News and Opinions  –  2021

UN High-level Dialogue on AMR: political will and investments needed

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End April, the United Nations General Assembly (UNGA)75th session hosted a high-level interactive dialogue on antimicrobial resistance (AMR). The dialogue had participation from government leaders, industry leaders, health and development experts, delegates of the Tripartite-plus (WHO, OIE, FAO & UNEP) as well as representatives from civil society organisations including ReAct Africa and South Centre. Here you can find a few key points from the meeting.

Photo: Shutterstock.

The dialogue objective was to focus on:

  • strengthening political commitment
  • taking stock of progress
  • committing to actions and
  • building back better from COVID-19

Further practical steps must be discussed to effectively address challenges in tackling antimicrobial resistance, which should be part of future pandemic preparedness, through a one health approach, while supporting the delivery of the Sustainable Development Goals. In his opening speech The President of UNGA, Volkan Bozkir, expressed his concern on antimicrobial resistance being a great threat especially during the pandemic.

Volkan Bozkir said:

“We’re all now actually aware of the impacts of health crisis. COVID-19 has caused the biggest global emergency in the United Nations history. We ignore AMR at our peril.

The overuse and misuse of antimicrobials in humans, animals and agriculture has driven up resistance in the microorganisms these medicines are meant to fight. AMR threatens to make the medicines we rely on to keep us, or animals and plants healthy, redundant. It threatens to take us backwards and undo many medical advancements.”

Bozkir further expressed his concerns by noting that as a world, we are moving towards a post antibiotic era in which common infectious disease will once again cause mortality. None of the 43 antibiotics currently in development are enough to combat the increasing emergence and spread of antimicrobial resistance. If current trends continue, sophisticated interventions like organ transplantation, joint replacements, cancer chemotherapy and care of preterm infants that require antibiotics, will become too dangerous and will no longer be possible if no action is taken.

The high level interactive dialogue was a follow up to the call of the General Assembly in its resolution 74/2 and of 10th October 2019, entitled Political Declaration of the High Level Meeting on Universal Health Coverage.

Bozkir stressed that by 2030, antimicrobial resistance could force up to 24 million people into extreme poverty. Despite its devastating consequences, there is a startling lack of awareness about this silent pandemic.

As we have seen with the COVID-19 pandemic, when there is political will, we can achieve remarkable results. The President encouraged member states to:

  • develop and implement National Action Plans on AMR
  • Strengthen regulation on antimicrobials
  • Improve knowledge and awareness
  • Promote best practices
  • Foster innovative approaches using alternatives to antimicrobials and new technologies for diagnosis and access

Bozkir emphasized effective communication, education and training as critical to raising awareness and encouraging expert driven behavior change.

Bozkir remarked:

“Multi stakeholder partnerships are key; the private sector, doctors, medical workers, farmers, the food industry and regulators, as well as consumers are critical partners in this battle.

I call on the pharmaceutical industry, public, private, and philanthropic donors, and other funders to increase investment and innovation into new quality issued antimicrobials, in particular antibiotics and promote and support, equitable, and affordable access to existing and new quality issued antimicrobials.”

The high-level dialogue put forward discussions from top representatives of WHO, UNEP, FAO and OIE who all highlighted the threat of antimicrobial resistance and the need for action in the various sectors they represented. These discussions opened up to further deliberations under the theme, Antimicrobial Resistance in the Context of COVID-19. The panel included represenatives from organizations such as UNICEF, ReAct Africa, Wellcome Trust, Centre for Disease Dynamics, Economics and Policy, South Centre and Global Vaccine Alliance.

Weak health systems unable to respond to pandemics such as COVID-19 and AMR

Dr Mirfin Mpundu, Director of ReAct Africa discussed the challenges of antimicrobial resistance in the African region. He shared his experiences:

Mirfin Mpundu, Director of ReAct Africa.

“Working with several African countries on AMR, the greatest challenge I have observed is the implementation of the One Health National Action Plans on AMR – moving from paper to action. These challenges include half-hearted political will, multi sectoral collaboration and underfunded National Action Plans on AMR.”

Mpundu pointed out that the current weak health systems in low-and middle-income countries are unable to respond to pandemics such as COVID-19 and antimicrobial resistance.

Furthermore, the lack of the systems view and fragmentation have caused countries to seek small funding from different sources that could complicate coordinated planning and implementation. Although several antimicrobial resistance activities are ongoing in many countries, most are time bound projects which are not integrated into budgets, policies or systems.

He emphasized that it is high time to respond to the IACG recommendation of systematic and meaningful engagement of civil society organizations as key stakeholders in the One Health response to antimicrobial resistance at global, regional, national and local levels.

Civil society and professional organizations to be included as partners in country efforts

Mpundu remarked that civil society and professional organizations have a lot to offer if they are included as partners in countries’ work and efforts to implement National Action Plans on AMR and in building resilient systems.

Civil society organizations such as React Africa have been supporting national governments in the development and implementation of National Action Plans on AMR as well as various antimicrobial resistance strategic goals. This includes awareness raising, health education to reduce unnecessary demand for antibiotics, as well as collaborating with the Tripartite and Africa CDC on various antimicrobial resistance agendas. Unfortunately, civil society organization engagement is still minimal at national and regional level.

He further remarked that COVID-19 and antimicrobial resistance are giving us time to rethink our approaches and mobilize a true national and global response that will bring everybody together. He ended his speech by reminding delegates and listeners that each day that passes is a missed opportunity and the time to act is now.

5 key points on role of non-governmental stakeholders

Civil society organizations can actually support in many ways. Below are a few key points from Dr Mpundu’s contribution to the high-level dialogue on the role non-governmental stakeholders play to support, complement, and enhance national efforts to address antimicrobial resistance and implement National Action Plans on AMR:

  1. Civil society can contribute in the development and implementation of national strategies.
  2. Cilvil society organizations are usually well positioned to work in communities and support community based interventions;
  3. Civil society can increase the visibility of antimicrobial resistance and promote stewardship; they can also help in raising awareness in hospital care, in prevention and also in treatment.
  4. They can also be an advocacy agent that brings up this issue of antimicrobial resistance and engages the media. For instance, ReAct Africa has trained a lot of media organizations about antimicrobial resistance so that there is an increased interest on this issue from the media to spread the message. 
  5. Another area that civil society organizations can play a role is in the area of research, through addressing the current gaps and being able to provide new innovation and contributing to global discussions.

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