The World Health Organization (WHO) has identified Antimicrobial Resistance as a top ten priority global health threat for 2019. Three years after the Political Declaration on Antimicrobial Resistance 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 (AMR) as a top priority, and would like to see the following happen:
1. Concrete international action should be taken by championing countries
→ Member States will need to engage in the consultation on the forthcoming recommendations from the Inter-Agency Coordination Group on Antimicrobial Resistance (IACG), and the Global Framework for Development & Stewardship to Combat AMR which is under development by WHO, FAO, OIE and UNEP.
Country engagement and ownership are needed in order to carry forward a lasting global response for managing AMR during the 74th session of the UNGN General Assembly.
→ Countries must be placed at the center of these processes and leading the way towards a lasting approach for tackling AMR.
Unfortunately, in current discussions there is severe under-representation of low- and middle-income countries (LMICs) and little attention to the disastrous consequences of AMR in these countries. We hope to see a group of countries come together to act decisively and collectively on AMR and also voice LMICs views.
2. A concrete vision on the governance of AMR should be formed
→ The UN General Assembly in September creates a unique opportunity for countries to agree on the future governance for AMR.
We hope countries will take all opportunities during the spring and summer to develop concrete proposals, on the future governance of AMR.
→ Future governance for AMR should:
- Ensure strong safeguards against conflicts of interest as this is essential for mechanisms to work in the public interest and towards the global common good.
- Bridge the different mandates of the Tripartite plus organizations (WHO, FAO, OIE and UNEP) to allow for an inclusive and coordinated leadership.
- Provide strategic advice and independent expert and scientific advice to guide efforts.
- Be able to monitor and evaluate country and regional efforts and keep track of the progress made and identify actions to take.
- Include mechanisms to consult with civil society and other relevant stakeholders.
3. Leadership should be taken on financing sustainable actions on AMR
→ Concrete proposals about how to finance AMR activities on global and country levels must be developed.
Funding is needed for core global functions such as coordination, guideline development and surveillance. Equally important is sustainable funding to develop and implement National Action Plans (NAPs) at a country level. Global financing channels needs to be clearly visible, accessible, and sustainable for LMICs so they can start up work on AMR.
Low- and middle-income countries experience the combination of the greatest burden of infectious diseases and the weakest health care and agricultural systems.
Therefore, increased financial and technical support is needed to support the strengthening of these systems. Short-term catalytic funding from global funds could play a large role in supporting countries in the early phases of developing and implementing National Action Plans on AMR. Countries should take leadership in setting up and engaging in discussions on what global mechanisms for providing catalytic funding could look like.
The Inter-Agency Coordination Group on AMR
An Inter-Agency Coordination Group on AMR (IACG) was tasked by the UN General Assembly Political declaration to provide practical guidance for approaches needed to ensure sustained effective global action. They will create recommendations to the UN Secretary-General on how to improve future coordination of the work on AMR. This work is now in its final stages, and an opportunity to provide input to these recommendations will come in a public consultation to be opened in late January/ beginning of February. A report, based on and in response to the IACG recommendations, by the UN Secretary-General will then be put forward to UN General Assembly in September. This process will greatly determine the governance and strategic direction of future work on AMR.
The Global Framework for Development & Stewardship to Combat AMR
Member States have the primary responsibility to implement National Action Plans on AMR. However, some areas of AMR cannot be addressed by any single country in isolation. Hence, a Global Framework for Development & Stewardship to Combat AMR is being developed by WHO, FAO, OIE and UNEP (Tripartite Plus). This process however moves slowly, and there is a need to put forward concrete proposals and reach agreements on them.