Info Service on Health Issues (May19/09)
Geneva, 27 May (Heba Wanis): Member States at the 72nd World Health Assembly adopted a resolution on antimicrobial resistance (AMR), reiterating their commitment to urgently address AMR in recognition of the emerging public health threat of the loss of treatment options.
AMR is estimated to kill 700,000 globally per year. By 2050, if AMR is not addressed, 10 million people will die annually because of drug resistance.1 In 2015 the World Health Assembly (2015) had adopted the Global Action Plan on Antimicrobial Resistance amidst alarm at the scale of this health threat. The current WHA session taking place in Geneva from 20 to 28 May reviewed the implementation of the Global Action Plan.
The adopted resolution, deliberated in an evening session on 23 May 2019, urges Member States to commit to AMR at the highest political level; increase efforts to implement the global action plan on AMR; enhance prudent use of antimicrobials through clinical guidelines to slow the emergence of drug resistance and sustain the effectiveness of existing drugs; conduct post-market surveillance of antimicrobials and take appropriate actions to eliminate substandard and falsified antimicrobials; strengthen efforts for the development, implementation and monitoring of multisectoral national action plans; conduct an annual antimicrobial resistance country self-assessment survey administered by the Tripartite tasked to support implementation, namely the World Health Organization (WHO), the Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE); and participate in the Global Antimicrobial Resistance Surveillance System (GLASS).
The resolution also invites international, regional, and national partners, and other relevant stakeholders to support Member States in the implementation of national plans on AMR in a collaborative manner and to consider AMR priorities in funding and programmatic decisions, including innovative ways to mainstream antimicrobial resistance-relevant activities into existing international development financing.
The Global Action Plan has five principal objectives: 1) Improve awareness and understanding of antimicrobial resistance through effective communication, education and training; 2) Strengthen the knowledge and evidence base through surveillance and research; 3) Reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures; 4) Optimize the use of antimicrobial medicines in human and animal health; and 5) Develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
The WHO Director-General’s report entitled “Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues: Antimicrobial resistance” (document AMR A72/18) provided an update on progress related to AMR. The document reported on the AMR country self-assessment survey conducted in 2017–2018 and on progress in implementing the Global Action Plan.
challenges were identified by the report as hindering the effective
implementation of national action plans to combat AMR, and these include:
prioritization and implementation in lack of scarce technical and
financial resources; multisectoral working; monitoring; maintaining
country-level political buy-in; and enhancing civil society, private
sector and stakeholder engagement.
Uganda spoke on behalf of the African region, acknowledging the health and economic implications of AMR and supporting the resolution. Uganda called upon Member States to promote rational use of medicines, upon the global community to fund the development of new medicines and reduce the prices of antibiotics; and upon the WHO and partners to provide technical support and resources for national action plans.
Speaking on behalf of WHO’s South-east Asia Regional Office (SEARO) countries, Bangladesh supported the resolution, while recognising the need for strengthening and improving national systems noting that SEARO countries face challenges in the supply management of antibiotics. Bangladesh also raised the need for rapid R&D on antibiotic alternatives such as herbal medicines, and called for support on post-marketing surveillance to fight substandard antibiotics.
Saudi Arabia spoke on behalf of WHO Regional Office for the Eastern Mediterranean (EMRO) countries, calling for Tripartite agencies to work according to their respective mandate, and for countries to provide the necessary financial and human resources.
Romania spoke on behalf of the European Union, and while welcoming the resolution, called for stronger AMR indicators and clearer targets. Romania noted that AMR needs to be addressed in the context of Universal Health Care, and requested the division of labour between organisations in the Tripartite.
Ethiopia observed that humanity is about to lose its antimicrobial “weapons” after less than 100 years from the discovery of antibiotics which has changed the history of medicine. Ethiopia called for more technical assistance at national level, particularly that they face challenges particularly in terms of human resources.
Lebanon emphasised the importance of addressing key issues such as self-medication and unregulated over-the-counter dispensing of antibiotics, both of which are widespread in developing countries, contributing to AMR.
Panama highlighted the importance of educating patients for a healthier lifestyle in response to AMR, emphasising the role of health personnel in the process.
Australia shared its progress made at national level in terms of decline in the use of antibiotics which is the most significant in 20 years.
Argentina supported placing AMR work in the context of Universal Health Care in a way to ensure that patients receive the medicines they need in a timely manner. Argentina also called for education on health at community level in response to AMR.
According to the Director-General’s report, the WHO prioritises a major public health threat caused by AMR which is the carbapenem-resistant gram-negative bacteria. These are bacteria with limited treatment options whose infections are associated with high mortality. The threat has also been recognised by many countries, according to the report.
In the past twenty-five years, no new antibiotics have been developed, and as reported by the WHO, treatment options for common infections are running out.+
1 O’Neill, J (2014) Antimicrobial Resistance: Tackling a crisis for the health and wealth of Nations. The review on antimicrobial resistance.