From Declaration to action: Antimicrobial resistance initiatives center stage at Jeddah conference

Concerned parties from around the world gathered on Thursday at the Ritz-Carlton in the Red Sea city ahead of the 4^th Global Ministerial Conference on AMR for a session focused on non-state actors – non-governmental organizations, private sector, academia and others – to work across sectors to address “one of the most urgent global health threats and development challenges”.

The conference is expected to bring together representatives of 57 states, including 48 Ministers and Vice-Ministers, and more than 450 participants from leading international and civil society organizations, including UN offices and agencies.

The aim is to move from “declaration to implementation” through multisectoral partnerships in the combat against antimicrobial resistance, which has had disastrous effects on health, economies, and societies, particularly in low- and middle-income countries.

A silent pandemic

When bacteria, viruses, fungi, and parasites stop responding to antimicrobial medications, it's known as antimicrobial resistance. Drug resistance raises the risk of disease transmission, serious sickness, disability, and death by making antibiotics and other antimicrobial medications ineffective and making it harder or impossible to treat infections.

In the political declaration adopted by the General Assembly, world leaders agreed to reduce the estimated five million human deaths associated with AMR annually by 10 per cent by 2030. They further called for sustainable national financing and $100 million in catalytic funding, to help achieve a target of at least 60 percent of countries having funded national action plans on AMR by 2030.

It also formalized the Quadripartite Joint Secretariat on Antimicrobial Resistance, which includes the UN World Health Organization (WHO), the UN Development Programme (UNEP) and the UN Food and Agriculture Organization (FAO) along with the World Organization for Animal Health (WOAH), as the central coordinating structure to support the global response.

Saudi Minister of Health Fahad Al-Jalajel has stressed the need to adopt a “One Health” approach that systematically addresses the obstacles hindering progress as AMR impacts humans, animals, and the environmental alike. “The Jeddah meeting is a crucial opportunity to strengthen our collective global response to the risks of this growing, silent pandemic”, he has said.

The meeting will address priorities, including surveillance and stewardship, capacity building, funding provision, governance, innovation, research and development.

Political commitment at the highest level

UN News is in Jeddah covering this global conference and spoke to Kathrine Urbaez, Executive Director of the Geneva-based non-governmental organization (NGO), Health Diplomacy Alliance.

The Alliance focuses on advocacy and diplomacy to advance global health issues. She told us that the COVID-19 pandemic has proven the vital importance of ‘One Health’ policies and of garnering cooperation and awareness across sectors and stakeholders.

Ms. Urbaez underscored the need to move from commitments to practical actions and added that the General Assembly’s Political Declaration and the Jeddah Conference are great steps in the right direction, and what is needed is to ensure that the political momentum continues. The Executive Director insisted that implementing commitments is feasible if there is a political will to do so, and establishing “a monitoring and accountability mechanism” is key.

She added: “We have to see antimicrobial resistance from a really holistic global health perspective. I think it is important to have the involvement of politicians at the highest level, not only Ministers of Health, Environment, Agriculture or Finance. We really need political commitment to advance AMR policies and to engage in the one health approach”.

More than a health threat

The complexity of the issue, a lack of funding, and political will in some nations "with the competing health issues that governments have to grapple with" have made it difficult to move from policy documents to action, according to Julian Nyamupachitu, Deputy Director of ReAct Africa, a global network that works to catalyze action on AMR primarily in low- and middle-income countries.

As countries are reviewing and weighing new national plans, Ms. Nyamupachitu said ReAct Africa is helping them prioritize activities that are more practical, and use tools that are available to them to help inform their policy making, such as the WHO costing and budgeting tool.

The Deputy Director said the Political Declaration was an improvement over its 2016 predecessor, but it would have been “good to see commitments, and not just targets” on funding.

She said the theme “moving from declaration to implementation” is very timely and she hoped to see a serious commitment by Ministers in Jeddah.

“I believe awareness has been raised. They have appreciated the statistics that have been shared. This is indeed a global health threat, not just affecting the health sector, not just affecting the agriculture, environment, and animal sectors, but it's actually an economic problem as well”, she added.

‘The antibiotics market is broken’

Michiel Peters is the Secretariat Representative of the AMR Industry Alliance, which includes companies and industry organizations in the fields of research and development (R&D), pharmaceuticals, generics, biotech and diagnostics. He also represents the broader private sector on the AMR Multi-Stakeholder Partnership Platform Steering Committee, which was established and is facilitated by the four organizations supporting the global response.

Mr. Peters said antibiotics are “fundamentally different” than any other product brought to market “where your goal would be to sell as much of it as possible”. He said with antibiotics, the goal is to get the “right drug to the right person when they need it”, which is not always a lucrative business. He also noted that developing antibiotics requires an “incredible amount of time and investment” and in many cases the drugs don’t reach the market, and so “the marketplace for antibiotics is broken”.

Mr. Peter’s added that there is a serious lack of government funding and incentives for antibiotic R&D, but the larger concern is that “the researchers actually needed to do the science in the laboratories are leaving this field”, as opposed to diseases like cancer, for example, where research is strong.

The private sector representative said a lot of progress was made since the first High-Level Meeting on AMR took place in 2016, but there is still so much more to do and “nobody can tackle this problem alone”.

He said the Jeddah conference and the plenary meeting for the Multi-Stakeholder Partnership Platform, running in parallel on the closing day, are both very important to see “not just what we can put on paper, but what it is that we are actually going to do”.