Tackling National Plans Financing, Equitable Access to Treatments, High-Level Meeting on Antimicrobial Resistance Approves Draft Political Declaration
Acknowledging that antimicrobial resistance is an urgent threat to global human and animal health, food security, the environment and development, Member States approved a political declaration on the menace this morning.
By the text, Member States would commit to, among other things, financing all related national action plans by 2030, strengthening health coverage and veterinary services, reducing the use of antibiotics in agriculture, promoting equitable access to treatments, vaccines and diagnostics and encouraging research and innovation. The declaration will be submitted to the General Assembly for final adoption.
Tedros Adhanom Ghebreyesus, Director-General for the World Health Organization (WHO), recalled Alexander Flemming, who accidently discovered Penicillin, adding: "If he were here today, he would probably say 'I told you so',". In Flemming’s acceptance speech for the Nobel Prize in Physiology or Medicine in 1945, the British microbiologist had already observed how easily resistant bacterial strains can be developed in a laboratory setting.
An estimated 1.3 million deaths, disproportionately affecting children, occur yearly due to resistant infection strains, Mr. Ghebreyesus continued. Highlighting a lack of funding, he noted that only 11 per cent of countries have budgets for implementing plans addressing the threat. “Antimicrobial resistance could reverse decades of medical progress making infections, routine surgeries, cancer treatment and organ transplants far riskier or even life threatening,” he warned. General Assembly President Philemon Yang (Cameroon) echoed these concerns, adding that antimicrobial resistance could cause 10 million deaths each year by 2050.
Speaking with first-hand experience, Gabriella Balasa, who was born with cystic fibrosis, said she wanted to put a human face on the issue of antimicrobial resistance. Because of her genetic disease, she is particularly vulnerable to lung infections, and in 2019, suffered a drug-resistant acute infection that almost killed her. Attributing her survival to an experimental combination of treatments, she said: “My health condition means that I am at a life-long risk of infections and this is something I will never escape from.” While antimicrobial resistance is the greatest threat to her life and many others in her situation, anyone can contract a resistant strain, she pointed out, issuing a call to raise awareness and act now to develop new antimicrobials before resistance cases increase exponentially.
Numerous experts, ministers and representatives emphasized the need to streamline the use of antimicrobials. The Minister for Health of Namibia recalled the establishment by his country of national guidelines on medical prescriptions, while the Minister for Health and Social Development of Mali announced the publication of learning modules on the rational use of antibiotics.
Further, the Minister for Health of Latvia highlighted the establishment of a platform, in collaboration with Sweden, to keep up to date with doctors’ decisions and guidelines. Similarly, the Minister for Health of Italy stressed the crucial role of education and awareness in reducing the use of antibiotics. “We must engage communities in understanding the importance of antimicrobials and the consequences of their misuse,” he declared.
Antimicrobial resistance does not just affect humans, however, Thanawat Tiensin, Deputy Director-General of the Food and Agriculture Organization (FAO) observed. Antimicrobial use must be limited in agriculture and livestock, he continued, citing his Organization’s RENOFARM initiative that addresses that, and doubles as an agricultural monitoring and training program in line with their 2021-2025 action plan.
Emmanuelle Soubeyran, Director-General of the World Organisation for Animal Health, said that an increase in good practices for livestock, including using vaccines, can reduce the need for antimicrobials. The guidelines for implementing strategies are clear, she said, calling for a greater investment in animal health which “is everyone’s health”.
On a positive note, she welcomed the fact that 130 Member States had established a register of antibiotic use in livestock, noting that such measures are essential for monitoring and decision-making. Moreover, the use of antimicrobials primarily used for humans reduced by 30 per cent in recent years, she added.
Several speakers stressed the importance of surveillance systems to inform health authorities and speed up decision-making, including the Minister for Health of Panama, who set up a group to monitor antimicrobial resistance in humans and animals. As well, the Minister for Health and Public Hygiene of Burkina Faso highlighted a national network of 22 surveillance sites, sounding the alarm about the frightening increase of the antimicrobial resistant Escherichia coli bacteria in particular.
Echoing that warning, the Minister of Mali, said that five national surveillance sites in his country had recorded an 89 per cent increase of Staphylococcus aureus strains resistant to penicillin, and 75 per cent of Escherichia coli resistant to several common antibiotics. A further step in surveillance must be taken, going beyond national borders, urged the Minister for Foreign Affairs and Expatriates of Yemen, calling for the creation of an international monitoring system in collaboration with WHO.
Several speakers stressed the importance of diagnostic tools and methods in the fight against antimicrobial resistance, as they are an essential to any surveillance system. The Minister for Health of Uganda called for rapid and affordable diagnostic methods, a necessity to promote research and development in this sector. The Prime Minister of the Republic of Moldova and the Minister for Health of Italy echoed her position.
Speaking for the Alliance of Countries against Tuberculosis, Indonesia’s Minister for Health called for drug-resistant tuberculosis to be included in the antimicrobial resistance agenda. They are not separate issues, he stressed, noting that globally, the disease accounts for one third of deaths from infections by a resistant strain of bacteria. Drug-resistant tuberculosis is longer and harder to treat, he noted, also highlighting more severe side effects for the patient and increased pressure on health systems.
The importance of funding research was also highlighted, including by Inger Andersen, Executive Director of the United Nations Environment Programme (UNEP), who said it was crucial to align research, grants and policies as “antimicrobial resistance was leaking into our environment, from municipal waste, as well as wastewater, from pharmaceutical production, from hospitals, [and] from farms that overuse an intensified crop production sprayed with antimicrobials”. Echoing that, Mia Amor Mottley, Prime Minister of Barbados and Chair of the Global Leadership Group on Antimicrobial Resistance added that funding research is the most important measure.
Several speakers underscored that antimicrobial resistance disproportionately affects developing countries and was hampering progress in combating other diseases, such as HIV/AIDS and hepatitis, in the Global South. As well, it was threatening not only human health, but also food security and the environment. Speakers also urged the “One Health” approach, which integrates and unifies public, animal and environmental health issues. To that point, Ms. Mottley echoed their concerns, warning against a silo approach, where health, agriculture and water are addressed separately.