Tackling AMR, Preventing the Next Pandemic
18 June 2020 - “We must limit the spread of antimicrobial resistance now and treat it as the emergency it is. Otherwise, a century of progress in health, economic and development gains can be jeopardized within a generation timeframe,” stated Maria Helena Semedo, FAO Deputy Director-General at a webinar co-hosted by FAO North America and the Embassy of Denmark in the USA. The aim of the webinar was to demonstrate the global threat of antimicrobial resistance (AMR) and ways to prevent its spread amid the COVID-19 pandemic.
“It is with open eyes that we see how AMR can threaten the very foundations on which modern medicine is built,” said Magnus Heunicke, Denmark's Minister for Health and Senior Citizens, in his keynote remarks. “We must remember that we are dealing with a kind of paradox here. On one hand, we all know how vital antimicrobials are to defend us against infections. On the other hand, we know that misuse and overuse can lead to the failure of these lifesaving treatments.”
Antimicrobials, such as antibiotics, are essential for treating and preventing infections in humans, animals and plants, and for enabling fundamental and life-saving medical interventions. However, their misuse or overuse can lead to their failure as microbes develop resistance to them placing everyone at great risk.
Linking COVID-19 with AMR
“While we have significantly benefited from antimicrobials, we have also realized its inherent danger,” said H.E. Lone Dencker Wisborg, Ambassador of Denmark to the United States. “COVID-19 is an indicator of the magnitude of the crisis that AMR has the potential to develop into.”
“COVID-19 is showing us how a pathogen without treatment looks like, and this is what we will face in the near future if we do not tackle AMR with the urgency it deserves,” said Deputy Director-General Semedo. “Bacterial infections are having significant impact on morbidity and mortality rates during the COVID-19 pandemic.”
“The COVID-19 crisis is warning us that while working to understand and control the current pandemic, it is crucial to prepare for the worst and prevent any future pandemic caused by superbugs, it important to know the origin and to tackle the disease at source and avoid its repetition,” Deputy Director-General Semedo added. “As drivers of antimicrobial resistance can be found in human, animal, plant, food and the environment, a sustained One Health response is essential to engage and unite all stakeholders.”
FAO’s role in addressing AMR
FAO works at the global level on data collection, surveillance, and the provision of guidelines and scientific evidence on terrestrial and aquatic animal health, crop production, food safety, standard-setting and legal aspects while helping countries to develop and implement national action plans against AMR. FAO is working with the World Health Organization (WHO), the World Organization for Animal Health (OIE), and the UN Environment Program, under the Tripartite Plus Initiative, to take collective action to minimize the emergence and spread of AMR through a “One Health” approach. The UN Secretary-General recently approved a One Health Global Leaders Group that was recommended by the UN Interagency Coordination Group (IACG) on Antimicrobial Resistance, in order to build on the political momentum for the fight against AMR. The Tripartite Plus Group is now working to put in place an Independent Panel on Evidence for Action against AMR.
“FAO is uniquely positioned to bridge the multi-sectoral response to antimicrobial resistance at the human, animal and environmental interface,” said Berhe Gebreegziabher Tekola, Director, Animal Production and Health Division, FAO. “More than 70 percent of the burden in the antimicrobial resistance scenario remains at the agricultural sector at FAO.” He emphasized that the prudent use of antimicrobials is especially important for the agricultural sector. He warned that “AMR is a slow-moving pandemic,” unlike COVID-19 and the cost of inaction would be much higher in the future.
Tacking AMR at the National Level
Robert Skov, Scientific Director, International Centre for Antimicrobial Resistance Solutions, underlined that while National Actions Plans on AMR are in place in many countries, their implementation is challenging especially in low and middle-income countries, where the social and economic cost burden is high. “There is an urgent need for the development of sustainable context-specific solutions to advance implementation of AMR mitigation,” emphasized Skov. Solutions need to be evidence-based, context-specific, and cost-effective to close the gap between technical solutions and practice, as well as holistic and cross-sectoral.
“The response to AMR is not equal to the level of the problem we are dealing with,” said Otridah Kapona, Lab Scientist-CD / AMR National Focal Point and Coordinator, Laboratory Systems and Networks, Zambia National Public Health Institute. Kapona shared challenges and lessons learned in implementing the 10-year AMR (2017-2017) action plan in Zambia. Implementing the action plan is capital-intensive requiring many resources including, financial, human, and infrastructure, and requires adequate enforcement of regulations surrounding the use of antimicrobials. Prioritizing activities for optimal use of resources for greater impact, mainstreaming AMR in existing programs, and collaborative multi-sectoral partnership, were some of the valuable lessons learned from implementing the national action plan.
“Antimicrobial resistance in animal and human health setting poses a significant burden in Vietnam,” said Bui Mai Thi Huong from the National Institute of Nutrition in Vietnam. The Vietnam action plan against AMR, currently under revision, was issued in 2013 and extended to include agriculture and livestock in 2017. While AMR surveillance is performed in the health care setting, it is lacking in the livestock and aquaculture sector, explained Huong. She added that self-medication, unregulated access and irrational prescription are common. The Vietnam government’s current priority is to strengthen collaborative surveillance networks to detect outbreaks and monitor trends.
“An ounce of prevention is worth a pound of cure,” said Julian Lampietti, Global Engagement Manager, Agriculture and Food Global Practice, World Bank. “To prevent AMR it’s not just about how we use the drug and which we use and trying to prevent people from using the drugs, but it’s creating the right environment for sustainability.”
In closing, Vimlendra Sharan, Director of FAO North America noted that “the Tripartite Plus or the One Health Global Leaders Group and ICARS established by Denmark are living examples of the growing international collaboration.” Moving forward continued collaboration and dedication will be required to ensure that our understanding and concern for AMR feeds into policies, programs and actions that will deliver results will be essential.
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