Antimicrobial Resistance at the U.N. General Assembly: Goals, Action Plans, and Implications for Low- and Middle-Income Countries
People who die after being exposed to AIDS, for example, tend to die months or years after infections, while people who die from Malaria, for example, do not last as long. A child with an underlying illness, who develops a fever in the mornings, can be dead if they don’t get the right antibiotics. But in low- and middle-income countries, those are unavailable in many public-sector clinics. Parents and other carers must frequently turn to their local pharmacies for help. Because it is harder in those pharmacies than in public-sector ones to set up systems that limit the entry of inappropriate, poor-quality or fake drugs, hundreds of millions of people are using them.
The problem of antimicrobial resistance (AMR) — bacteria, fungi or protozoans evolving resistance to antimicrobial substances — is worsening. This month, heads of state are gathering in New York City at the 79th session of the United Nations General Assembly to discuss the issue, among other global challenges.
This is the second time that AMR has been featured at a high-level UN meeting. The first one, in 2016, highlighted the importance of the problem, which is associated with nearly five million deaths each year worldwide. Although there has been some progress in the past eight years, such as the development of national action plans by many countries, the pace of change has been slow. I am presenting at the upcoming meeting, and I hope to convince attendees that the next eight years could look very different.
International funders, such as the Global Fund, must step up. People with HIV have a high risk of developing bacterial, viral, fungal and protozoal infections. The Global Fund is already mandated to give people access to effective diagnostics and antibiotics targetingbacterial infections.
Both the United States Agency for International Development in Washington DC and the Vaccine Alliance need to support the provision of vaccines and safe water as well as other prevention strategies. They also need to be prioritized in national budgets in low- and middle-income countries.
With investment from global funders, specific targets and accountability through an independent panel, there is a much higher chance of this year’s meetings at the General Assembly leading to action to tackle AMR.
The authors hope the report will “guide information on how to develop new drugs, which new drugs to focus on, what new vaccines to focus on”, says co-author Eve Wool, a research manager at the Institute for Health Metrics and Evaluation in Seattle, Washington.
Policymakers should also address the overuse of antibiotics in farming, which speeds up bacterial resistance, and invest in research for innovative antibiotic drugs, Walsh says.
South Asia, Latin America and the Caribbean are regions with the highest predicted mortality rates.
According to the study co-author, we have a problem in health system quality and prevention of infections.
Carbapenem drugs are a class of antibiotics used to treat infections and they are resistant to Gram-negativebacteria, which can swap antibiotic-resistance genes with other species. The number of deaths caused by Carbapenem- resistant gram-negative bacteria have increased by 149.51% in the last twenty years.
There have been reductions in the number of children dying from drug- resistant infections over the past 3 decades, but the rate of deaths for people over 70 has gone up.
A contribution like this helps us understand how we’ve gotten where we are, and gives a rational expectation of the future burden of resistance, according to Joseph Lewnard.