CPA’s recommendations to the UN High-level Meeting on AMR
Today, September 26th 2024, delegates from United Nations (UN) member states are convening in New York for the General Assembly’s second High-Level Meeting (HLM) on Antimicrobial Resistance (AMR), in recognition of the enormous threat to human health and prosperity that AMR poses to lower-and-middle income countries (LMICs) in particular.
The political declaration that is the focus of today’s meeting affirms on behalf of the national governments participating that AMR is “one of the most urgent global health threats and development challenges” facing the world in the coming century, calling for “immediate action to safeguard” our shared future.
Earlier this year, General Assembly delegates had already noted with concern how transformative advances in healthcare over the last century were being “gravely challenged” by the growing threat of AMR – and whilst the human cost is falling disproportionately on LMICs, higher-income countries and their most vulnerable citizens also face significant risks from AMR.
Millions of deaths globally are already linked in some way to the current AMR crisis. Millions more will follow without action. The economic cost of failing to deal with this crisis and change its trajectory has been put at more than $1trillion USD in additional healthcare costs alone globally by 2050, with hundreds of billions more to be lost in productivity and agricultural decline.
As an accredited organisation of the Commonwealth, we are incredibly proud that The Honourable Mia Motley, Prime Minister of Barbados, is one of the driving forces behind this vital HLM. Prime Minister Motley has been a powerful advocate for the citizens of Barbados, the Commonwealth and the world in trying to secure commitments to decisive action to safeguard human life and health by tackling AMR.
The Commonwealth Pharmacists Association (CPA) has been at the forefront of the struggle to fight AMR on the ground in African and Asian LMICs, for example through our CwPAMS and SPARC programmes, where we provide technical leadership in developing effective antimicrobial stewardship (AMS) interventions – supporting Pharmacists to ensure that these vital drugs are used in safe and sustainable ways.
Drawing on our extensive expertise, research and experience in delivering in-country interventions in the places where the threat from AMR is sharpest, we are calling for delegates at the HLM to commit to coordinated international action on ten key points:
1. ENHANCE EQUITABLE ACCESS TO HIGH-QUALITY PHARMACEUTICAL PRODUCTS AND SERVICES
Pharmacists must be better supported to lend their expertise not only to ensure that access to antimicrobials is optimised for sustainable and safe usage, but also in primary care interventions – like vaccine roll-outs – that reduce the prevalence of diseases needing antimicrobial treatment.
2. STRENGTHEN GOVERNANCE, POLICY AND REGULATORY SYSTEMS
Appropriate regulation is essential to ensure that high-standards and regulatory requirements are being enforced. Effective regulation must itself be accompanied by investment in training and remuneration, technological enhancements in practice and better end-to-end supply chain management.
3. ADDRESS SOCIOECONOMIC BARRIERS TO ACCESSING HEALTHCARE
An increase in investment in public healthcare systems is required to ensure healthcare services are more affordable and accessible. We need to promote educational initiatives that raise awareness about the dangers of self-medication and the importance of seeking professional medical advice.
4. BUILD AMS AND LEADERSHIP CAPACITY FOR AN INTEGRATED AMR RESPONSE
We need to empower and support more pharmacists to further develop their leadership skills and behaviors, to drive sustainable changes within healthcare facilities and services. Continuous professional development and fellowship programs, such as those offered by the CPA, are unique opportunities to further develop knowledge, skills and leadership in AMS and AMR in practice.
5. IMPROVE PUBLIC AWARENESS AND EDUCATION IN AMR
Utilizing multiple channels, including social media, community outreach, and school programs, to disseminate information might be some of the strategies. Collaborations with local health authorities, community leaders, and media organizations to ensure widespread reach and impact are also needed.
6. PROMOTE INNOVATION IN DIAGNOSTICS AND TREATMENT
Incentives for pharmaceutical companies and research institutions can be provided to develop new antibiotics and alternative therapies. We need to ensure that new diagnostics and treatments are affordable and accessible in LMICs. We need to take measures to promote the use of rapid diagnostic tests to guide appropriate antibiotic prescribing and reduce the misuse of antibiotics.
7. USE HIGH-QUALITY ANTIMICROBIAL PRESCRIBING AND USE DATA FOR CONTINUOUS QUALITY IMPROVEMENT
Quality and transparency of data on antimicrobial prescribing must be improved and become ore comprehensive, enabling us to make informed and strategic decisions about how to improve prescribing practices. This will require investment in new technologies and strengthening of supply systems.
8. IMPROVE RESOURCE DISTRIBUTION AND SUPPLY SYSTEMS
We need to address resource supply challenges by establishing reliable procurement and distribution channels for lab reagents, consumables, and medicines to support sustained high standards and best AMS practices.
9. ENHANCE ONE HEALTH APPROACHES
Encourage interdisciplinary collaboration among human health, veterinary, and environmental sectors to develop comprehensive AMR strategies. We need to implement coordinated surveillance systems that monitor antimicrobial use and resistance across humans, animals, and the environment.
10. FOSTER INTERNATIONAL COLLABORATION AND POLICY AGREEMENT
World leaders must commit to adopting and implementing the WHO’s Global Action Plan on AMR. In order to preserve the efficacy of antimicrobials, especially newer ones, it is also imperative to encourage member states to develop and implement AWaRE categorization, ensuring different levels of authorization of antimicrobials depending on level of diagnostic investigations and indication for use.
As the voice of Commonwealth Pharmacy, CPA welcomes that the political declaration already speaks to many of our recommendations and those being made by other organisations working on this important issue. We hope that today’s HLM will lead to productive, tangible and coordinated international action against antimicrobial resistance whilst there is still time to act decisively.
The CPA is currently facilitating the exchange of knowledge, resources, and best practices on AMS across Commonwealth countries, especially in LMICs, through international partnerships and networks, which could be extended to other nations across the globe as well. We stand ready to support and empower Pharmacists around the Commonwealth to do our part to ensure that the commitments made at today’s meeting are transformed into tangible actions.
In association with our partners at the Tropical Health & Education Trust (THET), we have also developed an evidence-based policy briefing on effective AMS interventions based on our learnings from the CwPAMS programme. Download the briefing from the THET website here, or hear more from the THET team about our joint recommendations on LinkedIn.
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