This 71st session of the World Health Assembly (WHA) offers a unique space for health specialists, in a multitude of areas affecting global health and its future, to interact, share and learn. Mirfin Mpundu, Head of React Africa, contributed to a side brainstorming event for civil society with the title: "AMR Control: Are We Off Track?"
At this year’s WHA, a number of side events included antimicrobial resistance (AMR), one of which was the Geneva Global Health Hub where Mirfin Mpundu, Head ReAct Africa, sat on the panel whose theme was ‘”Antimicrobial Resistance – Are we on track?”. This event was in the form of a round table discussion with audience participation.
The primary purpose was to think through and evaluate concerns where antimicrobial resistance control currently stands, on the global health goals set. Other panelists included Marc Sprenger (WHO), Mireille Martini (Finance Watch), Awa Aidara Kane (WH)-AGISAR) and Jean Carlet, (WAAR) and was moderated by Garace Upham (WAAAR).
Civil society organizations can catalyze action
One encouraging point was that many countries have developed National Action Plans on AMR, however, very few countries have begun implementation, in particular low- and middle income countries. Lack of financial resources and technical capacity are some of key obstacles.
Mirfin Mpundu highlighted the role that civil society has played in catalyzing action on antimicrobial resistance by providing technical and financial support for National Action Plan development in the African region. He emphasized that civil society organizations (CSOs) can play an instrumental role not only as partners with the government but also providing stakeholder platforms for collaboration and integration of the plan.
He also added that civil society organizations have the capability to function as monitoring and evaluation agents tracking the progress on commitments that governments make in areas such as surveillance, affordable access, infection prevention and control, and raising AMR awareness as outlined in the various National Action Plans.
Reminding everyone of the Abuja Declaration of 2001 where African countries committed to spending at least 15% of their national budget to the strengthening of health systems, Mirfin Mpundu noted that only a few countries have achieved this target, with many still hovering below 10% spending. This is a clear area where civil society organizations monitoring efforts are needed to hold governments accountable.
“Everyone needs to pitch in while holding African countries accountable to their Abuja Declaration of investing at least 15% of their national budgets to health systems strengthening, which is not happening.”
Mirfin Mpundu, Head of ReAct Africa
It is worth noting that is has been almost 10 years since ReAct and EPN with support from USAID/SIAPS, began the efforts to support African countries with their NAP on AMR. From carrying out situational analysis to support with the development of National Action Plans on AMR to now the implementation process, it is and continues to be, a long standing commitment by React and Ecumenical Pharmaceutical Network (EPN) to see the African continent succeed containing antimicrobial resistance.
“Africa has the highest burden of infectious diseases and continues to face a high threat of antibiotic resistance. Poor health systems, weak or nonexistent surveillance systems, weak regulatory systems, influx of substandard medicines and the lack of access to affordable and quality-assured medicines, puts Africa in a precarious situation in relation to antimicrobial resistance. However, Africa is a resilient continent and its countries do need support, both technical and financially, in the development and implementation of National Action Plans on AMR.”
Discussions tackled fundamental components of antibiotic resistance
The discussion was vibrant with many questions and contributions adressing fundamental components of antimicrobial resistance such as:
- Challenging the notion of putting emphasis on the production of new antibiotics instead of public investment in other important areas.
- Questioning why stewardship dominantly focused on the poor patient at the end of the line rather than marketing i.e. FDCs of antibiotics being produced and marketed.
- Pondering why there seemed no attention was made to the acute shortages in the production of old yet effective antibiotics and vaccines, from Bangladesh to France.
- Pointing to the shortfalls in laboratory capacities in poor countries that would otherwise make surveillance “home-based’, and
- Suggesting that we take a couple of steps away from the threat of AMR and take a preemptive approach by improving health care delivery systems which would reduce transmission and make care for AMR infections fewer and cheaper.
At an earlier event with the International Federation of Medical Students Associations (IFMSA) Mirfin extensively spoke on how CSOs play a part in AMR NAP development using ReAct/EPN examples and connecting them with the SDGs. The meeting theme was “Addressing Antimicrobial resistance: A Threat to Global Health and the Achievement of UHC”.
The work that EPN has done supporting NAP development with other partners in Zimbabwe, Malawi, Kenya, Ghana, Zambia, Zimbabwe, Uganda, Tanzania and Nigeria shows how instrumental civil society can be in this space.