With less than four months to the United Nations High-Level Meeting (HLM) on Antimicrobial Resistance (AMR), global leaders have proposed a variety of measures to address the growing threat of pathogens that are resistant to antibiotics.

The recently published zero draft of the political declaration for the meeting aims to reduce global deaths caused by bacterial AMR by 10% by 2030 (using 2019 as the baseline).

Mia Mottley, Prime Minister of Barbados and chairperson of the Global Leaders Group on AMR, called for “adequate, predictable and sustainable financing” to address the problem,  including financing for research and development for new antibiotics and the implementation of national action plans on AMR, especially in low- and middle-income countries. 

“Fundamentally, we must focus on prevention across all sectors – clean water, safe and effective sanitation, food security, infection prevention and control in all settings,” Mottley told a lunchtime roundtable during last week’s World Health Assembly.

“I believe that we should establish an independent panel to monitor and report on the science and the evidence to facilitate collaborative and coordinated action against AMR,” She also called for the quadripartite joint secretariat on AMR to be formalised and adequately resourced. This is made up of the World Health Organization (WHO), the UN Food and Agriculture Organisation (FAO), UN Environment Programme (UNEP), and the World Organisation for Animal Health (WOAH).

The agricultural sector is responsible for the vast majority of antibiotic overuse, leading to drug resistance. 

Threatens to ‘unwind century of medical progress’

“In 2019, 1.3 million deaths resulted directly from bacterial AMR, more than two every minute,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told the meeting.

“AMR threatens to unwind the century of medical progress and also threatens animal health, global food production, food security, and the environment.”

Dr Jean Kaseya, Director-General of Africa CDC, noted over one million deaths in Africa were associated with AMR and 250,000 caused by ARM. 

“Only 1.3% of our labs in Africa are able to perform bacterial resistance testing. It means this data that I’m sharing with you is an underrepresentation of the reality in Africa,” said Kaseya.

Four years ago, the African Union Assembly established a task force to control AMR and recommended that all member states implement national action plans.

“But less than 10% of a member states have national action plans that are fully funded and implemented,” he added.

Kaseya appealed to The Global Fund to expand its mandate from HIV, TB, and malaria to include AMR.

Professor Sally Davies, the UK Special Envoy on AMR and a member of the Global Leaders Group, called for the high-level meeting to “truly address the needs of the most vulnerable communities, offering clear support to low and middle-income countries” that carry the greatest burden of this antibiotic emergency and need fair and equitable access to antibiotics and diagnostics.

Surviving AMR

South African Vanessa Carter, chair of WHO Taskforce of AMR Survivors, shared her nightmare of being unable to shake an infection after being seriously injured in a car crash in Johannesburg and losing her right eye. 

The infection turned out to be the drug-resistant Methicillin-resistant Staphylococcus aureus (MRSA). Hospital patients, people with wounds, and those who have surgery and medical devices implanted in their bodies are particularly at risk of MRSA.

Today, I was privileged to share my lived experience of #AMR at the #WHA77 & talk about the work we have already achieved with the @WHO Task Force of AMR Survivors since its inaugural meeting in October 2023

Patients, carers & survivors help to demonstrate the real-world impact… pic.twitter.com/k9onObOpm5

— Vanessa Carter 🇬🇧🇿🇦 (@_FaceSA) May 31, 2024

Carter, who spent a month in hospital, had a prosthetic eye inserted and a number of surgeries.

“In my sixth year of surgeries, and my fourth prosthetic [eye], I went out shopping one day, I came back to the car and I felt moisture on my face. When I pulled down the rearview mirror, I saw this pus seeping out of the cheek of the prosthetic,” Carter told the roundtable meeting.

Her doctor told her she needed emergency surgery, but two weeks’ later the infection came back again.

“I was under the care of different types of specialists, an ENT surgeon, ophthalmologist, plastic surgeon, maxillofacial surgeon, each of them prescribing antibiotics during surgeries,” she added.

After almost a year of continued infections, doctors removed the prosthetic eye and sent it for testing and it was found to be contaminated with MRSA. What followed was a long and harrowing process during which the infection got into Carter’s bones before she was finally cured.

“I’ve been an advocate for the last 11 years and, most recently, we’ve established the WHO Task Force of AMR Survivors,” said Carter.

“Our biggest objective is to bring the human impact. When policy makers and members of the public understand exactly what it is, we can we can empower them. One of the documents we have worked on is a strategic technical guidance document for meaningful patient involvement. I would encourage you to go take a look at it.”