are widely used in the fields of medical and health care and agricultural aquaculture, and play an important role in treating infectious diseases to save patients' lives, preventing and treating animal diseases to improve breeding efficiency and ensure public health and safety. However, due to the lack of research and development capacity of new antimicrobial drugs, drugstores without prescription sales of antimicrobial drugs, medical and aquaculture areas unreasonable application of antimicrobial drugs, pharmaceutical enterprise waste emissions are not up to standard, the public awareness of rational drug use is not high and other factors, the problem of bacterial resistance is becoming increasingly prominent. Bacterial resistance ultimately affects human health, but the factors and consequences of bacterial resistance go beyond the field of health, bringing to human society the adverse effects of increased biosecurity threats, increased environmental pollution, economic development constraints, and so on.2. Objectives
To implement comprehensive management strategies and measures at the national level, strengthen supervision in the research and development, production, circulation, application and environmental protection of antimicrobial drugs, strengthen publicity, education and international exchanges and cooperation, and address the risks and challenges posed by bacterial resistance. By 2020:
(i) strive to develop and market new antimicrobial drugs 1-2, new diagnostic equipment and reagents 5-10.
(ii) The proportion of antimicrobials sold by retail pharmacies on prescription has basically reached full coverage. The proportion of provinces (districts and cities) selling antimicrobial drugs on veterinary prescriptions has reached 50%.
(iii) Improve the monitoring network of medical institutions, animal-sourced antimicrobial applications and bacterial resistance, build laboratories and germ centers for bacterial drug resistance, and establish an evaluation system for the application of antimicrobial drugs and the control and control of bacterial resistance in the field of medical and aquaculture.
(4) The clinical application management mechanism of antimicrobial drugs has been basically established in hospitals above the second level, and the growth rate of the main drug-resistant bacteria in medical institutions has been effectively controlled.
(v) The growth rate of the main drug-resistant bacteria in animal sources has been effectively controlled by the gradual withdrawal of antimicrobial drugs shared by humans and animals or that are prone to cross-drug resistance as animal-promoting applications.
(6) To complete the training of medical personnel, first-line veterinarians and aquaculture practitioners throughout the country on the rational application of antimicrobial drugs, to fully implement the popular science education on the rational application of antimicrobial drugs in primary and secondary schools, and to carry out publicity weeks on the rational application of antimicrobial drugs., the main measures
(i) to play the advantages of joint defense and control, to perform departmental responsibilities.
Development and reform departments to promote antimicrobial drug research and development and industrialization, science and technology departments through relevant scientific and technological programs (special, funds, etc.) to coordinate support for antimicrobial and bacterial resistance research, financial departments to arrange funds related to bacterial drug resistance control, strengthen fund management and supervision, food and drug regulatory departments to strengthen the approval, production and circulation of antimicrobial drugs, focusing on strengthening the retail pharmacies on prescription sales of antimicrobial drug management, industry and information technology departments to improve drug industry policies and promote The industrialization of green production and related achievements of antimicrobial drugs; the health and family planning department is responsible for strengthening the management of the clinical application of antimicrobial drugs, doing a good job in organizing and supervising the implementation of the work of curbing bacterial resistance; the chinese medicine administration department and the military health department respectively do a good job in the clinical application management of antimicrobial drugs in Chinese medicine medical institutions and military medical institutions; The environmental protection department strengthens the prevention and control of antimicrobial environmental pollution, strengthens the capacity-building of antimicrobial environmental law enforcement and environmental monitoring, accelerates the construction of the antimicrobial drug pollutant index evaluation system, the education department integrates the knowledge of the rational application of antimicrobial drugs into the content of primary and secondary school health education and implements it, and the cultural department, the press, the press and radio departments widely publicize the knowledge of the rational application of antimicrobial drugs to the public through radio, television and other major media.
(ii) to increase research and development of antimicrobial drugs.
1. Encourage research on the epidemiology and drug resistance mechanisms of bacterial drug-resistant molecules. Timely grasp the development trend, spread and difference of bacterial drug resistance in different regions, populations, medical institutions, animals and so on in China, increase the intensity of basic research, explain the mechanism of bacterial disease and drug resistance, and provide scientific data for the formulation of drug resistance control strategies and research and development of new drug technologies.
2. Support the development of new anti-infectant drugs, instruments and vaccines. Strengthen the deployment of bacteria resistance prevention and control technology, support the research and development of new anti-infective drugs, especially innovative drug research and development with different mechanisms and molecular structures, support the rapid diagnosis of drug-resistant bacterial infection technology, especially the rapid identification of bacterial infection and non-bacterial infection technology equipment, drug-resistant bacteria rapid detection equipment and basic medical institutions to apply microbial detection equipment research and development, support related vaccine research and development. Promote the research and development of animal disease prevention and growth-promoting products for animal-specific antimicrobial drugs and alternative antimicrobial drugs.
3. Support the diagnosis, treatment and control of drug-resistant bacterial infections. Including new treatment options, optimal dosage, drug-resistant bacterial infection treatment strategies and clinical evaluation of less antimicrobial drugs, improve the clinical treatment of infectious diseases.
. To carry out antimicrobial environmental pollution control research, antimicrobial drug pollution control technology, antimicrobial drugs in the water environment and soil removal and repair technology.
(iii) strengthen the management of antimicrobial drug supply guarantee.
1. Improve the antimicrobial drug registration management system. In accordance with the requirements of the reform of the drug review and approval system, strict approval of antimicrobial drugs for listing. In accordance with the policy, the review and approval of innovative drugs, instruments and vaccines used in drug-resistant bacterial infections is accelerated. Research and establish an antimicrobial drug environmental hazard assessment system, in medicine, veterinary drugs, fertilizer registration link, to carry out the environmental hazard assessment of drugs.
2. Strengthen the management of the production and circulation of antimicrobial drugs. We will increase supervision over the production and circulation of antimicrobials, strictly implement the sale of antimicrobials by retail pharmacies on prescription, prohibit the online sale of antimicrobial drugs, and crack down on the sale of counterfeit and inferior antimicrobial drugs. Retail pharmacies should do a good job of prescription retention and inspection, in various forms to avoid the sale of antimicrobial drugs on prescription, increase penalties.
promote the upgrading of the antimicrobial industry. We will improve the pharmaceutical industry policy, guide enterprises to develop new antimicrobial drugs, and support the industrialization of new varieties of antimicrobial drugs. We will promote the merger and reorganization of antimicrobial drug manufacturers, encourage them to adopt new technologies and equipment for technological transformation, and promote green production of antimicrobial drugs.
(iv) strengthen the application of antimicrobial drugs and drug resistance control system construction.
1. Standardize the clinical application management of antimicrobial drugs. We will strictly implement the relevant provisions of the Drug Administration Law, the Regulations on the Administration of Medical Institutions, the Prescription Management Measures, the Regulations on the Administration of Pharmaceuticals in Medical Institutions, the Measures for the Clinical Application of Antibacterial Drugs, the Guidelines for the Administration of Prescription Reviews in Hospitals (Trial), and the Guidelines for the Clinical Application of Antimicrobial Drugs. We will encourage the establishment of multidisciplinary cooperation mechanisms to enhance the level of professional management through multidisciplinary work teams in clinical departments, infectious diseases, clinical microorganisms, pharmacy, and hospital infection management. We will continue the clinical application of antimicrobial drugs and the monitoring of bacterial resistance, issue monitoring reports in due course, and improve the utilization level of monitoring results. We will strengthen the capacity-building of medical personnel in the rational application of antimicrobial drugs, and focus on strengthening the knowledge training of primary health care workers. Improve the basic environment of medical institutions and strengthen the management of hospital infections. We will vigorously strengthen the information construction of medical institutions, reflect the requirements of antimicrobial drug management through information means, and gradually realize scientific and efficient management to form a sustainable development of drug resistance control mechanism.
2. Strengthen the supervision and management of veterinary antimicrobial drugs. We will formulate guidelines and management measures for the safe use of veterinary antimicrobial drugs, and revise the regulations for the use of drug feed additives and the list of prohibited drugs in a timely manner. Implementation of veterinary drug classification management system, the implementation of veterinary prescription sales of veterinary antimicrobial drug management.
strictly manage the various sales channels of antimicrobial RAW drugs. We will implement animal health breeding methods, strengthen the health management of breeding sites, improve the breeding environment, strengthen breeding management, and maintain animal health. Strengthen the management of drug feed additives, reduce the concentration of sub-therapeutic preventive drugs, prohibit the use of important antimicrobial drugs in the aquaculture industry. We will increase the safety risk assessment of veterinary antimicrobial drugs and speed up the phase-out of high-risk varieties. A classification table of human and veterinary antimicrobial drugs was formulated to distinguish between human and veterinary antimicrobial types, and to determine the level of application according to the importance of drugs, cross-resistance and clinical application varieties.
(v) improve the application of antimicrobial drugs and bacterial resistance monitoring system.
1. Improve the clinical application of antimicrobial drugs and bacterial resistance monitoring network. On the basis of the existing institutions, the establishment of a national antimicrobial clinical application and bacterial resistance monitoring center, responsible for the medical institutions antimicrobial and drug resistance monitoring, the development of monitoring standards and monitoring programs, the organization and implementation of monitoring work. We will further improve the monitoring network for the clinical application of antimicrobial drugs and the monitoring network for bacterial resistance, and carry out universal monitoring, active monitoring and target monitoring. The monitoring surface covers level 3 and level 2 hospitals and primary medical institutions, covering inpatient and outpatient patients, and obtains comprehensive epidemiological data on bacterial resistance.
2. Establish and improve antimicrobial applications and bacterial resistance monitoring networks in the field of aquaculture. On the basis of the existing institutions, the Establishment of the National Veterinary Antimicrobial Application and Animal-sourced Bacterial Resistance Monitoring Center, responsible for the field of antimicrobial and drug resistance monitoring in the field of aquaculture, the development of monitoring standards and monitoring programs, the organization and implementation of monitoring work. Establish and improve the veterinary antimicrobial application monitoring network and animal-sourced bacterial resistance monitoring network, carry out universal monitoring, active monitoring and target monitoring. The monitoring covers different fields, different breeding methods, farms (households) of different varieties and representative market for animal-based food circulation, and obtains epidemiological data on drug resistance of animal-sourced bacteria.
. Establish a mechanism for the rational application of antimicrobial drugs in the field of medicine and aquaculture and the monitoring network for bacterial resistance, so as to realize the monitoring results in the two fields for reference. The establishment of a scientific and reasonable evaluation index system for the medical and aquaculture field to strengthen the management of antimicrobial applications to provide a basis.
4. Establish a bacterial drug-resistant ginseng laboratory and a database of biological specimens. The laboratory is responsible for the identification of drug-resistant bacteria, the establishment of standard drug-resistant research and monitoring technology system, the collection and preservation of a variety of isolated drug-resistant bacteria, to provide clinical and research needs of standard strains.
(vi) to improve the ability of professional bacterial resistance and control.
1. Strengthen the training of medical students. Conditional higher medical institutions are encouraged to offer courses in rational drug use in clinical medicine and pharmacy. To encourage qualified institutions of higher agriculture and for forgingation to offer courses in animal medicine in the treatment of animal infectious diseases.
2. Strengthen the training of relevant medical professionals. We will vigorously train personnel for rational application and drug resistance control of antimicrobial drugs, focus on training professionals in infectious diseases, clinical pharmacy, clinical microorganisms, etc., and ensure that the number of trainings meets the needs of medical institutions. Strengthen the rational application of antimicrobial drugs and drug resistance control of medical personnel to continue education, medical personnel each year to complete a certain number of hours of continuing education training and assessment through.
strengthen the education of the aquaculture and veterinary practitioners. We will train and strengthen the veterinary team and strengthen the education and training of veterinarians and farmers in the rational application of antimicrobial drugs. Through regular or irregular training, to promote the implementation of relevant institutional norms, improve the level of rational application of veterinary antimicrobial drugs.
(7) to strengthen the prevention and control of antimicrobial environmental pollution.
from the planning and planning EIA point of view of strict antimicrobial pharmaceutical enterprises site selection, at the same time, new, modified, expanded antimicrobial pharmaceutical projects must strictly implement the environmental impact assessment system. We will speed up the construction of an antimicrobial pollutant index evaluation system, strengthen environmental law enforcement and capacity-building in the technical methods and norms for monitoring antimicrobials such as water, soil and solid waste. We will carry out scientific research on the possible ecological impact of antimicrobial drugs, study the prevention and control measures of antimicrobial environmental pollution, and promote the reduction of antimicrobial waste.
(viii) to step up publicity and education efforts.
make full use of traditional media such as radio and television and new media such as the Internet, Weibo and WeChat to widely publicize knowledge of the rational application of antimicrobial drugs and raise public awareness of the bacterial resistance crisis. The rational application of antibacterial drugs and the socialist new rural construction and culture, science and technology, health, "three rural areas" and other activities to support farmers and farmers, in the grass-roots cultural activities to increase antibacterial drug content, reduce unnecessary antimicrobial applications. To carry out the education and publicity activities on the rational application of antimicrobial drugs and bacterial resistance in primary and secondary schools, and to establish the concept of rational application of antimicrobial drugs from an young level. Medical institutions strengthen the education and guidance of patients on the rational application of antimicrobial drugs and correct the behavior of self-antimicrobial drugs. Regularly conduct awareness weeks on the rational application of antimicrobial drugs, which are carried out annually in sync with the World Health Organization.
(9) to carry out extensive international exchanges and cooperation.
has been actively involved in the work of international organizations such as the World Health Organization, the World Organization for Animal Health and the Food and Agriculture Organization of the United Nations, including the development of prevention and control strategies and technical standards, antimicrobial applications and bacterial resistance monitoring, personnel training, seminars, etc. Collaborate with other countries and regions on drug resistance monitoring to control the cross-regional spread of drug-resistant bacteria. Share relevant drug-resistant monitoring results and research results with the international community to jointly develop a control strategy with international harmful drug-resistant bacteria. Research and development of new drug-resistant control technologies and products with the international community. Actively support drug resistance control activities in countries and regions in need. , safeguard measures and
(1) to increase the intensity of protection. According to the government's health input policy, the level of economic and social development and the trend of bacterial resistance, we will increase investment in curbing bacterial drug resistance, build drug resistance control-related facilities, equipment and personnel training, and link the completion of the task of curbing bacterial resistance and performance appraisal results with financial assistance.
(ii) to exert the power of experts. The state has set up a consulting committee on curbing bacterial resistance. The Advisory Committee of Experts is composed of experts in medicine (basic and clinical medicine, Traditional Chinese medicine), veterinary medicine (veterinary medicine), microbiology, pharmacy, biopharmaceuticals, health management, environmental protection, circulation management, epidemiology, biostatization, economics, education, media, information construction, etc., and provides advice and policy recommendations on antimicrobial drug management and drug resistance control. All regions may refer to the establishment of the region's anti-bacterial resistance advisory expert committee.
(iii) strengthen supervision and inspection. In accordance with the requirements of this action plan, the work objectives and task measures should be broken down into specific departments to implement the work responsibilities. Relevant departments everywhere should check the annual work of the region, focusing on medical and health care