AMR-specific indicator proposed for monitoring Sustainable Development Goals

2019-08-28

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. The World Health Organization-proposed indicator on AMR is among the potential changes to Goal 3 (Good Health and Wellbeing). This proposal would aim to “reduce the percentage of bloodstream infections due to selected antimicrobial resistant organisms”. Earlier this year, ReAct highlighted antibiotic resistance’s implications for the Sustainable Development Goals and supports this proposed SDG indicator.

This proposed indicator is timely and necessary for the success for the SDGs which aim to address global challenges. In May 2019, the UN Secretary General stated:

“Antimicrobial resistance is a global threat to health, livelihoods and the achievement of the Sustainable Development Goals”.

Antibiotic resistance is undoubtedly an inter-sectoral challenge. However, only taking into account the prevalence of drug-resistant pathogens misses equally important concerns over needed access to antibiotics.

Universal access to antibiotics can stop 445,000 deaths

Providing universal access to antibiotics could avert 445,000 deaths from community-acquired pneumonia in children younger than 5 years—this statistic is only for children with pneumonia. This statistic points to a significant contributor to the estimated 700,000 annual deaths related to drug-resistant infections.

ReAct has proposed adaption of indicators to capture access of antibiotics

To ensure that the SDGs monitor not just excess use of antibiotics, ReAct has proposed that existing indicators might be adapted to capture access to these life-saving drugs.

One approach might be to extend the tracking of care-seeking behavior for children with suspected pneumonia (one of the tracer conditions already tracked under SDG Indicator 3.8.1).

Under SDG Indicator 3.b.3, there already is monitoring of a basket of medicines, including four antibiotics on WHO’s Essential Medicines List. Strategically selecting the four antibiotics being tracked under this SDG Indicator could focus attention on availability and affordability of these medicines, but more would need to be done to assess their appropriate use. And it might be important to include a last resort antibiotic among these four in order to capture more fully the picture of antibiotic access.

Need to monitor and reporting of antibiotic use in animal sector

Use of antibiotics for animals accounted for around 80% of total global consumption in 2013. Critically important antibiotics for humans are also used in food-producing animals. Monitoring and reporting of antibiotic use in the animal sector would also be vital to ensure that global policymakers can anticipate the impact of AMR on the SDGs. However, there are no proposed indicators to capture this One Health dimension of the problem.

Adding a new indicator means another indicator will be deleted

In considering new proposed indicators, the IAEG-SDG seeks to keep the burden of reporting unchanged, so every addition of a new indicator may well result in the deletion of another. So, the AMR-specific indicator will be competing against a broad array of proposed and existing indicators for a place in the monitoring of the SDGs.

Submit comments to the Open Consultation on SDGs by 8 September

To ensure the issue of antimicrobial resistance does not remain neglected in the monitoring of the SDGs, civil society groups and other stakeholders can submit comments to the Open Consultation on Sustainable Development Goals Google Form by 8 September, 2019.