August 15, 2024
Call to action: Advancing global cooperation, R&D, and equity to address AMR
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PATH/Christopher Nelson
Antimicrobial resistance (AMR) poses a significant global health threat; it is associated with nearly 5 million deaths each year across the world, according to the World Health Organization (WHO). Growing resistance to antibiotics, antivirals, antifungals, antiparasitics, and other antimicrobial drugs disproportionately affects low- and middle-income countries (LMICs), which bear the significant burden of AMR-associated deaths.
AMR is intricately linked to global health security due to its potential to undermine the effectiveness of essential medicines. Addressing AMR, through a One Health approach, research and development (R&D), and global coordination is critical for achieving universal health coverage and maintaining the security of health care systems worldwide. The Political Declaration of the United Nations High-Level Meeting on AMR is an opportunity to drive a robust political agenda to combat this silent pandemic.
While the current text highlights many key priorities, implementation and follow-up will be vital in ensuring the success of this multilateral moment. As the Global Health Technologies Coalition, a coalition of 50 nonprofit organizations, academic institutions, and aligned businesses working to save and improve lives by encouraging the R&D of essential health technologies, we urge leaders to take the following actions:
1. Establish an Independent Panel on Evidence for Action against Antimicrobial Resistance by the end of 2025, through the support of the Quadripartite organizations1, to monitor progress, identify gaps, and provide Member States with regular guidance and updates on the science, data, and evidence across all sectors related to combatting AMR.
- The process for creating the panel must be inclusive and transparent. Few details are articulated in the current text regarding the governance structure.
- Its leadership must be representative of different communities and stakeholders, especially those from underserved populations.
- Key metrics, including on R&D, must be developed to adequately measure progress.
- Countries should facilitate and support greater evidence generation for unmet needs, such as through coordination with the Global AMR R&D Hub, which provides an evidence base to enhance AMR R&D activities and policies across the One Health spectrum.
2. Ensure equitable access to antimicrobials, vaccines, and diagnostics, especially in LMICs, in line with the WHO Model List of Essential Medicines and the Global Essential Veterinary Medicines List , taking into account national contexts and treatment needs.
- Countries should explicitly support key mechanisms to ensure equitable access to antimicrobials, including the SECURE initiative for antibiotic access.
- Research funders should ensure underserved populations, including children and pregnant women, are included in research efforts, so that they can benefit from new technologies.
- Increase transparency of AMR R&D to fast-track progress and ensure equitable access and maximal return on public investment in scientific progress.
- Update country-aligned lists for medicines.
3. Mobilize sufficient, sustainable, and predictable funding to advance the development of new health technologies and strengthen the research ecosystem to fight AMR.
- Addressing AMR globally will require robust financing well beyond what is currently available within existing funding mechanisms. Financing commitments and responsibilities should reflect countries’ available resources and capacity, and funding mechanisms should be harmonized with existing programs for health and pandemic preparedness and response to reduce fragmentation and administrative burdens on LMICs.
- Robust funding should include support for nonprofit partnerships, such as the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator, the Global Antibiotic Research & Development Partnership, and other product development partnerships that play a critical role in supporting the discovery, development, registration, and introduction of new antimicrobials to all populations in need.
- The political declaration must emphasize the need for increased financing and support from large pharmaceutical companies beyond their investment in the AMR Action Fund.
- Acknowledge the importance of global collaboration in the field of antimicrobial R&D and ensure that there are explicit platforms for the coordination of basic and clinical research, as well as product development and manufacturing.
4. Reach the target of 100 percent of countries having basic water, sanitation, and hygiene (WASH) services in all health care facilities and 90 percent of countries meeting all WHO’s minimum requirements for infection prevention and control (IPC) programs at the national level by 2030.
- Countries must strengthen health systems as part of universal health coverage through fully funded comprehensive primary and secondary prevention strategies, such as IPC; stewardship programs; WASH; vaccination; early diagnosis and prompt treatment; and environmental management of air, water, soil, food, and vectors for better human, animal, and environmental health.
- Member states must ensure that IPC and WASH indicators are included in AMR assessments, evidence generation, and monitoring, guiding investments into AMR interventions.
1 Quadripartite includes the Food and Agriculture Organization of the United Nations, the UN Environment Programme, WHO, and the World Organization for Animal Health.
Tags: Advocacy action