A milestone moment in global health: Drug resistance at the UN
Tamar leads the Longitude Prize.
History was made this week as antimicrobial resistance (AMR) was the subject of a UN High Level Meeting, only the fourth time in history for a health topic. It was an honour to be at this meeting, with 193 countries signing the declaration to tackle this global problem, which could lead to 10million deaths a year by 2050. Over the last 6 years England’s Chief Medical Officer, Dame Sally Davies, has been working tirelessly on awareness and action on AMR, with the support of many other governments, organisations and programmes.
We are proud to have played a part in highlighting this topic and encouraging innovators from across the world to get involved.
Amongst the commitments in the declaration is the encouragement of innovative ways to improve rapid diagnostics. At the Longitude Prize we currently have 205 teams, from 37 countries, working on the development of a point-of-care diagnostic test. To win the £8m award, it needs to be affordable, accurate, easy to use anywhere in the world and capable of producing a result in 30 minutes – telling you if you need an antibiotic, and potentially which one. There is no doubt, hearing speeches from the countries at the high level meeting, that a quick test that would help to determine whether antibiotics are needed would help in tackling this issue.
The UN, WHO, FAO and OIE backed up the need to consider human and animal health, agriculture, aquaculture and the environment in tackling AMR. Indeed many countries cited ambitions to reduce or stop the agricultural use of antibiotics as preventative treatment and for animal growth promotion.
One of the challenges with the Prize is around how the winning diagnostic test would work in over-the-counter settings, where prescriptions may not be used. The representative from Italy spoke about the ambition to eradicate self-prescriptions, however, we are aware that for some countries the lack of access to healthcare services compounds this problem. It’s important we work with pharmacy groups to understand how our winning test could increase appropriate use.
The problem of AMR is most challenging in developing countries, and those with resource-poor health settings. The Prime Minister of Thailand, speaking on behalf of the Group of 77 and China, reminded us that the capacity of countries to deal with AMR varies drastically. Sierra Leone spoke about the current challenges around recovering from Ebola, and South Africa talked about the ongoing challenge from MDR TB.
Our winning test must be able to perform in these constrained settings, so we need to see more innovation coming from teams who understand these contexts and barriers. Assessing the 76 entries for our Discovery Awards is a reminder to secure more funds for teams from resource-poor health settings. Although 193 countries have signed up to the declaration, we have only 37 nations working on ideas for the Prize. We must work to identify and provide support to enable more countries to get involved.
In the declaration there is also a commitment to raise awareness about AMR. We welcome this. The winning rapid diagnostic will not achieve its goal without awareness and confidence of patients and health workers to use the test and act on its results. Our surveys show there is still confusion over when we should use antibiotics, and what resistance really means, which is particularly high in progressively younger age groups. Our recently launched game, Superbugs, is aimed at tackling this audience.
UN Secretary General Ban Ki-Moon stressed that “commitment today must be turned into swift action” and we look forward to seeing how the recommendations in the declaration move forwards, and how we can help achieve its goals.
Chief Medical Officer for England Dame Sally Davies joined by world leaders at the AMR side meeting on 20 September:
Video property of the United Nations.