The story of ReAct started 15 years ago with a small group of people, many who are still with the network today. They all shared a passion for global health, and felt the urgency to address the growing problem of antibiotic resistance. The network has since grown, with the presence of offices in 5 continents and many passionate members working together. This year ReAct is celebrating 15 years of action on antibiotic resistance!
ReAct was created in 2005 with the goal to become a catalyst for global engagement and action on antibiotic resistance by bridging the gap between science and policy and turning what was then largely seen as a medical and technical issue, into one of social and political importance.
Together with the Dag Hammarskjöld Foundation, Professor Otto Cars, internationally renowned specialist in infectious diseases, organized a small pre-meeting on antibiotic resistance in 2004. His mission to wake the world up to the threat of antibiotic resistance started in Sweden already in the 1990’s. The meeting brought forward the idea of creating an international network on antibiotic resistance.
In 2005, a larger meeting was held with engaged champions from across the globe at which ReAct was formally inaugurated. Several people who attended this first meeting are still with ReAct today: Dr Arturo Quizphe-Peralta Director of ReAct Latin America, Professor Sujith Chandy Director of ReAct Asia Pacific, Professor Anthony So Director of ReAct North America and Professor Otto Cars.
ReAct’s engagement for concerted action to antibiotic resistance has significantly contributed to many of the important initiatives that today are ongoing globally at different levels.
For more detailed accomplishments:
THE EARLY YEARS 2004-2010
Targeting the WHO – generating evidence and identifying barriers for innovation of antibiotics
In the early years, ReAct’s main focus of work was on convincing the WHO to take leadership on the issue. The WHO had published its first strategy on antibiotic resistance already in 2001, but follow up was limited. Dr. Richard Laing (WHO) who attended the antibiotic resistance pre-meeting in 2004, was working on the WHO report “Priority Medicines for Europe and the World”. ReAct’s advocacy helped to position antibiotics strongly in the report, as co-authors of a chapter on antibiotics.
Data needed – for political attention
At the time a major obstacle for getting political attention to antibiotic resistance was due to limited reliable data on the burden of resistant infections. To address this gap ReAct worked with the European Center for Disease Control (ECDC) and the European Medicines Agency (EMA) to produce a joint technical report called “The bacterial challenge: time to react”, which succeeded in creating a lot of attention at the time.
Changing the paradigm of antibiotic resistance in Latin America – it is not a war
Meanwhile, ReAct champions continued to take action in many parts of the world. In 2007, ReAct Latin America was initiated. Today it is a strong network with strong roots in communities and academia in Ecuador, Argentina, Bolivia and Peru. Changing the paradigm of antibiotic resistance away from “a war on bacteria” has been and still is central to the work in the node.
Very first pipeline analysis for development of new antibiotics
Another key focus area was to address the barriers causing a lack of a sustainable pipeline of new antibiotics. Again together with the ECDC and the EMA, data was collected as part of the very first pipeline analysis which showed the pipeline to be in a very worrying state. Two major events came out of this analysis. ReAct supported Sweden in making the development of new antibiotics a core focus of the work program under the Swedish European Council Presidency in 2009. This lead to the Conclusions of the European Council on Innovative incentives for effective antibiotics, laying the groundwork for the first EU Action plan on Antimicrobial Resistance, adopted a few years later.
The second event was a ReAct-organized Global Conference in 2010; “Global Need for Effective Antibiotics – moving towards concerted action” organized in Uppsala, Sweden. More than 200 participants from all across the globe met for 3 days to discuss the complexity of the problem and identifying possible solutions. ReAct subsequently co-authored the publication “Critical shortage of new antibiotics in development against multidrug-resistant bacteria—Time to react is now”.
THE EXPANSION YEARS 2010-2019
First international ReAct conferences in Latin America
One of the earliest awareness raising activities organized by ReAct Latin America, was an early project called PhotoResistenciá – a travelling photo-exhibition on antibiotic resistance to raise awareness amongst health professionals and the public. ReAct Latin America’s regional efforts include the organization of several large international conferences beginning in 2013 with “Recovering the health of ecosystems to contain bacterial resistance to antibiotics”, with participants from 32 countries.
A long-term project is the Alforja Educativa – an educational package for children in middle school using child to child learning methodology. The material also engages and educates the teachers, and the children educates their parents – giving a long-term perspective to bacteria and health. This project has been expanded to include a number of counties in Kenya by ReAct Africa in 2018.
2010: ReAct South East Asia: champions mobilized to transform national level policies and implement community programs on antibiotic resistance
In 2010, a ReAct network in South East Asia was initiated. Leveraging the close links of ReAct members with key health activists, champions were mobilized trying to transform national level policies and implement community outreach programs on antibiotic resistance. Fruitful links with for example the Thai Antibiotic Smart Use programs were made, and early meetings held in the region attracted participants from for example Singapore, Malaysia, Vietnam, Thailand, and India. The dispersed nature of the network was difficult to maintain while growing and after a period of hiatus, in 2016 the ReAct Asia Pacific node was inaugurated with a base in Vellore, India. ReAct Asia Pacific works to mobilize policy makers and encourages locally appropriate initiatives to develop innovative solutions to the issue of antibiotic resistance, such as work to establish antibiotic SMART communities. They have also provided input to the first state Action Plan on AMR, in Kerala.
2015: ReAct Africa: grown into a credible resource and trusted partner for important African actors
One unintended positive outcome from the ReAct 2010 conference mentioned earlier, was a collaboration in 2011-2012 between ReAct and the Ghanayan government to support the formation of a national working group on antibiotic resistance. This led to Ghana being the first country in Africa to form a multi-sectorial coordination group on antibiotic resistance. In addition, ReAct also collaborated with other organizations and individuals in Africa. In 2015, a regional meeting was held where the establishment of a new African node was suggested – and so ReAct Africa was born. The node is now firmly established as a credible resource and trusted partner of a number of important actors in the African region including governments, the African CDC, and local and regional communities. African AMR champions trained by ReAct have gone on to lead country initiatives on antimicrobial resistance and ReAct Africa’s fingerprint is on most NAPs in the region, as well as regional initiatives, such as the SADC AMR Framework. The ReAct Africa conference has become an important regional meeting place and gathered over 120 multi-sector participants from 31 African countries in 2019.
The Antibiotic Resistance Coalition – a CSO network initiated by ReAct
The Antibiotic Resistance Coalition (ARC) consists of civil society organizations and stakeholders from six continents working in the health, agriculture, consumer and development sectors. Established in May 2014 and launched during the World health Assembly in Geneva, the Coalition advocates for policy change and action on antibiotic resistance. At the launch, a declaration on antibiotic resistance was adopted and today its ranks include 30 civil society groups, bringing breadth in expertise and advocacy networks for stronger civil society voice in global policy processes. ReAct North America functions as the coalition’s secretariat.
ACCESS TO EFFECTIVE ANTIBIOTICS – CORE OF ReAct’s MISSION
Since its inception, ReAct has highlighted the need for novel antibiotics and was among the first to discuss the idea of de-linkage in the field of antibiotics – i.e. divorcing the cost of investment in research and development on antimicrobial resistance from both the price and volume of sales.
Early on, ReAct initiated high-level discussions on how new antibiotics could and should be managed to secure both affordable access and to make sure they are appropriately used. ReAct has since then been engaged in a number of policy initiatives for the development of new antibiotics and has advised policymakers on the complex and interrelated challenges of innovation, access and conservation.
ReAct participated in first-ever UN Briefing on AMR
In June 2015, ReAct participated in the first-ever UN Briefing on “Antimicrobial Resistance: An Emerging Global Threat”, hosted by Every Woman Every Child. In 2016, the work of ReAct and many others paid off when antimicrobial resistance (AMR) was elevated to the UN level, as only the 4th health topic ever to be discussed in the UN General Assembly in 2016. The resulting political declaration signed by all member countries highlighted both the principle of de-linkage and led to the establishment of the ad hoc UN Interagency Coordination Group (IACG) on Antimicrobial Resistance in 2017.
Two of ReAct’s staff, Professors Otto Cars and Anthony So were members of the IACG, which delivered its recommendations for global action to the UN Secretary General in 2019.
In 2017, ReAct Europe initiated work to showcase how the realization of several the Sustainable Development Goals (SDGs) were jeopardized by lack of effective antibiotics and initiated advocacy to influence the indicator framework. In 2020, at the first revision of the SDG framework, an indicator on antibiotic resistance was included.
The ReAct Toolbox
The ReAct Toolbox is a repository on antibiotic resistance that provides you with information, inspiration and guidance to take action. The purpose of the toolbox is to raise awareness, and to be a reliable resource for policy makers, health professionals and civil society organizations. It was officially launched at a side event at the World Health Assembly in 2015.
The development of the Toolbox was started by ReAct Europe in 2013 and the Toolbox has continuously been updated to better suit the needs of actors based in resource poor contexts, in low- and middle-income countries. It contains more than 500 quality reviewed open access resources and is continuously updated based on scientific evidence and experiences from those working in the field. It is supported by an advisory group of renowned experts that provide strategic and scientific advice. In 2020, more than 150,000 users from over 150 countries visited the ReAct Toolbox.