Urgent Government Action and Investment Needed Against Antimicrobial Resistance, Says New Report
Launch of the AMR Preparedness Index Panel – left to right – James Anderson, Susan Schwarz, Neil Clancy, Anand Anandkumar, Christine Ardal, Mike Hodin, Norio Ohmagari, Tiemo Wolken

Government action against the threat of “superbugs” in most of the world’s leading economies gets a score of less than 50%, according to a new AMR Preparedness Index, released today by a global coalition committed to fighting current trends. 

Great Britain, the United States, Germany and France rated highest on a score of 1-100 in an assessment of responses in 11 of the world’s leading economies to antimicrobial resistance (AMR) threats.  

Meanwhile, emerging economies such as Brazil, China, and India scored the worst in the assessment that looked at national strategy; awareness and prevention; innovation; access; appropriate and responsible use; AMR and the environment; and collaborative engagement. 

The index was launched today by the Global Coalition on Aging (GCOA) and the Infectious Diseases Society of America (IDSA), to shine more light on how the governments are living up to their commitments to address antimicrobial resistance (AMR). 

“We need health systems and policymakers to really step up and advocate that federal, state, and local governments prioritize AMR,” said Neil Clancy of the AMR Committee, Infectious Disease Society of America, during an event Wednesday launching the Index.

“Without significant national and global coordination and multi-party interventions in this area, our efforts are not going to succeed.”

The AMR Preparedness Index ranked 11 countries across 7 categories in a 1-100 point scale.

UN Report Warns That AMR Could Cause As Many as 10 Million Deaths/ Year 

Livestock applications of antibiotics in metric tons/year, among countries reporting use. (The Antibiotic Footprint)

An estimated 700,000 people already die each year from drug-resistant infections and the lack of antimicrobials to treat them. A 2019 UN report warned that if trends are ignored, AMR could  cause as many as 10 million deaths per year, and GDP losses of more than US $100 trillion by 2050. 

The report assigns scores to each of the 11 countries across seven categories for needed and achievable policy action. 

Although the assessment considered national policies on “AMR and the Environment” it was unclear how heavily weighted that issue was in the overall index.  Per capita, the US agricultural industry is one of the heaviest users of antibiotics in the world

COVID-19 Is a Warning Light to Act Preemptively on AMR  

The cost of AMR action pales in comparison to the future costs of inaction, participants underlined, drawing comparisons with the COVID-19 pandemic. Delays in responding to urgent public health crises have deadly consequences.  

“If the pandemic has taught us one thing, it is that we are not well-prepared to combat the serious threat that emerging infectious diseases can pose to human health and our economies,” said Tiemo Wölken, member of the European Parliament, Germany. 

In Europe, AMR causes the annual death of 33,000 people and costs 1.5 billion Euros in regards to healthcare costs and productivity losses. 

COVID-19 has highlighted the need for increased monitoring tools, more improved detection, prevention, and control practices, said Wölken. 

“The time to act is now. COVID already put our healthcare systems under extreme pressure, and this could only be a foretaste of what we could expect from a world where antibiotic microbials are no longer effective.” 

All Countries Fail in Awareness & Prevention of AMR  

Testing for antimicrobial resistance at the Liverpool School of Tropical Science.

The analysis identified critical opportunities for all governments to act upon to slow the growth of drug resistant bugs. 

“Despite the progress that’s being made and despite the good work being done in countries throughout the world, we need to do more,” said Clancy. 

Several trends have emerged from an analysis of the different indices that went into the combined score. 

All countries performed insufficiently with regards to awareness and prevention of AMR, with India lagging furthest behind. 

More developed countries tended to fare better in the appropriate and responsible use of existing antibiotics and other antimicrobial agents – as compared to developing country counterparts.  

Outside of the UK and US, most other countries performed poorly in assessments of the quality of national strategies, innovations, and collaboration.  

Innovation Important  

Training on standardized and harmonized surveillance methods for antimicrobial resistance in food animals in Southeast Asia

Innovation is another area that requires more significant action going forward, said James Anderson, Executive Director of Global Health at the International Federation of Pharmaceutical  Manufacturers and Associations (IFPMA).

“We do need to really drive pipelines. We do need investments in AMR.” 

In the fight against the borderless threat of drug resistance, the Index included key insights and guidance for governments to immediately prioritize in order to fulfill their commitments on AMR. 

Overall, the top-level priorities identified in the Index were to: Strengthen and fully implement national AMR strategies; and raise awareness of AMR and its consequences. 

Along with that, other key priorities were to: 

  • Bolster surveillance and leverage data across AMR efforts;
  • Enable a restructured antimicrobial marketplace to stimulate innovation;
  • Promote responsible and appropriate use of antibiotics;
  • Enable reliable and consistent access to needed and novel antimicrobials;
  • More effectively integrate the One Health Approach, including environmental concerns, into national strategies;
  • Better engage with other governments, third-party organizations, and advocacy groups 

Despite AMR being one of the top five global health challenges, as cited by the WHO, a large majority of the public remains unaware of their role. Local, national, and international efforts are needed in raising awareness and investment in AMR. 

“All of us have a stake in preserving antibiotics and assuring the development of new antibiotics,” said Clancy. 

Vaccinating Older Groups Against COVID – Can Help Fight AMR 

93-year-old Lebanese actor Salah Tizani, who falls into the elderly priority group, receives his first vaccine dose against COVID-19 in Beirut on Feb. 14, 2021.

In terms of the battle against COVID and AMR, the report underlines how vaccinating older adults can help fight overuse of antibiotics during the pandemic. 

That is because people who become seriously ill with COVID, are often given antibiotics preventively in order to ward off secondary infections.  Adequately vaccinating older populations against other infections such as pneumococcal pneumonia and tuberculosis, and even infections like influenza is also critical step to combatting AMR. 

In other ways, too, older adults have a key stake in fighting AMR, because they tend to be major consumers of health services, and also may be more vulnerable to drug resistant bacteria and viruses overall. 

“We are at a time now when the megatrend of aging is at the top of our agenda, not just the public health agenda but the economic and social agenda as well,” said GCOA CEO Michael Hodin. 

As the UN Decade of Healthy Aging was launched in January, AMR needs to be a central part of this initiative, applied not only to older people but to all of us for a healthy and active aging, Hodin added. 

Coordination and Collaboration Across Low- and Middle-income Countries and High-Income Countries  

Most countries examined in the report are not making adequate investments to combat the AMR threat, with the lack of commitment felt globally. Huge disparities in total public AMR research funding remains an issue across high, middle, and low-income countries.  

“We cannot afford to be only US-centric, or only LMIC centric. It takes a very globalized approach,” said Anand Anandkumar, Founder and CEO of Bugworks Research, India. 

Greater support and collaboration is necessary to increase capacity for AMR initiatives, such as monitoring and surveillance in many low and middle-income countries (LMICs). 

Consequently, high income countries must collect and provide more complete data to increase the robustness of international, regional, and domestic efforts.  

“Access and equity are global challenges and the central tilt to competitive AMR,” said Clancy. 

“[We need to ensure] that we get antibiotics and access to these drugs in an equitable fashion. We’re all at risk from AMR.” 


Image Credits: GC, antibioticfootprint.net, Flickr – UK Department for International Development, USAID Asia/Flickr, World Bank: Mohamed Azakir.

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