World leaders commit to decisive action on antimicrobial resistance

26 September 2024, New York – Global leaders have approved a political declaration at the 79th United Nations General Assembly (UNGA) High-Level Meeting on Antimicrobial Resistance (AMR), committing to a clear set of targets and actions, including reducing the estimated 4.95 million human deaths associated with bacterial antimicrobial resistance (AMR) annually by 10% by 2030.

The declaration also calls for sustainable national financing and US$100 million in catalytic funding, to help achieve a target of at least 60% of countries having funded national action plans on AMR by 2030. This goal is to be reached through, for example, diversifying funding sources and securing more contributors to the Antimicrobial Resistance Multi-Partner Trust Fund.

The Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH), known as the Quadripartite, welcome the declaration. The Quadripartite applauds countries for recognising the need for global, regional and national efforts to address AMR through a One Health approach, which recognises that the health of people, animals, plants and the wider environment, including ecosystems, are closely linked and interdependent.

Global champions involved with the meeting include Prime Minister Mia Mottley of Barbados, AMR survivors, civil society and stakeholder organisations from around the world.

AMR occurs when bacteria, viruses, fungi and parasites no longer respond to medicines, leading to infections becoming difficult or impossible to treat, increasing the risk of disease spread, severe illness and death.

Global multisectoral action needed to reach targets by 2030

On human health, the declaration sets a more ambitious target that at least 70% of antibiotics used for human health globally should belong to the WHO Access group antibiotics with relatively minimal side effects and lower potential to cause AMR.

It also includes targets around infection prevention and control (IPC), such as 100% of countries having basic water, sanitation, hygiene and waste management services in all health care facilities and 90% of countries meeting all WHO’s minimum requirements for IPC programmes by 2030. There are also commitments on investments to facilitate equitable access to and appropriate use of antimicrobials, as well as on reporting surveillance data on antimicrobial use and AMR across sectors.

On agriculture and animal health, the declaration has commitments to, by 2030, meaningfully reduce the quantity of antimicrobials used globally in the agri-food systems by prioritising and funding the implementation of measures to prevent and control infections and ensuring prudent, responsible and evidence-based use of antimicrobials in animal health. This is to be achieved in the context of the WOAH list of priority diseases and FAO’s RENOFARM initiative, as well as preventive strategies, including animal vaccination strategies, good husbandry practices, biosecurity, and water, sanitation and hygiene (WASH).

On the environment, the declaration underscores the need to prevent and address the discharge of antimicrobials into the environment. It also calls for increased research and knowledge on the environmental dimensions of AMR and for catalysing actions to address key sources of antimicrobial pollution.

Acknowledging that AMR is a complex problem, the declaration recognises the need for a multisectoral response combining human, agricultural, animal, and environmental sector-specific interventions.

“The intersectoral challenge of AMR demands a One Health systems approach that unites human, animal, plant, and environmental health, backed by robust and accountable global AMR governance. Sustainable, consistent and diversified financing is essential to support the clear priorities and measurable targets for decisive action, while recognizing local, national and regional contexts. We must ensure universal access to medicines, treatments, and diagnostics, while promoting preventive measures and investing in research, innovation, capacity building, and bold awareness initiatives. Our health depends on safe, nutritious food, and food security hinges on efficient, inclusive, resilient and sustainable agrifood systems. For nearly 80 years, FAO has been steadfast in its mission to secure safe, healthy foods for all. We fully support this declaration and remain committed to a collective action to eliminate AMR risks in agriculture and food systems,” said FAO Director-General QU Dongyu.

“Evidence is mounting that the environment plays a significant role in the development, spread and transmission of AMR, including transmission between humans, and animals to humans. And why if we’re to reduce the burden of AMR and its risks, the environment must be part of the solution. Today’s declaration recognises this need, and UNEP will continue to be at the forefront of efforts to reduce the burden of AMR on societies and tackle the triple planetary crisis,” said Inger Andersen, Executive Director of UNEP.

“In the century since Alexander Fleming stumbled across penicillin in a laboratory in London, antibiotics have become a mainstay of medicine, transforming once-deadly infections into treatable and curable conditions,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Antimicrobial resistance threatens to unwind that progress, making it without question one of the most pressing health challenges of our time. Today’s declaration includes vital commitments that, if translated into action, will help to track AMR, slow it down, expand access to antibiotics and other medicines and spur the development of new ones.”

Antimicrobials help animals and humans live longer and healthier lives, but many of these life-saving drugs are dangerously losing their efficacy, which has devastating impacts not only on human health, but also on livestock and the economy at large. Urgent action is needed and we welcome the numerous commitments made by countries through this political declaration. The prioritisation of preventative measures against infectious diseases in animals is of paramount importance. That is why WOAH will continue to assist countries by developing standards and guidelines, assessing policy frameworks for antimicrobial prescription and supporting the implementation of biosecurity and vaccination programs on priority diseases that can help reduce the need for antimicrobials, among other measures.

Dr Emmanuelle Soubeyran, WOAH Director General

Clear way forward

The declaration formalises the standing Quadripartite Joint Secretariat on AMR as the central coordinating mechanism to support the global response to AMR. It also requests the Quadripartite organisations, together with countries, to update the Global Action Plan (GAP) on Antimicrobial Resistance by 2026 to ensure a robust and inclusive multisectoral response, through a One Health approach. The declaration also gives the Quadripartite the mandate to follow up and report back on implementation of the GAP and political declaration outcomes.

It also acknowledges the critical contributions of global AMR governance mechanisms, including the Global Leaders Group and the AMR Multi-Stakeholder Partnership Platform, committing to strengthening the latter, among others, to facilitate the multisectoral exchange of experiences, best practices, and the assessment of Member States’ progress in implementing multisectoral national action plans on AMR. The Quadripartite is pleased to take on the declaration’s request for it to establish an independent panel for evidence for action against AMR in 2025, after a global consultation with countries. The panel will support countries in efforts to tackle AMR.

The declaration emphasises key aspects, including the importance of access to medicines, treatments and diagnostics, while calling for incentives and financing mechanisms to drive multisectoral health research, innovation and development in addressing AMR. A stronger, transparent partnership between the public and private sectors, as well as academia is critical.

The declaration also encourages countries to report quality surveillance data on antimicrobial resistance and antimicrobial use by 2030, utilising existing global systems such as the Global Antimicrobial Resistance and Use Surveillance System (GLASS), the Global Database for Antimicrobial Use in Animals (ANIMUSE) of WOAH, and the International FAO Antimicrobial Resistance Monitoring (InFARM) . It further calls for 95% of countries to annually report on the implementation of their AMR national action plans through the Tracking AMR Country Self-assessment Survey (TrACSS).