PMAC 2018
Making the World Safe from the Threats of Emerging Infectious Diseases
The Prince Mahidol Award Conference (PMAC) is an annual international conference focusing on policy-related health issues. The Prince Mahidol Award Conference 2018 is co-hosted by the Prince Mahidol Award Foundation, the Thai Ministry of Public Health, Mahidol University, the World Health Organization, The World Bank, U.S Agency for International Development, Japan International Cooperation Agency, The Rockefeller Foundation, with support from other key related partners. The Conference will be held in Bangkok, Thailand, from 29 January – 3 February 2018. The theme for PMAC 2018 is “Making the World Safe from the Threats of Emerging Infectious Diseases”.
We live in an era when the emergence of novel infectious disease agents is posing an increasing threat to global health and security. The threat from novel infectious diseases is accelerating at a pace and with an intensity unprecedented in human history, driven by increasing human populations, climate change and surging global travel. The possibility that a single lethal microbe could suddenly emerge and sweep through every household, through every community without regard to national borders or social and economic standing is a shared fear across the globe. Just the fear can cost billions, as illustrated by recent Ebola and Zika virus panics in little-affected countries. But the reality of the threat is all too clear, proven by the decades of response to the HIV-AIDS pandemic. Yet the world is not prepared to either mitigate the impact of an emergent disease threat or prevent its emergence.
Zoonotic and AMR related diseases account for more than 95% of all emerging infectious diseases reported during the second half of the 20th century. In this century the emergence of SARS, pandemic influenza, MERS, and the spread of Ebola and Zika reflect the world’s increasing vulnerability to novel zoonotic threats. The simultaneous emergence of pathogens resistant to antibiotic therapies raises the prospect of a “post antibiotic” world. While the drivers underlying the emergence of zoonotic and antibiotic resistant diseases are complex, human behaviours and their impact on animal populations and the environment are understood to be central to the emergence of both disease threats. The role of increasing animal-human contact in the emergence of zoonotic diseases has been well documented and been increasingly the focus of One Health initiatives across the globe. The contribution made by the inappropriate use of antibiotics in animal husbandry to AMR is less well documented but in recent years has been increasingly understood to be a core driver behind the emergence and global spread of antibiotic resistant organisms, along with inappropriate “prescriber-user” practices associated with antibiotic use in clinical care. Changing environmental and climatic conditions have also been closely linked to the emergence of novel infectious diseases. That infectious disease emergence is closely associated with practices and behaviours at the animal-human-environment interface speak to the importance of an expanded multi-sectoral alliance across the animal, human and environmental sectors to address the threats posed by both zoonosis and AMR. The Global Health Security Agenda and related One Health movement provide important frameworks for mobilizing international action.
Since the Influenza Pandemic of 1918 when between 50-100 million died (5-10% of the human population) we have been fully aware of how vulnerable our place on this planet is.
Even in the absence of significant global mortality, epidemics and pandemics can cost tens of billions of dollars, reversing development gains and pushing communities and households into poverty. The SARS outbreak in 2003 cost the economies of East Asia between $30-50 billion and estimates of the global economic cost of an influenza pandemic range from $374 billion, for a mild pandemic, to $7.3 trillion, for a severe pandemic - with a 12.6% loss of gross domestic product.
Strategically, policies to address a potential pandemic threat are constrained by an unresolved debate over the use of adaptive measures - that aim through the use of technological measures to reduce the impact of diseases after they have emerged vs mitigation measures - that focus on the underlying causes of disease emergence. The adaptive tools we traditionally rely on to protect us from the world of infectious diseases – vaccine and therapeutics – too often are shown ineffective against a novel threat; and, the timely development and deployment of new and effective biomedical countermeasures is undercut by the speed at which the threat spreads.
Similarly, our ability to mitigate the emergence of new threats is undermined by a lack of knowledge about the viral ecology and the drivers, including human behaviors, which propel the emergence of a new threat. It is at these moments we realize just how few our adaptive and mitigation options are – and how vulnerable the global community is. After each episode the world admonishes itself for being ill prepared to deal with a global threat – but after decades of largely reacting adaptively to each event, with only a tangential focus on mitigation, we are only marginally better able to deal with the next one.
The development and commercialization of antimicrobials stands as a defining achievement of 20th century medical practice. Antimicrobials heralded an era of expanded life expectancy, paved the way for advanced medical and surgical treatments, improved animal health and welfare, and made possible curative therapy for once fatal infections. Decades of superfluous and inattentive use of antimicrobials across the human and animal health sectors now threaten these advancements. The pace of reported treatment failures and antimicrobial resistance (AMR) in common pathogens is increasing, with multi-drug resistant pathogens creating the prospect of a ‘post antibiotic’ world. In the absence of interventions, AMR-associated human mortality is projected to soar from a current rate of 700 000 to over 10 million annually by 2050—as readily treatable infections become life threatening, and routine procedures are rendered unsafe. Asia is expected to account for half of this projected global mortality. The impact of AMR on morbidity and mortality is matched by a substantial economic burden, with resistance linked to aggregate losses anticipated to exceed USD 100 trillion by 2050.
Antimicrobial resistance is exacerbated by the unregulated use of antimicrobials across both the human health and animal health sectors. A particular concern is the shared use of same classes of antibiotics in humans and in animals, potentially exacerbating the selection pressures on pathogen populations in animals and humans that encourage the development of resistance and exchange of resistance genes. By example, in the United States the livestock production industry accounts for 80% of the total use of antibiotics used for treatment of human infections.
Antimicrobial resistance is one of the three flagship topics for the tripartite (FAO, OIE and WHO) collaboration. At the Sixty-eight World Health Assembly in May 2015, the World Health Assembly endorsed the Global Action Plan (GAP) on AMR and requested to strengthen the tripartite collaboration between FAO, OIE and WHO for combating antimicrobial resistance in the spirit of the “One Health” approach. The Global Action Plan, which ensured a One Health approach and consistency with Codex Alimentarius and OIE inter-governmental standards and guidelines, aims to ensure continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them. Guided by this global action plan, the Member States, the Secretariat, and their international and national partners aim to: (1) improve awareness and understanding of antimicrobial resistance; (2) strengthen knowledge through surveillance and research; (3) reduce the incidence of infection; (4) optimize 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.
A high level meeting on anti-microbial resistance was held in September 2016 at the United Nations General Assembly, generating a statement of global commitment to address AMR through a multi-disciplinary approach.
Protecting the world from the threat of zoonotic diseases and ensuring effective stewardship of antibiotics requires a common and well-coordinated multi-sectoral effort. While there has been significant progress in building multi-sectoral One Health action against zoonotic diseases, AMR efforts remain highly siloed with an unequal focus on the respective contributions made by the inappropriate use of antibiotics in clinical care and animal production, as well as limited opportunities for bringing human, animal and environmental health sectors together to forge a common strategy. There is an urgent need to bring a comprehensive One Health risk mitigation approach to address zoonotic and AMR related diseases that addresses the direct consequences of animal-human interactions and contributory pressures related to environmental and climate changes.
PMAC 2018 will provide an important setting for fostering policy and strategic action by engaging multi-sectoral experts in zoonosis and AMR, as well as climate change and related environmental fields from across the public and private sectors, international organizations, foundations, academics and non-governmental organizations, as well as critical players in Global Health Security Agenda (GHSA). Importantly, a PMAC sponsored “Making the World Safe from the Threats of Emerging Infectious Diseases” would build on PMAC 13’s highly successful conference on One Health and lead to real change.
Since 2007, the Prince Mahidol Award Conference has been organized as an annual international conference focusing on policy-related public health issues of global significance – including, Universal Health Coverage, Health Equity, Meeting the Needs of Vulnerable Populations, and addressing the threats posed by infectious diseases. Each of these meeting has brought together leading public health leaders and stakeholders from around the world to propose concrete solutions and recommendations. PMAC 2018 will explicitly look to build on the successes of past PMACs and to identify opportunities to further contribute to the systems and capacities required to address the comprehensive health needs of the world’s populations.
Learning from the Past: Towards Effective and Sustainable Policies, Practices and Capacities for “Prevention, Detection and Response” to Emerging Zoonosis and Antimicrobial Resistance
Read moreHarnessing the Power of Public-Private-Community (PPC) Partnerships for “Preventing, Detecting, and Responding” to Zoonosis and AMR
Read moreUnderstanding the Selection Pressures Underlying Emergence of Zoonotic Diseases and Antimicrobial Resistance and the Broad Benefits Realized From Promoting Healthy Animals and Healthy People
Read morehis sub-theme is focused on presenting evidence for how efforts across the globe over the past two decades to address zoonotic and AMR related threats are contributing to more effective policies, practices and capacities for “prevention, detection and response” to EIDs. Given the inherent multi-sectoral aspects of disease emergence this is an opportunity to learn from recent experience with efforts such as the Global Health Security Agenda (GHSA), International Health Regulations, the One Health movement, and other platforms illustrating challenges and solutions for building effective partnerships for addressing zoonosis and AMR.
Issues to be discussed under this sub-theme are:
What we have learned from country, regional and global level experiences in addressing EIDs
What are the lessons learned on building global and regional level partnerships, including the GHSA, One Health and Planetary Health, to address EIDs
What is the evidence for proactive, flexible structures that enhance capacities and preparedness across the prevention-detection-response continuum?
What are examples of sustainable financing structures? What have we learned from:
What are examples of “preparedness” activities that address long-term sustainability?
Which financing models have proven utility in employing an evidence driven approach to discouraging high risk practices and incentivizing risk mitigation in approaching pandemic prevention as a global public good?
This sub-theme is focused on examining the evidence for building effective partnerships that bring together community, private sector and public sector resources for sustainably addressing the threats posed by zoonosis and AMR. As with the previous sub-theme, the inherently multi-sectoral nature of zoonosis and AMR requires active engagement across multiple stakeholders. In addition to the Public sector, Private sector actors who may be directly engaged in activities that inadvertently contribute to “drivers” for EIDs will need to be actively involved in any efforts to better mitigate the consequences of their activities. Similarly, communities are key stakeholders, both as consumers and potential contributors to some of the drivers that underlie disease emergence (e.g. inappropriate use of antibiotics in rearing of livestock and aquaculture)
Issues to be discussed under this sub-theme are:
What are the lessons from PPC partnerships in addressing EIDs
What are examples of how risk communications have successfully affected community and/or individual level practices and behaviors on a scale significant enough to reduce the risk from zoonotic threats and/or AMR
This sub-theme is focused on both:
There has been a general recognition that the adoption of a core set of best practices that are designed to directly target the drivers associated with zoonosis and AMR are likely to simultaneously contribute to positive outcomes across a range of “other” domains and the achievement of the United Nations Sustainable Development Goals, such as food security, household wealth and economic growth, as well as healthier environments and sustainable communities.
a.) Issues to be discussed under this sub-theme will allow a presentation of the evidence for the drivers of EID emergence:
b.) Issues to be discussed under this sub-theme also will allow a presentation of the evidence to broad collateral benefits accrued from targeting the drivers of EID emergence:
Name – Surname |
Position |
Organization |
Role |
---|---|---|---|
Dr. Vicharn Panich |
Chair, International Award Committee |
Prince Mahidol Award Foundation, Thailand |
Chair |
Dr. Peter Salama |
Executive Director, Health Emergencies Programme |
World Health Organization, Switzerland |
Co-Chair |
Dr. Timothy Evans |
Senior Director for Health, Nutrition and Population (HNP) |
The World Bank, USA |
Co-Chair |
Mr. Magdy Martínez-Solimán |
Assistant Secretary General, Assistant Administrator, and Director, Bureau for Policy and Programme Support |
United Nations Development Programme, USA |
Co-Chair |
Dr. Michel Sidibé |
Executive Director |
Joint United Nations Programme on HIV/AIDS, Switzerland |
Co-Chair |
Ambassador William Lacy Swing |
Director General |
International Organization of Migration, Switzerland |
Co-Chair |
Dr. Osamu Kunii |
Head, Strategy, Investment and Impact Division (SIID) |
The Global Fund to Fight AIDS, |
Co-Chair |
Dr. Irene Koek |
Acting Assistant Administrator |
United States Agency for International Development, USA |
Co-Chair |
Dr. Roger Glass |
Director, Fogarty International Center Associate Director for International Research |
National Institutes of Health, USA |
Co-Chair |
Dr. Takao Toda |
Vice President for Human Security and Global Health |
Japan International Cooperation Agency, Japan |
Co-Chair |
Dr. Lincoln C. Chen |
President |
China Medical Board, USA |
Co-Chair |
Mr. Michael Myers |
Managing Director |
The Rockefeller Foundation, USA |
Co-Chair |
Dr. David Heymann |
Head of the Centre on Global Health Security |
Chatham House, United Kingdom |
Co-Chair |
Dr. Trevor Mundel |
President of the Global Health Division |
Bill & Melinda Gates Foundation, USA |
Co-Chair |
Dr. Kazuaki Miyagishima |
Director, Department of Food Safety and Zoonoses (Tripartite Secretariat) |
World Health Organization, Switzerland |
Member |
Dr. Juan Lubroth |
Chief Veterinary Officer |
Food and Agriculture Organization of the United Nations, Italy |
Member |
Dr. Tianna Brand |
Head, Biological Threats Reduction and Operational Partnerships |
World Organisation for Animal Health, France |
Member |
Ms. Karin Hulshof |
Regional Director, East Asia and the Pacific Regional Office |
UNICEF, Thailand |
Member |
Dr. Sabrina Sholts |
Curator, National Museum of Natural History |
Smithsonian Institution, USA |
Member |
Dr. Katherine Bond |
Vice President, International Regulatory Affairs |
U.S. Pharmacopeia, USA |
Member |
Dr. Ceci Mundaca-Shah |
Director, Forum on Microbial Threats |
The National Academies of Sciences, Engineering, and Medicine, USA |
Member |
Dr. Larry Madoff |
Editor, ProMED-mail |
International Society for Infectious Diseases, USA |
Member |
Dr. George Gao |
Deputy Director-General |
Chinese Center for Disease Control and Prevention, China |
Member |
Dr. Mark Smolinski |
Chief Medical Officer and Director, Global Health Threats |
Skoll Global Threats Fund, USA |
Member |
Dr. Anette Hulth |
International Coordinator, Unit for Antibiotics and Infection Control |
Public Health Agency of Sweden, Sweden |
Member |
Dr. Soonman Kwon |
Technical Advisor (Health) |
Asian Development Bank, Philippines |
Member |
Dr. Kamran Abbasi |
Executive Editor |
British Medical Journal, United Kingdom |
Member |
Dr. David Sanders |
Founding Director of the School of Public Health |
University of the Western Cape and People's Health Movement, South Africa |
Member |
Mrs. Busaya Mathelin |
Permanent Secretary |
Ministry of Foreign Affairs, Thailand |
Member |
Dr. Jedsada Chokdamrongsuk |
Permanent Secretary |
Ministry of Public Health, Thailand |
Member |
Dr. Supat Vanichakarn |
Secretary General |
Prince Mahidol Award Foundation, Thailand |
Member |
Dr. Sakchai Kanjanawatana |
Secretary General |
National Health Security Office, Thailand |
Member |
Dr. Peerapol Sutiwisesak |
Director |
Health Systems Research Institute, Thailand |
Member |
Dr. Banchong Mahaisavariya |
President |
Mahidol University, Thailand |
Member |
Dr. Prasit Watanapa |
Dean, Faculty of Medicine Siriraj Hospital |
Mahidol University, Thailand |
Member |
Dr. Piyamitr Sritara |
Dean, Faculty of Medicine Ramathibodi Hospital |
Mahidol University, Thailand |
Member |
Dr. Suwit Wibulpolprasert |
Vice Chair |
International Health Policy Program Foundation, Thailand |
Member |
Dr. Viroj Tangcharoensathien |
Senior Advisor |
International Health Policy Program, Thailand |
Member |
Dr. Attaya Limwattanayingyong |
Director, Global Health Division |
Ministry of Public Health, Thailand |
Member |
Dr. Sylvie Briand |
Director, Pandemics and Epidemic Diseases |
World Health Organization, Switzerland |
Member & Joint Secretary |
Dr. Toomas Palu |
Sector Manager for Health, Nutrition and Population, East Asia and Pacific Region |
The World Bank, Thailand |
Member & Joint Secretary |
Dr. Douglas Webb |
Cluster Leader, Mainstreaming, Gender and MDGs, HIV, Health and Development Group |
United Nations Development Programme, USA |
Member & Joint Secretary |
Dr. Eamonn Murphy |
Director, UNAIDS Asia Pacific Regional Support Team |
Joint United Nations Programme on HIV/AIDS, Thailand |
Member & Joint Secretary |
Dr. Davide Mosca |
Director of the Migration Health Division |
International Organization for Migration, Switzerland |
Member & Joint Secretary |
Dr. Dennis Carroll |
Pandemic Influenza and Other Emerging Threats Unit Director |
United States Agency for International Development, USA |
Member & Joint Secretary |
Mr. Ikuo Takizawa |
Deputy Director General |
Japan International Cooperation Agency, Japan |
Member & Joint Secretary |
Dr. Piya Hanvoravongchai |
Southeast Asian Regional Coordinator |
China Medical Board, Thailand |
Member & Joint Secretary |
Ms. Natalie Phaholyothin |
Associate Director |
The Rockefeller Foundation, Thailand |
Member & Joint Secretary |
Dr. David Harper |
Deputy Head of the Centre on Global Health Security |
Chatham House, United Kingdom |
Member & Joint Secretary |
Dr. James Platts |
Strategy Advisor |
Bill & Melinda Gates Foundation, USA |
Member & Joint Secretary |
Dr. Manee Rattanachaiyanont |
Deputy Dean for Academic Affairs |
Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand |
Member & Joint Secretary |
Dr. Pongpisut Jongudomsuk |
Senior Expert |
National Health Security Office, Thailand |
Member & Joint Secretary |
Dr. Churnrurtai Kanchanachitra |
Professor |
Institute for Population and Social Research, Mahidol University, Thailand |
Member & Joint Secretary |