Billy Kelleher (Cork North Central, Fianna Fail)
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422. To ask the Minister for Health if he is aware of the recommendations contained in the recent UK Government report authored by Lord O’Neill on antimicrobial resistance, AMR; his plans to introduce the key recommendations contained in the report; if he is satisfied that Ireland’s AMR policy is robust enough to meet the huge challenge of AMR and with the situation that Ireland, unlike the UK, does not have set targets for the reduction of usage and or prescribing of antibiotics in health care settings such as hospitals or primary care; and if he will make a statement on the matter. [14416/16]

Simon Harris (Wicklow, Fine Gael)
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The Report Chaired by Lord O'Neill which was published on 19 May 2016, is welcomed by Ireland and is a valuable addition to the serious debate on the worldwide threat of antimicrobial resistance (AMR).

Lord O'Neill's concerns about both the human and economic costs of increasing resistance to often life saving treatment in the form of antibiotics is a matter which is being addressed at international, EU and national levels. The Report’s recommendations on reducing demand for antimicrobials, improving global surveillance of drug resistance and antimicrobial consumption in humans and animals are in line with the World Health Organisation’s Global Action Plan on Antimicrobial Resistance, which Ireland supports.

Ireland, through membership of the World Health Organisation, is part of the international effort aimed at tackling the global public health threat of AMR, which requires action across human and animal health sectors, agriculture and the wider environment.

In May 2015, at the WHO 68th World Health Assembly the final WHO Global Action Plan was endorsed. It sets out five strategic objectives:

(1) to improve awareness and understanding of antimicrobial resistance;

(2) to strengthen knowledge through surveillance and research;

(3) to reduce the incidence of infection;

(4) to optimise the use of antimicrobial agents; and

(5) develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.

Through adoption of the Global Action Plan, governments committed to have in place, by May 2017, a national action plan on antimicrobial resistance that is aligned with the global action plan. This national plan needs to cover the use of antimicrobial medicines in animal health and agriculture, as well as for human health. WHO will work with countries to support the development and implementation of their national plans, and will report progress to the World Health Assembly in 2017.

In recognition of the serious and increasing threat of antimicrobial resistance and the requirement for a ‘whole of Government’ approach to health issues, the Department of Health’s Chief Medical Officer (CMO) and the Department of Agriculture, Food and the Marine’s Chief Veterinary Officer (CVO) established, with Ministerial approval, a high level National Interdepartmental AMR Consultative Committee to address this issue. The Committee meets Ireland’s requirements to have an Intersectoral co-ordinating mechanism for addressing AMR at European level.

The Committee has a clear role and mandate across the human and animal health sectors. Committee membership consists of representatives of both Departments and of the relevant HSE and veterinary specialist agencies, including other relevant bodies with a remit across the two sectors; membership is representative of major stakeholders. The Committee meets bi-annually and its most recent meeting took place on 13 April last. The Committee agreed as a key action for 2016 the development of Ireland’s AMR national action plan, aligned to the WHO Global Action Plan.

In addition, the prevention and control of healthcare associated infections (HCAIs) and AMR has been a significant, long-standing patient safety and public health priority for the Department of Health for many years. A wide range of initiatives has been put in place in the Irish health system in response to the rising incidence of AMRs including improved surveillance of infections and prescribing, infection prevention and control processes, antimicrobial stewardship initiatives and public and professional awareness raising, with a significant emphasis on the education and training of healthcare professionals.

Ireland is fully committed to and engaged in addressing resolution of the problem of AMR and will continue to collaborate at international, EU and national levels to this end. Ireland contributes reporting to the European Antimicrobial Resistance Surveillance System.

Billy Kelleher (Cork North Central, Fianna Fail)
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423. To ask the Minister for Health the number of persons or incidents, if any, where antimicrobial resistance has occurred within the health care services over the past ten years; the hospitals which treated these patients and the measures being undertaken to address this issue; and if he will make a statement on the matter. [14417/16]

Simon Harris (Wicklow, Fine Gael)
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The rise in antimicrobial resistance (AMR) is recognised at global, European and national levels, including Ireland, as one of the greatest potential threats to human and animal health with possible serious consequences for public health, animal welfare and the agriculture and food sectors.

The emergence of resistance is a normal biological phenomenon but is increased through the overuse and misuse of antimicrobials in human and animal medicine. While most bacteria are effectively killed by antibiotics, certain types of bacteria possess the capacity to develop resistance to certain antibiotics whereby they are less effective and in the worst case scenario, no longer work against bacterial infections. The spread of these resistant strains is further increased, however, through poor hygiene practices and increased global travel and trade. There are also increasing concerns about the potential for spread of antimicrobial resistance in food and environmental pollution with antimicrobials e.g. through water contamination and agricultural run-off.

In Ireland AMR in key clinically important bacteria known to cause potentially serious infections, such as bloodstream infection, (BSI) has been systematically monitored over the past decade by Irish microbiology laboratories serving all acute hospitals. There has been almost complete reporting of AMR data on BSI to the Health Service Executive's Health Protection Surveillance Centre (HPSC) where data is analysed and reported back directly to participating laboratories and hospitals on a quarterly basis. HPSC also published reports on the latest available national BSI AMR surveillance data and hospital level AMR surveillance data on its website at:

htp://www.hpsc.ie/A-Z/MicrobiologyAntimicrobialResistance/InfectionControlandHAI/Surveillance/HPSCSurveillance/and.

The prevention and control of healthcare associated infections (HCAIs) and AMR continues to be a significant, long-standing patient safety and public health priority for the Department of Health. A wide range of initiatives has been put in place in the Irish health system over several years in response to the rising incidence of AMRs. These include:

- improved surveillance of infections and prescribing;

- infection prevention and control processes;

- antimicrobial stewardship initiatives;

- public and professional awareness raising, with a significant emphasis on the education and training of healthcare professionals;

- currently reviewing and updating of National Clinical Effectiveness Committee (NCEC) national Guidelines on MRSA (2013) and Clostridium difficile(2014) for healthcare professionals;

- currently reviewing and updating of HIQA's National Standards for the Prevention and Control of Healthcare Associated Infections (HCAIs) (2009).

Ireland also fully supports the World Health Organisation (WHO) Global Action Plan on Antimicrobial Resistance and through the Interdepartmental AMR Consultative Committee, established and co-chaired by the Chief Medical Officer of this Department and the Chief Veterinary Officer of the Department of Agriculture, Food and the Marine and endorsed by both respective Ministers, is addressing the WHO's requirement for all countries to have in place an Intersectoral co-ordinating Mechanism to develop a national action plan against AMR to encompass both the human and animal sectors, agriculture and the wider environment. The Committee was launched on European Antibiotic Awareness Day in November 2014 and has a clear role and mandate across the human and animal health sectors. Committee membership consists of representatives of both Departments and of the relevant HSE and veterinary specialist agencies, including other relevant bodies with a remit across the two sectors; membership is representative of major stakeholders. The Committee meets bi-annually and its most recent meeting took place on 13 April 2016.

A key action for the Committee's work during 2016 is the development of Ireland's AMR national action plan in order to have in place, by May 2017, a national action plan on AMR that is aligned with the WHO's Global Action Plan. This plan will cover the use of antimicrobial medicines in animal health and agriculture, as well as for human health. The WHO is working with countries to support the development and implementation of their national plans, and will report progress to the World Health Assembly in 2017.

Ireland is fully committed to and engaged in addressing resolution of the problem of AMR and will continue to collaborate at international, EU and national levels to this end. Ireland also supports and has actively engaged on the European Commission's Draft Council Conclusions on AMR which will be presented for adoption to the Ministerial meeting of EPSCO (Employment, Social Policy, Health and Consumer Affairs) on 17th June 2016; this document will call on Member States and the European Commission to develop a new and comprehensive EU Action Plan on AMR.