The United Nations Ad hoc Interagency Coordinating Group on Antimicrobial Resistance (IACG) has released a report on Antimicrobial Resistance to the Secretary-General of the United Nations recently.
Background Information:
The 2016 Political Declaration of the High-level Meeting of the United Nations General Assembly on Antimicrobial Resistance represented a landmark in the world’s commitment to tackling antimicrobial resistance, calling for greater urgency and action in response to its many challenges.
In the political declaration, Member States requested the Secretary-General, in consultation with the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE) and the World Health Organization (WHO) to convene an ad hoc interagency coordination group (IACG) co-chaired by the Executive Office of the Secretary-General and the Director-General of WHO to provide practical guidance for approaches needed to ensure sustained, effective global action to address antimicrobial resistance. It also requested the Secretary-General to submit a report for consideration by Member States by the seventythird session of the General Assembly in 2019 on the implementation of the political declaration and on further developments and recommendations emanating from the IACG, including on options to improve coordination, considering the 2015 Global Action Plan on Antimicrobial Resistance.
The IACG was convened in March 2017 . Its membership consisted of representatives of United Nations and multilateral agencies and individuals with expertise across human, animal and plant health, as well as the food, animal feed, trade, development and
environment sectors. The IACG’s mandate was to provide practical guidance for approaches needed to ensure sustained effective global action to address
antimicrobial resistance. Its terms of reference include d
- promoting, planning and facilitating collaborative action to align activities so that gaps are closed and resources are optimally utilized;
- exploring the feasibility of developing global goals and targets related to antimicrobial resistance; and
- reporting back to the Secretary-General by the seventy-third UN General Assembly in 2019.
One Health approach:
A One Health approach is defined by the US Centers for Disease Control and Prevention as “ A collaborative, multisectoral, and trans-disciplinary approach – working at the local, regional, national, and global levels – with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. ”
Key Messages:
Antimicrobial resistance is a global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals. * Antimicrobial (including antibiotic, antiviral, antifungal and antiprotozoal) agents are critical tools for fighting diseases in humans, terrestrial and aquatic animals
and plants, but they are becoming ineffective.
- Alarming levels of resistance have been reported in countries of all income levels, with the result that common diseases are becoming untreatable, and lifesaving medical procedures riskier to perform.
There is no time to wait. Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation.
- Drug-resistant diseases already cause at least 700,000 deaths globally a year, including 230,000 deaths from multidrug-resistant tuberculosis, a figure that could increase to 10 million deaths globally per year by 2050 under the most alarming scenario if no action is taken. Around 2.4 million people could die in high-income countries between 2015 and 2050 without a sustained effort to contain antimicrobial resistance.
- The economic damage of uncontrolled antimicrobial resistance could be comparable to the shocks experienced during the 2008-2009 global financial crisis as a result of dramatically increased health care expenditures; impact on food and feed production, trade and livelihoods; and increased poverty and inequality.
- In higher-income countries, a package of simple interventions to address antimicrobial resistance could pay for itself due to costs averted. In lower income countries, additional but still relatively modest investments are urgently needed.
Because the drivers of antimicrobial resistance lie in humans, animals, plants, food and the environment, a sustained One Health response is essential to engage and unite all stakeholders around a shared vision and goals. * National Antimicrobial Resistance Action Plans are at the heart of a multisectoral One Health response, but financing and capacity constraints in many countries need to be urgently addressed to accelerate implementation.
- Strengthening infection prevention and control in health care facilities and farms using available tools and ensuring access to clean water, sanitation and hygiene in health facilities, farms, schools, household and community settings are central to minimizing disease transmission and the emergence and transmission of antimicrobial resistance in humans, animals, plants, food and the environment.
- Strengthening surveillance, regulatory frameworks, professional education and oversight of antimicrobial prescription and use, and increasing awareness among all stakeholders are also significant challenges that need to be urgently addressed to ensure the responsible use of antimicrobials and to minimize resistance in humans, animals, plants, food and the environment.
Recommendations:
Countries should
- prioritize national action plans to scale-up financing and capacity-building efforts;
- put in place stronger regulatory systems and support awareness programs for responsible and prudent use of antimicrobials by professionals in human, animal and plant health;
- invest in ambitious research and development for new technologies to combat antimicrobial resistance;
- urgently phase out the use of critically important antimicrobials as growth promoters in agriculture.