News and Opinions  –  2018

ReAct reflections on the Prince Mahidol Award Conference and the IACG Civil Society Engagement Panel

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2018-02-08

Thailand, being one of the most committed countries in dealing with antimicrobial resistance, proved the perfect host for this productive conference, with over 1000 visitors from over 70 countries. Given the strong emphasis on antimicrobial resistance, several people from ReAct joined the conference and discussions on sustainable solutions to contain antibiotic resistance. Antimicrobial resistance was at the top of the agenda, and for the first time at a high-level conference prominently discussed as an emerging infectious disease.

From the 29th of January to the 3rd of February the Prince Mahidol Award Conference (PMAC) took place in Bangkok, Thailand. The conference is unique in its focus on and ability to attract wide and active representation from lower and middle income countries. This year’s theme was “Making the World Safe from the Threats of Emerging Infectious Diseases”.

ReAct’s key messages at PMAC

ReAct presented at several of the side meetings and sessions. Mirfin Mpundu, head of ReAct Africa, spoke on the importance of quality-assured medicines for successful implementation of National Action Plans on AMR in Africa. He argued for the use of existing regional structures for joint surveillance programs, and the pooled procurance of antibiotics to improve quality of antibiotics. He also expressed his worries over the fact that many countries have developed their national action plans, but that almost no one has started implementation, and that financing is needed at all levels to make implementation possible.

Professor Otto Cars, founder of ReAct.

Professor Otto Cars, founder and Senior Advisor at React, also a member of the Interagency Coordination Group on AMR (IACG), argued for a more sustainable messaging on antimicrobial resistance:

“We need to get the narrative right, we need to move away from the war metaphor, and emphasize the importance of the microbiome”.

He also emphasized that the disposition that antimicrobial reistance is not a disease creates the lack of a ‘face’ for the problem. For the same reason there is also no funding home for antimicrobial resistance. There is a urgent need for antimicrobial resistance to find its place in global health funding.

Professor Cars also spoke on his experiences and the lessons learned from his work with Strama, the Swedish Strategic Program against antibiotic resistance. Among other things, he highlighted the usefulness of point prevalence surveys, which can be especially useful in resource-limited settings for getting a quick overview of the situation.

IACG Civil Society Engagement Panel: a success, with room for improvement

The panel at the IACG Civil Society Engagement Event.

During the Conference, the UN Inter Agency Coordination Group (IACG) on AMR arranged a civil society panel with the theme “Access without Excess”, moderated by Stefan Swartling Peterson, Chief of Health at UNICEF. On the panel was Mirfin Mpundu from ReAct and representatives from People’s Health Movement, Third World Network, Médecins Sans Frontières (MSF), the Access to Medicines Foundation, South Centre and the IACG itself. About 50% of the IACG was present and engaging actively. The consultation was opened by the WHO Director-General Dr. Tedros, who emphasized that participation of civil society is essential. He also promised increased support to the IACG.

ReAct’s Mirfin Mpundu highlighted  that access is not just about availability of antibiotics, but is a matter of getting the right medicine, the right dose, and of the right quality: “No quality – no access”. Worryingly, most national action plans on antimicrobial resistance have not focused on quality of medicines.

Other suggestions and standpoints that were voiced during the session included:

  • A costing template would be useful to help countries in the implementation of national action plans on AMR.
  • There are old antibiotics that still function that should be produced again by the public sector.
  • For the development of new antibiotics there is market failure, but we should not accept partial delinkage that only marginally takes away perverse incentives.
  • It was also suggested that the IACG more clearly outline when and on what topics they will engage with civil society in the future.