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Experts call for response to antibiotic resistance similar to UNAIDS
Experts are calling on the United Nations to implement a global plan for sustainable access to effective antibiotics that resembles the UN’s response to the AIDS pandemic 20 years ago.
Writing in The Lancet, 11 experts from institutions and universities worldwide said the UN’s high-level meeting on antimicrobial resistance in September should establish a four-part plan that resembles what was undertaken when UNAIDS was launched in 1996.
“The meeting must develop realistic goals, stimulate political will, mobilize resources, and agree on an accountability mechanism for global collective action on this issue,” Ramanan Laxminarayan, PhD, MPH, director of the Center for Disease Dynamics, Economics and Policy, and colleagues wrote.
Ramanan Laxminarayan
Four core functions
Worldwide, more people die each year from lack of access to antibiotics than from resistant bacterial pathogens, according to Laxminarayan and colleagues. However, over 700,000 deaths are attributed to antimicrobial resistance annually, including 214,000 neonatal sepsis deaths — and the numbers are increasing in every country, regardless of income level, they wrote.
To address the issue, they believe a coordinated effort from a wide array of groups involved in health, agriculture, environment, trade, and the breeding of farm animals, are needed to address the issue.
“The elements of effective country-level action are described in WHO’s Global Action Plan on Antimicrobial Resistance, which has been ratified by the World Health Assembly and is supported by the Food and Agricultural Organization of the United Nations and the World Organization for Animal Health,” they wrote. “Yet, antimicrobial resistance transcends the capabilities of these organizations and requires the involvement of UNICEF, UNDP, UNEP, UNESCO, the World Bank, and other multilateral agencies as part of a globally coordinated plan.”
Laxminarayan and colleagues are calling for the establishment of a UN high-level coordinating mechanism with four core functions.
The first function would be to launch a global advocacy campaign to raise awareness about drug resistance and the lack of access to antibiotics. This will “change attitudes and norms toward antibiotics to enable health care and veterinary professionals and the public understand the value and potential side-effects of antibiotics,” Laxminarayan and colleagues wrote.
Second, the effort would monitor, evaluate and report on defined, enforceable targets to reduce the number of global deaths attributable to the lack of access to effective antibiotics, they said.
Third, the mechanism should mobilize resources from donors, aid agencies and countries to finance the effort. And fourth, it should support and coordinate action across multiple sectors.
“Since antibiotics are used widely in livestock, humans and in the environment,” Laxminarayan said in a news release, “the problem of antibiotic resistance can be tackled only by involving all of these sectors. The United Nations is the appropriate forum for countries to set goals and commit themselves to global collective action to ensure that our children and grandchildren are able to enjoy the benefits of effective antibiotics.”
Figure 1. The United Nations’ efforts to combat the spread of HIV/AIDS helped focus global attention on the pandemic; experts argue a similar response is needed to address antibiotic resistance.
Source: UN photo by Manuel Elias.
Plan resembles UNAIDS
By the time UNAIDS was established in 1996, 15 years after the first AIDS cases were reported in Los Angeles, more than 4.6 million patients had died from the disease and more than 20.1 million were living with HIV, the majority of them in sub-Saharan Africa. UNAIDS was formed to strengthen the UN’s response to the deadly pandemic after an initially slow global response.
Laxminarayan and colleagues said the UN meeting in September is a chance to coordinate a global response to antimicrobial resistance, and one that cannot be missed.
“Sustainable access to effective antimicrobials is a key development issue and the September 2016 UN General Assembly high-level meeting is a rare opportunity to change how we as a global community use the only currently feasible method to treat bacterial infections,” they wrote. “It is an opportunity that should not be squandered because of lack of ambition.”– by Gerard Gallagher
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Margaret Fitzpatrick
In this commentary, written by an international group of experts led by the Center for Disease Dynamics, Economics and Policy, the authors place the interdependent issues of access to antimicrobials and appropriate use of antimicrobials in a global context. The authors emphasize the importance of the growing problem of antimicrobial resistance in developing countries. Broadening our attention in the fight against antimicrobial resistance to developing countries is critical because traditionally the focus in these regions has been on lack of antibiotics rather than antibiotic overuse or misuse. This commentary provides a clearly defined framework for how the United Nations can address this issue at its upcoming General Assembly high-level meeting via the formation of a "High-Level Coordinating Mechanism on Antimicrobial Resistance." The authors make a compelling argument that a cooperative effort such as this would most effectively pool the resources of both developed and developing countries behind the collective power of the UN to combat the problem of antimicrobial resistance worldwide.
Margaret Fitzpatrick, MD
Assistant professor of medicine, Division of infectious diseases, Loyola University Medical Center
Disclosure: Fitzpatrick reports no relevant financial disclosures.