October 21, 2024
Prioritizing commitments to AMR prevention efforts ahead of UN High-Level Meeting
OHT’s Dr. Ramanan Laxminarayan spoke at a media summit ahead of the United Nations High-Level Meeting on Antimicrobial Resistance (AMR), calling for urgent action to curb the AMR crisis. He emphasized the importance of strengthened infection prevention and control (including water, sanitation, and hygiene measures), expanded access to antimicrobial agents, and increased antibiotic innovation and development. He emphasized that commitments to solving the crisis must not end with the meeting; rather, countries should prioritize and fortify policies and systems that work towards global AMR targets. [Devex]
Antimicrobial resistance could be exacerbated by mpox outbreaks in Africa.
Dr. Jean Kaseya, the director general of the Africa Centres for Disease Control and Prevention, spoke at a UN General Assembly (UNGA) side event co-hosted by the One Health Trust and warned that mpox transmission is driving over-the-counter antibiotic use in Africa as people desperately seek treatment and prevention. He cited data from an Africa CDC report in which an assessment of the laboratory network in 14 African countries found that just 1.3 percent of laboratories had the capacity to conduct AMR surveillance, likely leading to underreporting of the true AMR burden in the continent. With 840 weekly deaths due to mpox reported in early September, Dr. Kaseya called for increased AMR surveillance and interventions that target vaccine hesitancy to reduce inappropriate antibiotic use. [the bmj]
Improved antibiotic access could avert nearly 100 million deaths in 25 years.
In an article featuring new Lancet findings that AMR-related deaths among adults 70 and older skyrocketed between 1990 and 2021, OHT’s Dr. Ramanan Laxminarayan called for expanded antibiotic access across all age groups. While developing new antimicrobials is essential as first-line treatments gain resistance, low- and middle-income countries also grapple with the issue of limited access to antibiotics. Improved access and enhanced infection prevention and control efforts (including food safety and hygiene practices) could avert 92 million global deaths between 2025 and 2050. [EuroNews]
Inequitable antibiotic access in low- and middle-income countries
This year’s UN High-level Meeting on AMR saw a paradigm shift away from simply drug development and stewardship towards the recognition that most of the world’s poorest are burdened by a lack of access to effective antimicrobials. Dr. Ramanan Laxminarayan noted that infections linked to poor sanitation infrastructure have killed more people than antimicrobial-resistant infections. Furthermore, many of the newest antibiotics are not available for sale in low- and middle-income countries, highlighting the need for cross-sectoral and international commitments to mitigate the inequitable burden of bacterial infections. [New York Times]
The 2024 UN political declaration on AMR includes specific and attainable targets.
Ahead of the 2024 UN High-level Meeting on AMR, OHT President Dr. Ramanan Laxminarayan was interviewed by the Center for Infectious Disease Research & Policy, where he discussed his understanding of the future of AMR. He cited the specific and timely targets in the political declaration on AMR and a progressive acknowledgment among countries of the nuances of AMR as reasons for his optimism for the future. He noted that UN Member States must also horizontally integrate AMR initiatives as they are inextricably linked to existing vaccine; water, sanitation, and hygiene; and infection prevention infrastructure. [CIDRAP]
Experts from LMICs call for increased infection prevention and political will to mitigate AMR.
Four experts (including three authors of The 2024 Lancet series on AMR, written by experts led by the One Health Trust) from Bangladesh, Brazil, Nigeria, and Lebanon discussed critical changes that would help mitigate the burden of AMR in their respective countries. Common themes included the need to prioritize prevention efforts, such as vaccines and infection control in hospitals, and for investment and political buy-in to raise awareness of AMR as a public health threat. [Nature]
Biotech and artificial intelligence can revolutionize the antibiotic innovation pipeline.
Global health experts at a symposium to kick on UNGA week co-hosted by the One Health Trust discussed key drivers of AMR, such as inequitable global access to antimicrobials, inappropriate antibiotic prescription/provision, antibiotic overuse, and poor access to safe water and sanitation. Trevor Mundel, President of Global Health at the Bill & Melinda Gates Foundation, stated that he believes that artificial intelligence will change the drug discovery landscape by accelerating drug development and involving more stakeholders. OHT’s Dr. Laxminarayan added that smaller biotech companies should receive support to be able to continue their efforts to contribute to antibiotic innovation. [SciDev.Net]
Older adults saw a jump in AMR-related mortality between 1990 and 2021.
A systematic analysis of hospital, microbiological, and pharmaceutical data found that global AMR-related mortality decreased from 1.2 million attributable deaths in 2019 to 1.14 million attributable deaths in 2021. A subgroup analysis revealed that despite a 50 percent reduction in attributable and associated AMR mortality among children under the age of 5 between 1990 and 2021, adults 70 years and older experienced a more than 80 percent increase in both attributable and associated AMR mortality in the same time period. The study forecasted 39.1 million deaths attributable and 169 million associated AMR deaths between 2025 and 2050, with the greatest estimated burden in South Asia, Southeast Asia, East Asia, Oceania, and Africa. [The Lancet]
The need to integrate immunization in AMR mitigation strategies in South Africa
OHT’s Dr. Erta Kalanxhi and Isabella Impalli and the Global Antibiotic Resistance Partnership (GARP) members in South Africa co-authored an article summarizing barriers, facilitators, and solutions to the integration of vaccination as a critical prevention strategy for AMR. Despite their value, vaccines are underutilized in the AMR mitigation context. Similarly, AMR is not included as a metric for vaccine value assessments. Recommendations included conducting awareness campaigns adapted to varying health literacy levels, leveraging the pharmacy workforce to promote immunization and antibiotic stewardship, and integrating AMR and Vaccine research, among others. [South African Medical Journal]
Global amoxicillin shortages indicate a greater access gap.
OHT’s Dr. Ramanan Laxminarayan and co-authors highlighted global disparities in antibiotic access as exemplified by long-lasting shortages of amoxicillin, a first-line WHO Access antibiotic recommended for treatment of 10 out of 12 of the most common primary care infections in adults and children. The low cost of amoxicillin leads to slim profit margins along the supply chain, disincentivizing all actors – from manufacturers to prescribing physicians – to prefer the higher-priced Watch antibiotics. While solving the access gap is complex, public investment in the supply chain is already underway in the European Union, with plans to expand to other regions. Universal Health Coverage plans should incorporate access to antibiotics and prioritize strengthening regional manufacturing capacity to achieve equitable, universal access to these essential medicines. [CMI Communications]
Better use of vaccines could reduce antibiotic use by 2.5 billion doses annually.
Better use of vaccines could reduce antibiotic use by 2.5 billion doses annually. A recent comprehensive report by the World Health Organization further supports vaccines’ role in AMR mitigation. The report details the impact of 44 vaccines targeting 24 pathogens causing infections that contribute to a significant health and economic burden globally. A malaria vaccine alone was estimated to save 25 million antibiotic doses linked to antibiotic misuse in malaria treatment. Highlighting the huge impact that vaccines can have on AMR, the report estimates that vaccination could save up to 2.5 billion antibiotic doses or nearly one-fourth of antibiotic use globally, each year. [WHO]
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