2023-12-20-世界卫生组织-Global_campaign_to_phase_out_over-the-counter_OTC_antibiotic_sales_Consultation_Report_13页_326kb

Global Campaign to Phase Out OTC Antibiotic Sales: Meeting Summary

Meeting Objectives

• Reviewed findings from a 2020 policy mapping review on OTC antibiotic sales across 20 countries.
• Aimed to build consensus on launching a WHO-led campaign to phase out OTC antibiotic sales and define its concept and outcomes.

Methods

• Two-day meeting involving key stakeholders (civil society, academia, WHO).
• Presentations followed by facilitated group discussions using working guidelines, templates, and background documents (WG report, scoping review, country review).
• Day 1: SWOT analysis and identification of enabling actions.
• Day 2: Discussion on balancing access vs. excess antibiotic use, followed by campaign planning recommendations.

Key Outcomes & Priorities for Action

1. Clear Definition: Define “OTC” contextually for the campaign.
2. Integration: Align the campaign with complementary global efforts (e.g., UHC, primary health care).
3. Target Audience for Policymakers: Develop a concise document with case studies to influence policy and secure funding.
4. Pharmacist Capacity/Incentives: Strengthen training (AMR stewardship, behavior change) and offer incentives.
5. Regulation & Oversight: Identify gaps in OTC regulations, build regulatory capacity, control supply chains.
6. Industry Practices: Understand industry impacts on sales and develop solutions.
7. Campaign Design:
   • Focus on regions with high OTC sales, use standardized access metrics.
   • Tailor messages, focus initially (“reserve/watch” antibiotics).
   • Advocate behaviour change training for CHWs/pharmacists.
   • Promote transparency for the pharmaceutical industry.
   • Leverage existing platforms (GASM, political declarations).

SWOT Analysis Insights

• Strengths: Widespread recognition of the problem (AMR plan), target groups (pharmacists), existing regulations/interventions, valuable resources (AWaRe, Essential Medicines List), prepared training materials.
• Weaknesses: Health system weaknesses (delivery, resources), fragmented or outdated regulations, informal vendors, gaps in awareness and behaviour change, limited evidence, potentially conflicting guidelines.
• Opportunities: Engaging parliamentarians, civil society, leveraging existing UN/WHO initiatives, digital tools, heightened public awareness, political opportunities (GASM, High-Level Meetings).
• Threats: Dwindling political/patient funding commitment, lack of alternatives post-ban, industry resistance, under-resourced health systems, political instability, societal mistrust, difficulty sustaining the campaign, diverse target audiences requiring tailored approaches.

Recommendations for Campaign Launch

• Pilot Testing: Start in a few priority countries.
• Evidence Collection: Systematically gather data on OTC practices.
• Contextual Campaign Design: Develop adaptable tools and messages; focus initially on “reserve/watch” antibiotics.
• Integration: Weave the campaign into national action plans and UN processes (UNGASM, IMC).
• Regulatory Advocacy: Push for regulatory strengthening and clear dispositions.
• Stakeholder Engagement: Actively involve diverse groups (policymakers, civil society, associations) both for influence and implementation. Analyze the value chain.

Focus: Initially prioritize phasing out sales of "reserve" and "watch" antibiotics to combat AMR effectively while ensuring sustainable access to essential "access" antibiotics through complementary strategies like education, behaviour change training, and strengthening primary healthcare systems.