UN prioritizes fight against antimicrobial resistance

United Nations (UN) global leaders recently approved a political declaration describing antimicrobial resistance (AMR) as "one of the most urgent global health threats and development challenges" and committing member states to a 10% reduction in AMR deaths worldwide by 2030. The UN estimates AMR is directly responsible for 1.3 million human deaths a year.

The declaration also calls for sustainable national financing and sets a target of $100 million in international financing to help at least 60% of countries implement their national action plans on AMR by 2030. This goal is to be reached through diversifying funding sources and securing more contributors to the Antimicrobial Resistance Multi-Partner Trust Fund, according to a UN announcement.

A United Nations' political declaration aims to curb antimicrobial resistance by, among other things, improving veterinary oversight of antimicrobial use at the national level.

The declaration was adopted September 26 by 193 member states during the second UN high-level meeting on AMR. Member states agreed to take a One Health approach by strengthening public health and veterinary services; curbing antimicrobial use in agriculture; promoting equitable access to treatments, vaccines, and diagnostics; and encouraging research and innovation, according to a UN announcement.

Current AMR efforts

At the meeting, held during the weeklong 79th session of the United Nations General Assembly in New York City, several countries shared their efforts to prevent AMR, such as creating guidelines for antibiotic use and establishing surveillance systems. The meeting highlighted the disproportionate impact of AMR on developing nations, particularly in the Global South.

In a press release, Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), noted that only 11% of countries have budgets for implementing plans addressing the AMR threat.

"Antimicrobial resistance could reverse decades of medical progress making infections, routine surgeries, cancer treatment, and organ transplants far riskier or even life threatening," he warned.

Antimicrobial resistance does not just affect humans, however, said Thanawat Tiensin, deputy director-general of the Food and Agriculture Organization (FAO). Antimicrobial use must be limited in agriculture and livestock, he continued, citing his organization's Reduce the Need for Antimicrobials on Farms for Sustainable Agrifood Systems Transformation (RENOFARM) initiative. Launched earlier this year, RENOFARM is a global, 10-year initiative aimed at reducing the need for antimicrobials on farms and doubles as an agricultural monitoring and training program in line with the FAO's 2021-25 action plan.

Declaration details

Dr. Emmanuelle Soubeyran, director-general of the World Organisation for Animal Health (WOAH, formerly OIE), said that an increase in good practices for livestock, including using vaccines, can reduce the need for antimicrobials. The guidelines for implementing strategies are clear, she said, calling for a greater investment in animal health which "is everyone's health."

Dr. Soubeyran noted that 130 member states have established a register of antibiotic use in livestock, adding that such measures are essential for monitoring and decision-making.

Concerning AMR and animal health, the declaration commits member states to the following:

• Strive to meaningfully reduce, by 2030, the quantity of antimicrobials used globally in the agri-food system from the current level, taking into account national contexts by investing in animal and plant health to prevent and control infections; reducing the need for and inappropriate use of antimicrobials, including through investing in and promoting alternatives to antimicrobials and increasing implementation of stewardship guidance; and taking into account the Codex Alimentarius and standards, guidance, and recommendations of WOAH.
• Commit to ensure that the use of antimicrobials in animals and agriculture is done in a prudent and responsible manner in line with the Codex Alimentarius Antimicrobial Resistance Standards and the standards, guidance, and recommendations of WOAH.
• Ensure, by 2030, that animal vaccination strategies are defined with an implementation plan, including with international cooperation, taking into account WOAH's list of priority diseases for which vaccines could reduce antimicrobial use, and FAO guidance on vaccine quality control and field implementation, according to national contexts and based on scientific evidence.
• Invest in animal health systems to support equitable access to essential veterinary services, improve animal health and appropriate management practices to prevent infections, and promote the timely supply of quality and affordable essential veterinary medicines, vaccines, and diagnostics, and improve veterinary oversight of antimicrobial use in animals at the national level.

The first high-level meeting on AMR occurred in 2016, which also created a political declaration. Since then, over 90% of countries now have multisectoral national plans to combat AMR, according to the UN.

UN Deputy Secretary-General Amina Mohammed hailed the political declaration as paving the way for a robust response to AMR.

"I am calling on member states to be bold in implementing it. With actions that are inclusive, equitable, and coordinated," Mohammed said. "Actions that target sustainable and diversified financing of the AMR response. And actions that support health systems that address the needs of all populations for safe and nutritious food, fresh air and clean water, particularly in the Global South."

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