Table 2 The ten most urgent priorities for action against the spread of antimicrobial resistance cited by participants of the 4 ^th WHAI Forum

For policy-makers and health authorities:

1

Limit the use of antimicrobials in food-producing animals by banning non-therapeutic applications, including growth promotion and metaphylaxis

2

Establish and enforce regulations on sales of antimicrobials for use in human medicine, including prohibition of over-the-counter sales worldwide

3

Develop a detailed charter on antimicrobial conservation to be ratified and upheld by ministries of health worldwide

4

Develop coordinated and culturally sensitive awareness campaigns targeting the general public and imparting the importance of protecting antimicrobials as a limited and non-renewable resource

5

Rigorously support the improvement of sanitation systems to eliminate resistant microbes in wastewater; regularly provide education about fundamental practices such as hand hygiene to prevent the spread of infection

6

Together with the pharmaceutical industry, explore (1) incentives to stimulate research and fast-track development of novel antimicrobials and (2) new economic models that reconcile public health interests with industry profitability

For the human and veterinary healthcare communities:

7

Establish standardized, universal methods and metrics for surveillance of antimicrobial use and resistance development, respectively

8

In medical and veterinary school curricula, require universal and detailed instruction in microbial resistance development and the prudent use of antimicrobials; for physicians and veterinarians in training, require on-the-job refresher courses

For the general public:

9

Include patients and other antimicrobial consumers in the development and implementation of action plans

For industry:

10

Continue to develop and advance point-of-care rapid diagnostic tests to avoid the prescription of antibiotics for viral infections and allow more targeted therapy