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

2019-02-19

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 and also joined the Antibiotic Resistance Coalition (ARC) discussions for collective civil society response.

Country engagement and ownership are critical to lead the way towards a lasting global response for managing antimicrobial resistance. ReAct urges countries to actively engage in and follow up the IACG process, come together to act decisively and voice views from low- and middle-income countries.

Seven high-level standpoints from ReAct corresponding to the IACG draft recommendations:

1. We commend IACG on the strong emphasis on affordable and equitable access throughout the recommendations, and the link with the principles from the Political Declaration. There are strong reasons to reiterate the importance that present and future initiatives should follow all the principles already agreed on by the Member States.

2.  There is a lack of reflection on the process and the ways forward on how to implement the recommendations. We wish to see a more clear suggestion on who should be responsible to carry forward the recommendations, and more closely link them with global and national mandates and mechanisms for accountability.

3.  The relevance and importance of the individual recommendations would benefit from being framed within a larger systems perspective. All recommendations are connected and important for taking action. For example the role of civil society and how important their contribution to accelerate implementation of National Action Plans.

4. Make the urgency of reacting to the challenge of antimicrobial resistance more prominent in the recommendations. The imminent and already present threat posed by antimicrobial resistance must come across more strongly and that policy makers must urgently act and make it in connection with a pay now or pay much more later argument.

5.  Target-setting must be emphasized much more prominently throughout the recommendations. Targets must be set both at the country level and globally.  Measurable and achievable milestones will serve as a crucial accountability mechanism.

6.  Conflicts of interest must be addressed at all levels of the recommendations, particularly where industry is suggested to play a role or contribute in global governance, financing, and implementing interventions on stewardship or access.

7.  The recommendations should more strongly emphasize the need to mainstream AMR into broader agendas on universal health coverage, sustainable development, water and sanitation, infection prevention and control, food production and sustainable environment.

Reflections from ReAct for more thorough consideration – this under specific areas in the recommendations

Country action is key for success. Practical and feasible actions to implement at country level are worth lifting up in the main recommendations, including target setting, addressing shortages, surveillance, as well as capacity building and supporting national champions.

We support the IACG that funding must be mobilized for innovation and call for the lifting of the need for investments and innovation across different areas of research and development, including a broader research agenda.

We commend that IACG lifts the important role of civil society organizations (CSOs) in accountability, advocacy, monitoring progress and ensuring prudent use of antimicrobials.

Conflict of interest and due diligence regarding private sector engagement must be addressed. It is of particular concern that the recommendations promote the engagement of the private sector in ensuring access, equity, prudent use and stewardship. The public sector must be in charge of securing access and equity, so it would be important that this role of the public sector is much more prominent in the recommendations.

We call for a stronger emphasis on the urgency of resource mobilization and more concrete proposals on financial solutions at both global and country levels for the near future and longer term.

We commend that concrete proposals for global governance are suggested and would like to see greater clarity when describing the different levels of governance mechanism and who is accountable to drive the processes to create these new entities.