Mid May, 2018, members of the Antibiotic Resistance Coalition (ARC) and other civil society partners convened in Geneva for a three-day conference, “Charting A Future Free from the Fear of Untreatable Infections: A Civil Society Agenda,” organized by the South Centre, Third World Network and ReAct. The meeting brought together representatives from over 30 civil society organizations spanning all five continents.
This conference was an opportunity for groups working around the world to discuss key issues around antibiotic resistance that have emerged since the formation of ARC in 2014 and to develop next steps as a coordinated global civil society effort.
Participants heard from partners leading efforts in the field globally and with expertise on a number of intersectoral topics ranging from monitoring for accountability and mobilization, to supply chain interventions in food production and antibiotic resistance in the environment.
Civil society input to the IACG
The convening provided the opportunity for members of ARC and civil society partners to hold a consultation with the Interagency Coordination Group (IACG) on AMR Subgroup 4, which focuses on R&D (Research & Development), innovation and access, to provide input and feedback to the group’s preliminary findings and recommendations.
In discussions following two presentations, one by the Subgroup 4 representative from UNITAID and the other by Dr. Anthony So, Director of ReAct’s Strategic Policy Program, on behalf of civil society, participants emphasized several key points:
- The principles of delinkage, affordability, effectiveness, efficiency and equity should guide to the subgroup’s work, as they are central to the United Nations Political Declaration on AMR which gave rise to the IACG.
- Fulfilling the goals of sustainable innovation and access requires fair return on public investment and transparency about R&D costs, clinical trial data, and prices.
- R&D and access should not be viewed as two separate issues, but rather access should be a fundamental component of an end-to-end approach to R&D.
- Investments for innovation should focus not just on new antibiotics, but also on diagnostics, vaccines, complementary technologies and practice both in the human and animal sectors according to a One Health approach.
- There is a need for policy coherence and alignment between the mandates of the IACG, Tripartite and recently launched R&D collaboration hub, and the IACG should take on a coordination role in bridging the emerging initiatives.
A key decision point that emerged was the need for concerted civil society input into the IACG as the Subgroups work towards policy recommendations to the United Nations’ Secretary-General. ARC members and civil society partners produced a collective document capturing key points, principles and best practices, which was sent to the IACG on May 31 and endorsed by twenty-eight civil society organizations from around the world.
Read the Civil Society input to the IACG_May 2018 at the meeting in France on 31 May.
Read the Civil Society input to the IACG published on ARC:s website.
Discussions to develop a collaborative strategy
Each day, participants had the opportunity to discuss ways in which the civil society network of ARC and beyond could mount a collaborative strategy going forward. The discussions were structured around four key breakout session areas:
- Priority-setting, resource allocation and National Action Plan implementation.
- One Health: Principles for animal health and environment.
- Innovation, Research & Development (R&D) and access.
- Access and stewardship in healthcare delivery.
Discussions touched on the important role of civil society in supporting priority-setting and resource allocation for National Action Plans on AMR, coordinating the One Health approach to contain antibiotic resistance, ensuring sustainable innovation and access, enabling stewardship throughout healthcare delivery, and shaping the AMR global agenda.
Key takeaways from the meeting days:
Sustainable access. Access to effective antibiotics should be a twin goal to stewardship and an integral component of the end-to-end R&D process necessary for sustainable innovation.
Transparency. Leveraging transparency can enable civil society to hold governments and industry accountable, identify appropriate measures and benchmarks, and address the issues of underuse and overuse, substandard and falsified medication and mismarketing of antibiotics.
Conflict of interest and mismarketing. Civil society should advocate for independent and transparent professional education for medical students, healthcare professionals, veterinarians and farmers to avoid conflict of interest issues and mismarketing of antibiotics across the human healthcare delivery and animal agriculture sector.
Evidence-based guidelines. There is a need for evidence-based guidelines for disease prevention, treatment and antibiotic use in the human, animal and environmental sector.
One Health. Antibiotic use in animals and impact on the environment must be integral parts of the efforts to stop the spread of antibiotic resistance.
Low- and middle income countries concerns. The global community must lift up the voice and concerns of low- and middle-income countries (LMICs) in shaping the AMR global agenda.
Hosted fourth annual WHO-NGO dialogue
ReAct, South Centre, and Third World Network also hosted the fourth annual WHO-NGO dialogue while in Geneva. At the invitation of ARC, representatives from the WHO AMR Secretariat joined conference participants for a three-hour discussion around the Secretariat’s ongoing efforts to tackle AMR. This provided the opportunity for an open conversation with the WHO, enabling ARC members and civil society allies to assert hopes, concerns and recommendations for the WHO’s ongoing global AMR efforts. Based on the previous days’ breakout session discussions, participants highlighted, among other points:
- Challenges around R&D and stewardship.
- The need for broad support for principles on antibiotic use in animals.
- The importance of continuous emphasis on access and affordability.
- The critical role of CSOs in advancing these issues.