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End of 2019 to 2020

ReAct’s 2019 wrap up and 2020 expectations

2019 has been an important year in the global response to Antimicrobial Resistance. The recommendations put forward by the UN Interagency Coordination Group on Antimicrobial Resistance this year now needs to be acted upon and implemented. We see some first moves towards strengthening global governance on Antimicrobial Resistance. Other major important steps forward has been led by processes of the United Nations, but also by countries, organizations and individuals. In 2020 Governments and other actors should grasp the existing momentum and ensure that this progress continues.


Blog post by UNDP and ReAct: Antimicrobial resistance: An emerging crisis

An increasing number of infections are untreatable due to antimicrobial resistance. An estimated 214,000 newborns die every year from sepsis caused by antibiotic resistant bacteria, and lack of effective antibiotics threatens both basic and advanced medicine. The negative impact also extends well beyond health with serious implications on poverty reduction and inequality, animal welfare, the environment, food safety and security.


Water, sanitation and hygiene services critical to curbing antibiotic quick fix

Addressing antimicrobial resistance is a multifaceted challenge, but what is often overlooked is reducing the need to use antibiotics. Antibiotics are regularly relied on to treat infections in healthcare facilities and communities that don’t have adequate water, sanitation and hygiene services.


Diagnostics: Antibiotic susceptibility

For determining if an antibiotic treatment will be effective and appropriate, a species-level identification is not sufficient. With some bacteria and in some settings, it can be easy to determine which antibiotic is most appropriate. For example, penicillin resistance among Group A streptococci has never been reported, and as a consequence strep throats can be treated successfully without susceptibility testing. But as resistance among bacteria increases, so does the factual need for susceptibility testing in order to find the best available antibiotic. But susceptibility testing is also a central component of surveillance that can feed information about resistance levels both to clinicians to guide empiric therapy, as well as national or international surveillance systems that monitor resistance levels and trends.


ReAct highlights during World Antibiotic Awareness week 2019

With activities on the ground in Ecuador, India, Indonesia, Switzerland, the US and Kenya – and with an increased online activity – ReAct leaves this year’s World Antibiotic Awareness Week behind with a smile on its face. A week of interaction and intensified work on antimicrobial resistance is really motivating and strengthening – for a world free from fear of untreatable infections.


2019 AMR photo competition prizes announced

It was a tough call choosing between various entries to ReAct Asia Pacific’s 2019 photography competition on the theme of antimicrobial resistance. In the end a total of seven winners emerged for the top three prizes, with two sharing the first one, three sharing the second prize and again two dividing the third prize among themselves.

ReAct Interview

ReAct Interview: UNICEF’s new internal technical guidance paper on AMR

22 November, UNICEF will launch its very first internal technical guidance paper on antimicrobial resistance. The paper maps existing activities across the organization that have a direct or indirect impact on antimicrobial resistance – and – identifies areas for future work where Unicef has a comparative advantage.

To learn more, ReAct interviewed two key persons involved in the process: Stefan Peterson, Chief of Health, Unicer, and Alexandre Costa, HIV/AIDS Specialist, Unicef.


Launch of UNICEF’s institutional guidance on antimicrobial resistance

At their headquarters in New York, UNICEF hosted an event on Friday 22nd November, to launch their technical note on antimicrobial resistance. UNICEF staff, representatives from countries’ permanent missions to the UN, representatives from other UN agencies and civil society including ReAct joined the launch. The event was an opportunity to advocate for the inclusion of children’s health and rights as part of the global response to antimicrobial resistance.


Proposed ban on colistin for animal use announced in Indonesia

A ban on use of colistin in food-animal production and a series of colourful public events, university seminars and student competitions marked the World Antibiotic Awareness Week 2019 in Indonesia. ReAct participated in these events.

World Toilet Day

School children led celebration of World Toilet Day and World Antibiotic Awareness Week

This year’s World Antibiotic Awareness Week was definitely a memorable one. ReAct Africa was honored to combine the World Toilet Day celebrations on 19th November 2019 with antimicrobial resistance awareness activities, in an event led by pupils from 3 elementary schools from Siaya and Kisumu counties in Kenya; namely, Karapul, Segere and Orongo primary schools.


10 Innovate4AMR-winning teams enjoyed 3-day workshop in Geneva

In its second year, Innovate4AMR has gained widespread interest from both students and professionals working in the field. Through the summer of 2019, Innovate4AMR called for student teams from all around the world for their solutions on Antimicrobial Stewardship in resource-limited settings. In the midst of World Antibiotic Awareness Week the 10 winning teams for across the globe enjoyed a 3-day capacity building workshop in Geneva, Switzerland.


After 4 collaborative meeting days: Actions for the future in Latin America

From November 12 to 15, the second international meeting “Health in the Hands of the Community’”was held in Cuenca, Ecuador. The event focused on use of antibiotics in food production, the environmental impact and spread of bacterial resistance and the consequences it implies for human health.


Why are children more vulnerable to AMR?

Resistant bacteria is making effective treatment of common infections more and more challenging and children are especially vulnerable. Children are more susceptible to resistant bacteria because their immune systems are not fully developed. Children differ from adults in that they have many ways of being exposed to germs and infections because their behavior is different. Children living in poverty are even more susceptible to resistant bacteria.


Four key points from joint comments to One Health Global Leaders Group on AMR

Last week 24 civil society groups signed the Antibiotic Resistance Coalition’s comments on establishment of a One Health Global Leaders Group on Antimicrobial Resistance (AMR).


Why is preventing infections and the spread of AMR through WASH critical?

The rise of resistant bacteria poses a global threat where the simplest of injuries and illnesses could become life threatening and routine medical procedures could be too high-risk to perform. Next week, global attention turns to antimicrobial resistance with World Antibiotic Awareness Week with the focus “the future of antibiotics depends on all of us”. This statement is critical to keep at the forefront of all antimicrobial resistance activities, particularly for underlying causes of antimicrobial resistance.


ReAct activities for World Antibiotic Awareness Week 2019

During World Antibiotic Awareness Week 2019 ReAct will arrange and participate in a various set of activities – on the ground and online. The activities on the ground will take place in Ecuador, India, Indonesia, Switzerland, the US and Kenya, some of these activities will also be accompanied with online presence. ReAct will meet students, children, hold seminars, arrange community workshops, media workshops and civil society meetings and much more. We have listed all activities below.


Tracking antimicrobial resistance in the Sustainable Development Goals

Earlier this week, Professor Anthony So, Director of ReAct Strategic Policy Program and Prateek Sharma, Research Associate at the same, published an article in the SDG Knowledge HUB on why it is important with indicators for antimicrobial resistance within the Sustainable Development Goals.


International meeting in Eucador: Food and health in the hands of the community

Mid-November – in the context of World Food Day and World Antibiotic Awareness Week – ReAct Latin America will arrange an international 4-day meeting in Ecuador with the theme “Health in the Hands of the Community” – focusing on food production and use of antibiotics.

World Food Day

Food safety and antibiotic resistance

As the world is celebrating the World Food Day, it is well worth considering the impact of antibiotics and antibiotic resistance on safe food. Food safety is also linked to the sustainable development goals, in particular Sustainable Development Goals 2 – Zero Hunger and 3 – Health and Well-being.

International Day for the

Address antibiotic resistance and poverty - to empower children and their families

This year’s theme for the International Day for the Eradication of Poverty is “Acting together to empower children, their families and communities to end poverty”. 2019 also marks the 30th anniversary of the adoption of the Convention on the Rights of the Child, which recognizes every child’s rights to a standard of living adequate for child’s physical, mental, spiritual, moral and social development.

Antibiotic resistance and lack of access to effective antibiotics threaten children’s development or can unravel the important achievements in children’s rights.


We need public health principles for sustainable access to novel antibiotics - Policy brief by ReAct

Governments, philanthropies and public health institutions increasingly recognize that new antibiotics will not emerge from the pharmaceutical pipeline if things are just “left to the market”. Over the last five years, numerous investments have emerged to address the lack of novel antibiotics that are urgently needed to address drug-resistant infections.

ReAct has welcomed these efforts to address this market failure. Yet we are concerned that these efforts may not achieve the desired outcome of creating a sustainable new approach to antibiotic research and development. In a new policy paper, we outline the public health principles that should govern any public funding spent, to secure equitable and sustainable access to new antibiotics.

ReAct Interview

Dr Yoel Lubell, Health Economist, on Thailand, AMR, UCH and cultural factors driving AMR

Dr Yoel Lubell, heads the Economics and Implementation Research Group (EIRG) at the Mahidol Oxford Tropical Medicine Research Unit in Bangkok, Thailand. EIRG focuses on the evaluation of diagnostics, treatments and vaccines for malaria and other infectious diseases.

Here he speaks to ReAct about the link between AMR and Universal Health Coverage (UHC) and also the cultural and anthropological factors that drive AMR.


UHC and AMR: The Thai Experience

Thailand is among the few countries in the South East Asia region or among middle income countries worldwide, that boasts of a Universal Health Care (UHC) system, which allows access to publicly-funded healthcare without any co-payments and covers 98% of the population. UHC costs are financed through general taxation.

World Patient Safety Day

Why do effective antibiotics matter for quality of care and patient safety?

World Patient Safety Day is observed for the first time on 17 September this year. ”the safety of patients during the provision of health services that are safe and of high quality is a prerequisite for strengthening health care systems and making progress towards effective universal health coverage under Sustainable Development Goal 3 (Ensure healthy lives and promote health and well-being for all at all ages)”.

72nd World Health Assembly, Global action on patient safety, WHA72.6, 28 May 2019


New ReAct policy brief: Antimicrobial resistance and universal health coverage – What’s the deal?

Last July, ReAct and the South Centre jointly organized a conference in Nairobi, Kenya on ‘Achieving Universal Health Coverage while Addressing Antimicrobial Resistance’. Based on the insights from experts in antimicrobial resistance and universal health coverage from 33 different countries ReAct wrote a policy brief linking universal health coverage to antimicrobial resistance. The policy brief shows why antimicrobial resistance seriously threatens achieving universal health coverage, but also how their respective policies go hand in hand.


Antibiotic footprint: change the way food is labelled?

As consumers around the globe become more aware of the dangers of antimicrobial resistance meat producers and food retailers everywhere are rushing to label their products as “antibiotic-free” or as “raised without antibiotics”. The trouble is though, these labels do not fully explain in accurate terms what exactly they mean.


Pharmacologists' involvement will add new dimension

After the launch of the Kerala Antimicrobial Resistance Strategic Action Plan, ReAct Asia Pacific was asked to arrange a workshop for pharmacologists. One of the main purposes of this program was to initiate and strengthen the role of pharmacologists within the antibiotic stewardship team in tertiary care teaching hospitals.

ReAct Interview

Growing public response to AMR in Thailand

Thailand has very impressive health indicators and is among the few countries in the South-East Asia region that boasts of a Universal Health Care system. Despite these achievements, antimicrobial resistance has been a growing problem in Thailand. Dr Niyada Kiatying-Angsulee, Thailand’s foremost civil society activist on antimicrobial resistance, speaks to ReAct about the growing public awareness issues related to antimicrobial resistance in Thailand.


Outbreak of extremely drug resistant typhoid fever in Pakistan

Since November 2016, Pakistan has been plagued by an outbreak of extremely resistant typhoid fever. What is so special with this outbreak, and are there broader lessons to be learned from it?


Three key takeaways from the ReAct Africa conference

End July ReAct Africa, together with South Centre, arranged its annual conference, bringing stakeholders on antimicrobial resistance in the Africa region together. This year’s theme was antimicrobial resistance and the link to Universal Health Coverage and Sustainable Development Goals. Dr. Rashid Abdi Aman, Chief Administrative Secretary, Ministry of Health, Kenya, officially opened the conference. He lauded the theme of the conference, saying that it was timely and would inform the UN high level meeting, set to be held in September 2019.


AMR-specific indicator proposed for monitoring Sustainable Development Goals

In a public consultation, the Inter-agency Expert Group on Sustainable Development Goals indicators (IAEG-SDG) proposed an Antimicrobial Resistance (AMR)-specific indicator. This is the first suggested AMR-specific indicator among potential changes to the metrics tracking progress on the United Nations’ SDGs.


Diagnostics: Species identification

The first step in microbiological diagnostics is to determine whether the patient carries a pathogen that can explain the observed symptoms, and if so identify what species and sometimes subtype the infecting pathogen belongs to. For infections caused by bacteria, the gold standard method has, since the beginning of microbiological diagnostics, been culture on agar plates followed by microscopy and further subcultivation. New rapid diagnostic methods challenge this old and slow method – some more successfully than others.


Upcoming ReAct Africa Conference: universal health coverage and antimicrobial resistance in focus

23-25 July, ReAct Africa and South Centre will host a conference with the theme, “Achieving Universal Health Coverage while addressing Antimicrobial Resistance” in Nairobi, Kenya.


Five focus areas at the 2nd Ministerial Conference on AMR hosted by the Netherlands

The Netherlands hosted the 2nd Ministerial Conference on AMR, 19-20 June in Noordwijk, the Netherlands. The Conference aimed to bring together Ministers of health and high-level policy makers to reflect on the progress of the global implementation of the Global Action Plan on AMR, and to identify approaches to accelerate the multi-sectoral work for the coming years and to intensify the international cooperation.


Safety concerns of fecal microbiota transplants

Fecal microbiota transplants are emerging as a novel and effective therapy for antibiotic associated diarrhea. Two new cases in the USA highlight the risks of this therapy unless effectively controlled.


Diagnostics – what are we talking about?

Diagnostics are often lifted as a part solution in containing the development and spread of antibiotic resistance. Sometimes, the word is used as if it was a magic wand – if we only had more or better diagnostics all problems would be solved. But how do diagnostics work, and what effects can we expect from implementing a new diagnostic method?


ReAct colleagues featured in WHO Bulletin as leading profiles in the work on reacting to antibiotic resistance

Two ReAct colleagues, Mirfin Mpundu, Head of ReAct Africa, and Otto Cars, founder of ReAct and Senior Strategic Adviser, have been featured in interviews in the Bulletin of the World Health Organization April and June issues. Common themes in these interviews are the limited action on antibiotic resistance in many countries, and that the problem of antibiotic resistance needs to be viewed from a systems perspective.


Mother Earth conference in Argentina – the environment in focus

Beginning June, ReAct Latin America co-hosted the second Mother Earth conference in Rosario, Argentina. During five days different challenges in regards of human health and ecosystems were addressed and linked to communities, the use of antibiotics and antibiotic resistance.


Connecting global to local civil-society-agenda on AMR at CSO convening in Geneva

Beginning June, members of the Antibiotic Resistance Coalition (ARC) and civil society allies convened in Geneva, Switzerland for a three-day conference, “Charting a Civil Society Agenda on Antimicrobial Resistance: Connecting Global to Local”. Along with South Centre and Third World Network, ReAct invited more than 30 participants representing civil society organizations across five continents to discuss key issues on antimicrobial resistance.


ReAct Africa stakeholder at WHO IPC consultation – for standards and guidelines in African Union member states

Mid April, the Africa Center for Disease Control and WHO held a technical consultation in Addis Ababa, Ethiopia, to develop Infection Prevention & Control (IPC) minimum standards and guidelines for healthcare facilities within the African Union member states. ReAct Africa joined as one of the stakeholders at the consultation.


8 insights from ReAct Asia Pacific project on antibiotic stewardship in secondary level hospitals in India

Healthcare facilities managed by Faith Based Organizations are vital in delivering good quality healthcare to the vast rural hinterland of Asia and Africa. In the absence of a robust primary healthcare system, secondary level hospitals often serve as the most important healthcare provider for the rural population. Implementing antibiotic stewardship in secondary level hospitals in countries like India, presents its own challenges. ReAct Asia Pacific took up the challenge to pilot antibiotic stewardship programmes in secondary level institutions managed by Faith Based Organisations – this resulted in 8 major insights. Read more and see short video with three interviews.


Second time for Innovate4AMR competition!

The competition Innovate4AMR invites student teams from around the world to design innovative solutions for antimicrobial stewardship in resource-limited healthcare settings.


Open letter to UN Member States from former IACG members Anthony So and Otto Cars

As former members of the IACG, Anthony So and Otto Cars of ReAct have written a letter to the Member States which has been sent to the Permanent Missions to the UN organizations in Geneva, New York and Rome. The letter was sent to raise awareness around the IACG recommendations and to prompt discussion, and bring their perspectives on certain key recommendations.


WHA conversation on Antibiotic Resistance as a Global Development Problem co-organized by ReAct

On the margins of World Health Assembly that took place in Geneva last week and beginning this week, ReAct co-organized an event on antibiotic resistance. The event focused on the launch of the report: When the Drugs Don’t Work: Antibiotic Resistance as a Global Development Problem that ReAct and Dag Hammarskjöld Foundation published earlier this year.

ReAct Interview

Medicines Patent Pool’s view on the role of licenses for antibiotics – World Intellectual Property Day

As the world is recognizing the World Intellectual Property Day on April 26, we consider how the current system uses Intellectual Property and licenses in the case of antibiotics. Deciphering the role of intellectual property is a critical element in constructing a workable end-to-end model for sustainable access to novel antibiotics. In this interview with Esteban Burrone, the head of policy for the Medicines Patent Pool, we examine the particular role that the Medicines Patent Pool and licensing could play in such an end-to-end model.


ReAct Latin America honors Earth Day

International Mother Earth Day is a day to reflect on the relation between nature and humans. Human beings’ permanence depends on the existence of other species, animals, plants and natural elements such as land, water and air. In this framework ReAct Latin America honors life in commemoration of Earth Day.


World Health Day 2019: Universal Health Coverage

On Sunday, 7 April 2019, World Health Day is celebrated calling us to act on Universal Health Coverage to ensure that all people, everywhere, have access to medical services and basic health care.

ReAct Latin America is participating in an event and launching a call on this year’s topic on Universal Health Coverage, and ReAct Asia Pacific will participate in a radio discussion around this topic. ReAct will continue to raise awareness around the importance to recognise effective antibiotics as an essential part of achieving Universal Health Coverage through the year. The upcoming ReAct Africa Annual Conference this summer will feature the theme of Universal Health Coverage.

ReAct Interview

Erry Setyawan, FAO, on Indonesian NAP: We need to work together to make it possible to manage AMR

“Managing antimicrobial resistance should be done through integration and coordination of various sectors. It should not be merely led by the government, but also collaborated with private sectors, professional associations, academics and other non-governmental sectors. We all have to join hands together,” says Erry Setyawan, FAO National Technical Advisor in Indonesia, on implementing the National Action Plan on AMR in Indonesia.


Constraints for successful implementation of diagnostics

When discussing and developing interventions to curb antibiotic resistance, it is important to consider the constraints, especially in many low- and middle-income countries (LMICs). Some interventions and technologies are simply not possible to implement – this holds true regardless of the novelty of the intervention, but becomes especially apparent for new high-tech innovations. The problems exist all over the field of innovation, but in this article, we’ll focus on diagnostics for illustration.


Antibiotic Shortages: magnitude, causes and possible solutions: A new WHO meeting report

Unavailability and shortages of antibiotics is an increasing problem for many countries with consequences both for patient safety and societal cost. At a WHO meeting end 2018, a project funded by ReAct through Sida, the magnitude, causes and possible solutions of antibiotic shortages were discussed.


ReAct’s new 5-year strategic plan receives funding from Sida

ReAct will align its work to respond to the next challenge: to ensure that the long-awaited response is corresponding to meet the actual needs, in particular in low- and middle-income countries. To address this new situation, ReAct will focus on four strategic areas in the coming five years, this with continued core funding from Sida.


New ReAct Report: When the Drugs Don’t Work - Antibiotic Resistance as a Global Development Problem

This new report by ReAct and Dag Hammarskjöld Foundation looks at the state of global development when the drugs don’t work and a post-antibiotic era sets in. The report shows how antibiotic resistance is a global development problem by highlighting existing data and people’s experiences.


Antibiotic resistance and global development: alarming rates in armed conflicts

Antibiotic resistance is a major obstacle for achieving the Sustainable Development Goals. In ReAct’s report “When the Drugs Don’t Work – Antibiotic Resistance as a Global Development Problem’”, we have identified the vulnerability of populations in conflict and refugees to antibiotic resistance. People affected by conflict should not be overlooked, but be seen as an especially vulnerable group in the global response to antibiotic resistance.


How infections spread and how to stop them

Infectious diseases are different from other diseases in that they are caused by microorganisms that spread from one individual to another, sometimes passing through other humans, animals, or an environmental reservoir. While infectious diseases spread wherever and whenever they are able to, several situations increase the risk that infections as well as antibiotic resistance spread. To understand why and how some people are more vulnerable, we need to understand how infections are transmitted.


7 high-level standpoints from ReAct on the IACG draft recommendations

The IACG on AMR released the draft recommendations for public discussion from 29 January to 19 February. This marks the final round of stakeholder input collection before the recommendations are finalized for submission to the UN Secretary General by April 2019. The process towards the UN General Assembly will greatly determine the strategic directions of global response to antimicrobial resistance.

ReAct has developed our main opinions on the draft recommendations.


Three political actions needed on antimicrobial resistance in 2019

The WHO has identified antimicrobial resistance as a top ten priority global health threat for 2019. Three years after the Political Declaration on AMR was adopted by all Member States in 2016, we are now at a critical point in time to shape the world’s response to the issue. For 2019, political action must be stepped up. We urge countries to take up the work on antimicrobial resistance as a top priority, and would like to see the following happen…


Generating data for policy and practice

Knowledge is critical for good policy and practical work. In the Global Action Plan on AMR adopted by WHO in 2015, strategic objective 2 is to “Strengthen the knowledge and evidence base through surveillance and research”. But how can this be done in countries that lack funds and technical capacity?


New platform for setting the African research agenda

In the African region surveillance and laboratory data is sparse and there is concern that the National Action Plans on AMR are not founded on a strong evidence-base detailing the specifics of the problem nor on interventions proven to be effective in African contexts. This is why ReAct Africa hosted a research priority setting workshop end 2018.