In a bid to step up a battle against other emerging and untreatable pathogens that could wreak havoc on the world in ways similar to COVID-19, WHO on Friday announced the launch of a One Health Global Leaders Group on Antimicrobial Resistance (AMR).

The group, led by the prime ministers of Bangladesh and Barbados, aims to raise the political profile of the threat posed by drug-resistant bacteria, viruses and other microbes – and get politicians to act more firmly to ration and control the use of life-saving drugs that are slowly losing their potency due to rampant overuse in both human health and agriculture. 

But the new initiative co founded by the WHO, Food and Agriculture Organization of the UN (FAO), and the World Organization for Animal Health (OIE) stops short of setting a clear roadmap for making recommendations to governments about the kinds of tough new regulatory measures that some advocates say would be needed to stem the threat of AMR. 

Asked about the possibility that the FAO or OIE might consider recommending the mandatory labeling of animal products with details of antibiotics used in their production, OIE’s Deputy Director General, Matthew Stone, ducked the question, saying that at present the agencies are just trying to get country to track drug use in animals more systematically.  

“We’re now in our fifth year of data collection to work with our member countries to understand their usage patterns of antimicrobials in animals, across terrestrial animals and aquatic animals, to understand what molecules they’re using and what diseases they’re treating in terms of those molecules,” said Stone. “And this accounting mechanism ….is allowing countries to track their own usage and hopefully drive that usage down, towards prudent and responsible use.”  

WHO’s Global Action Plan to Combat AMR, which dates to 2015, also provides no concrete guidance about health or food safety policies to restrict over-the-counter antibiotic sales or label foodstuffs in which antibiotics were used; it merely recommends that countries develop national action plans to combat AMR.  

Along with labeling the use of antibiotics on food products, studies have suggested that other effective mandatory measures to combat AMR in both humans and animals could include: banning the sale of over-the-counter antibiotics in low- and middle income countries, where the use of non-prescription antimicrobials is often very high, and establishing national standard treatment guidelines to prevent clinical misuse of antimicrobials. 

AMR Trust Fund Announced Alongside Global Leaders Group 

The Global Leaders Group was launched at a WHO press conference on Friday, during the World Antimicrobial Awareness Week. 

Antimicrobial resistance (AMR) – which occurs when bacteria, fungi, viruses, and parasites develop resistance to common drugs  – threatens to undermine a “century of medical progress” and poses a serious risk to human, animal and environmental health, food security, and economic development, said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in announcing the new policy leadership group. 

“There is no doubt that antimicrobial resistance has become a global public health challenge both for humans and animals. We are running out of available antibiotics and soon we will face another world health emergency more severe than the current COVID-19 pandemic,”  said Bangladesh’s Prime Minister Sheikh Hasina Wazed, who will co-chair the group. 

“The systematic misuse and overuse of these drugs [antibiotics, antifungals, antivirals, and antimalarials] in human medicine and food production have contributed to this raising antimicrobial resistance or the ability of a microorganism to stop an antimicrobial from working against it,” said Mia Mottley, Prime Minister of Barbados and the other co-chair. 

The group is comprised of 20 members drawn from government, the private sector, research and civil society, with most being ministers, deputies or former ministers of agriculture, health, and environment. These include representatives from: Australia,  Bhutan, Iraq, Japan, Portugal, the Russian Federation, Nigeria, Saudi Arabia, Senegal, Singapore, and Sweden. The group also includes the UK’s Special Envoy on Antimicrobial Resistance, Dame Sally Davies, and Wellcome Trust Director General, Sir Jeremy Farrar, as well as Lothar Wieler, President of Germany’s Robert Koch Institute, and Brazil’s senior agriculture attaché to the European Union. From civil society, there is Sunita Narain, the prominent director-general of India’s Centre for Science and Environment, and from the private sector, Kenneth Frazier, CEO of the pharma giant Merck & Co. 

Launch of the group coincided with the announcement of $US 13 million in donations from The Netherlands, Sweden and the United Kingdom to a new trust fund to foster AMR action at country level, said WHO’s Director General Tedros Adhanom Ghebreyesus at the press conference.  An initial pilot will take place in Indonesia.  

The misuse of antimicrobials is being exacerbated by COVID-19, said Hanan Balkhy, WHO Assistant Director General on Antimicrobial Resistance. She cited one study that reported some 70% of patients hospitalized had received antibiotics, even though only 15% developed, or were at risk of developing, secondary bacterial infections.

She acknowledged that there have also been worrisome reports of new forms of pathogen resistance to detergents and other disinfectant products that are being used much more abundantly in health care facilities since the pandemic erupted, and said that it pointed to the need for good hospital hygiene and sanitation measures alongside disinfectant use. 

“Good News” That Recovered Covid Patients Sustain Immunity Levels 

In other developments, WHO officials said that a recent study indicating that COVID-19 immunity might persist for as long as six months after infection is “good news”.  The results of the study, while small, could also bode well for the prospects of upcoming vaccines conferring immunity for similar periods of time, said WHO Health Emergencies Executive Director Mike Ryan.    

The study published on the science server bioRxiv.org, prior to peer review, found that of the 185 patients examined, 90% had neutralizing antibodies present 6-8 months after their infection. Neutralizing antibodies are associated with protective immunity against a secondary SARS-COV-2 viral infection. 

“This is really good news to see that we’re seeing sustained levels of immune responses in humans so far,” said Ryan, “This is potentially significant news that extends the period for which we know there is likely protection and hopefully that period will extend further and further. 

“It also gives us hope as well on the vaccine side that if we start to see similar immune responses to the vaccine, we may hope for longer periods of protection,” Ryan said.

More long-term research will be needed to determine the precise length of COVID-19, but hundreds of studies on the topic are currently underway in  over 50 countries on the topic, said Maria Van Kerkhove, WHO Technical Lead on COVID-19. 

Said Van Kerkhove: “We still need to follow these individuals for a longer period of time so we can determine how long these antibodies last. But this is good news.”

Image Credits: WHO.