27 July 2015
On June 15th, Every Woman Every Child of the United Nations (UN) Secretary-General’s Office organized a UN briefing on Antimicrobial Resistance (AMR): An Emerging Global Threat for Member States and intergovernmental agencies in New York City. Ten Member States co-hosted the event as well as the UN Foreign Policy and Global Health group and the AMR Review commissioned by the United Kingdom. UK Ambassador to the UN, Matthew Rycroft, and Nana Kuo of Every Woman Every Child opened this first of a potential series of events to raise awareness over AMR.
Lord Jim O’Neill, chairman of an independent review on AMR, detailed the economic and medical need to address this issue, citing the cost of inaction as 10 million deaths and $100 trillion by the year 2050. His review noted that although AMR is a burden for countries at all income levels, Asia and Africa disproportionately bear the highest mortality, with both continents each projected to have greater than ten times the burden of AMR-related deaths than Europe, North America, or Latin America. Lord O’Neill concluded by calling for continued global cooperation to expand past the G7 and WHO to the G20 Economies and the United Nations.
Professor Anthony So, director of ReAct’s Strategic Policy Program and ReAct North America, then highlighted many bottlenecks in the research and development of novel antibiotics and discussed other tools needed to combat antibiotic resistance. Dr. So noted that tackling antibiotic resistance is an intersectoral challenge, requiring innovation of both new antibiotics as well as policies to protect their effectiveness through rational use and demonstration of responsible non-human use. He also described the dilemma of ensuring access, but not excess in antibiotic use, citing that fewer than one in three children with suspected pneumonia received antibiotics when necessary, while at the same time large numbers of children with diarrhea received inappropriate antibiotics when oral rehydration therapy would be most effective. Dr. So then discussed that although effective antibiotics are crucial to many levels of both basic healthcare and modern medicine, scientific bottlenecks in the R&D pipeline have resulted in a critical shortage of novel antibiotics. A proposed solution to finance the innovation of antibiotics and achieve access, but not excess, is delinkage—or the divorcing of return on investment from volume-based sales, price times quantity. Dr. So outlined how potential solutions such as delinkage might be characterized by how they share the 3 Rs–risks, resources, and rewards. He concluded by remarking how a new R&D framework for antibiotic innovation is not new, as demonstrated by the discovery and scale-up of penicillin in the 1940s, and urged that the need for a concerted global response to antibiotic resistance has never been greater.
Author and journalist Maryn McKenna followed these presentations by narrating the development of antibiotic use in animals. She began by citing the fact that in 2011 almost four times the amount of antibiotics used to treat humans were sold for meat and poultry production, with this gap appearing to widen in the past decade. She detailed concerns over agricultural antibiotic use dating back to the 1960s. McKenna also brought attention to the need for further scientific studies to demonstrate the threat irresponsible animal use of antibiotics poses to human health and showed that the largest use of antibiotics in agriculture spans through both high and middle income countries.
Dr. Nata Menabde, Executive Director of the World Health Organization (WHO) Office at the UN, discussed the Global Action Plan (GAP) on Antimicrobial Resistance, first describing the landscape of current resistance surveillance worldwide in communities, hospitals and veterinary sources. She then detailed the process through which the 2015 World Health Assembly (WHA) passed the GAP and its five guiding principles: whole of society engagement, prevention, access to health services and products, sustainability and incremental implementation. The GAP also includes five strategic objectives to improve awareness and understanding, strengthen surveillance and research, reduce infections, optimized antibiotic use, and ensure sustainable development.
Nana Kuo of Every Woman Every Child added, “There is an urgent need for innovation in the area of antibiotics and broader access to – but not excess use of – existing drugs. This will require investments and collaboration for both pharmaceutical innovation as well as financing approaches to ensure universal access to health care.”
Prepared interventions were also invited from Joanne Carter (Stop TB Partnership), Annette Hulth (Swedish Public Health Agency), Reinhard Krapp (Dept for Economic and Financial Affairs, Mission of Germany) and Carl Nathan (Cornell University).
The stream of the entire event webcast can be found online, alongside a compilation of starter resources (PDF) on antimicrobial resistance assembled by ReAct North America specifically for this meeting.