On April 29, experts from the United Nations and other organizations released a groundbreaking report – the culmination of more than two-and-a-half years of work – that calls for urgent global action on one of the most pressing and challenging global health threats of our time: antimicrobial resistance (AMR).
The report from the Ad hoc Interagency Coordination Group on Antimicrobial Resistance (IACG) outlines recommendations on how to tackle AMR. The work of the group will help inform UN Secretary-General António Guterres’ own report on AMR, which will be presented to member states of UN General Assembly in the coming months.
What’s at Stake
Globally, approximately 700,000 people die every year from drug-resistant infections. In some countries, it’s estimated that up to 82% of infections are resistant to at least one of the most commonly used antibiotics.
If we do not act, estimates show our everyday antibiotics and other tools we use to fight infection will rapidly fail – and superbugs will get so strong we may not have the tools to stop them. The toll could rise to 10 million deaths per year, with the majority of these deaths anticipated to happen in Africa and Asia.
By 2050, AMR is estimated to have a cumulative cost to the world economy of US$100 trillion. And according to the World Bank, an additional 24 million people in low- and middle-income countries will be pushed into poverty by 2030 if effective action is not taken. This puts AMR roughly on par with climate change or a global pandemic in terms of potential human and economic impact within a generation.
The time to act on AMR is now. But AMR is not a problem that the UN alone can solve. It will take cross-cutting solutions across different sectors to successfully combat this challenge. This is why the recommendations from the IACG are so critical – and timely.
Cutting Through the Alphabet Soup
Wading through the acronyms related to AMR can be challenging, but here are a few of the biggest takeaways from the report that are important to know.
- We’re not doing enough to get ahead of this problem.
Although countries are starting to step up and develop National Action Plans – a critical step – financing, research and development, and the appropriate use and stewardship of antibiotics are woefully inadequate. We’re seeing worrying signs of drug resistance faster than might have been expected, and if we don’t act with urgency and commitment, the superbugs will outpace us.
- Collective action must be at the center of our response to AMR.
In almost all of its recommendations, the IACG acknowledges that addressing AMR must include more coherent, efficient, and inclusive forms of collective action.Governments need to work more closely with the private sector, the animal health and human health communities must align, and donor countries must enhance their funding and partnership with lower-income countries. If we try to tackle this problem in silos, we won’t get ahead.The IACG called for urgent action – including a global partnership platform – to improve coordination, collaboration, and support to countries among governments, civil society, the private sector, and the UN. The role of this platform would be “to develop and implement a shared global vision, narrative and targets” to support countries to accelerate progress on AMR. The IACG was also clear that this approach will require new, additional funding and to be successful.
- We need to urgently accelerate public support and political momentum to address AMR.
As the IACG makes clear, AMR is one of the most fundamental challenges of our time, yet it has not invoked the kind of urgent public and political attention it deserves.The IACG strongly recommends the creation of the One Health Global Leadership Group on Antimicrobial Resistance to maintain urgency, public support, political momentum, and visibility of the AMR challenge on the global agenda, with representatives at the highest level of government, the UN, the private sector, and elsewhere to champion AMR at the global agenda.
- The UN must step up its “one health” approach to working on AMR.
The IACG sent a strong signal that robust coordination across multiple UN agencies, including the World Health Organization (WHO), UN Environment, the World Organization for Animal Health, and the Food and Agriculture Organization (FAO) must be at the center of any work on AMR, in order to help provide countries with the tools, resources, financing, and advice they need to meet their AMR goals. For change to happen, a “one health” approach, which looks at AMR across health, agriculture, veterinary, and environmental sectors must be taken.
- We can’t fix it if we don’t know how much it costs.
The report also called for UN partners to work in a coordinated way to quantify the financial needs and gaps for national and global responses to antimicrobial resistance, as well as calculating an estimated return on investment on the work to help stem AMR globally. The report also highlighted the need to put a definitive price tag on the costs of inaction on AMR in order to clearly state the need for urgent global action. - We need more evidence to help make better informed decisions on AMR.
It’s hard to know our progress or set global targets to curb the spread of drug resistance without a richer and deeper evidence base. The IACG report calls on the UN Secretary-General, in partnership with the FAO, the World Organization for Animal Health, WHO, UN Environment, and other international organizations to convene an Independent Panel on Evidence for Action against Antimicrobial Resistance in a One Health Context to monitor and provide countries with regular reports on the science and evidence related to AMR, its impacts and future risks, and to recommend options to adapt practices and reduce risks based on this information.The hope is for this robust evidence base to enable the global community to set meaningful targets at a global, regional, or even national level to curb AMR.