Thursday, September 26, 2024
10:00 a.m. EDT
High-level Meeting on Antimicrobial Resistance
Venue: Conference Room 4, United Nations Headquarters, New York
Click here to watch the full opening ceremony.
[H.E. Mr. Philemon Yang, President of the General Assembly]
The high-level meeting of the General Assembly on antimicrobial resistance is called to order. Health of State and Government, Deputy Secretary-General of the United Nations, President of the Economic and Social Council, Director-General of the World Health Organization, Excellencies, Distinguished Delegates, Distinguished Participants, Ladies and Gentlemen. I warmly welcome all of you to this high-level meeting convened under the overall theme and I quote, investing in the present and securing our future together, accelerating multi-sectoral, global, regional and national actions to address antimicrobial resistance.
The high-level meeting is held in accordance with General Assembly Resolution 70S/269 of 25th May 2024. Before proceeding further, I first invite the high-level meeting to turn its attention to the draft political declaration entitled and I quote, political declaration of the United Nations General Assembly high-level meeting on antimicrobial resistance end of quote, investing in the present and securing our future together, accelerating multi-sectoral, global, regional and national actions to address antimicrobial resistance. The text of which was transmitted to member states by the President of the General Assembly in a letter dated 9th September 2024. This action-oriented political declaration has been considered in advance through intergovernmental consultations.
May I take it that the high-level meeting approves the draft political declaration taking into account the need to combat antimicrobial resistance. I hear no objection. It is so decided.
I congratulate all member states on the approval of this draft political declaration which I will submit to the General Assembly for its adoption at a later date. Allow me to express my sincere appreciation to the co-facilitators of the negotiating process, His Excellency Francois Jackman, permanent representative of Barbados to the United Nations and Her Excellency Vanessa Frazier, permanent representative of Malta to the United Nations, for their skillful stewardship and dedicated hard work which has brought us to this significant outcome. I also extend my sincere thanks to all member states for their flexibility and constructive engagement.
Allow me now to make a statement as President of the General Assembly. Excellencies, ladies and gentlemen, I welcome you all to this important high-level meeting as we address one of the most urgent global health threats and development challenges of our time, antimicrobial resistance, AMR. I would like to acknowledge the presence of Her Excellency Prime Minister Mia Mottley, Chair of the Global Leaders Group on Antimicrobial Resistance and look forward to hearing her remarks.
I also extend my appreciation to the co-facilitators, the permanent representatives of Barbados and Malta, Ambassador Jackman and Ambassador Frazier, for their remarkable leadership in negotiating the political declaration on antimicrobial resistance which we have just approved. Additionally, I thank the representatives of the Quadripartite Organizations and all our partners for their support in this process. Finally, I would like to recognize the antimicrobial resistance survivors who are with us today.
Excellencies, AML is not only a global health crisis but also a critical development issue. It is an issue relevant to our ability to treat diseases in humans, animals and plants, improve food safety and security, enhance nutrition, foster economic development and equity and safeguard our environment. Success on all these fronts is essential to advancing the 2030 Agenda for Sustainable Development.
It is of concern. AMR is already linked to nearly 5 million deaths globally each year and by 2050 it is projected to cause up to 10 million deaths annually. The inappropriate use of antimicrobial medicines has led to resistant microorganisms undermining our ability to control infections.
AMR also affects food systems, exacerbating hunger, poverty and inequality. Its impact stretches across human health, agriculture and the environment. Addressing these issues is crucial to stopping its spread.
We must act urgently as AMR threatens our progress toward multiple sustainable development goals including SDG 3 on good health, SDG 6 on clean water as well as SDG 1 on no poverty and SDG on zero hunger. Excellencies, our response must be tailored to address those populations that are especially vulnerable. Developing countries bear the greatest burden of AMR yet lack the financial and the technical support to tackle these inequities.
In line with our commitment to ensuring human dignity for everyone, everywhere it is vital to strengthen the resilience of those in vulnerable situations especially in developing countries. We must strengthen international cooperation and partnerships to enhance capacity building, facilitate technology transfer and support these nations in the AMR response. This includes reinforcing health care systems, improving surveillance and monitoring and advancing environmental interventions such as waste and water management all while promoting responsible anti-microbial use.
We cannot afford to fail or leave anyone behind. We call for inclusive solutions and greater collaboration to promote equity and ensure that those most in need are part of the solution. Our focus must be on providing access to anti-microbial treatments, diagnosis and integrated water management while investing in health care, supporting rural farmers and producers and bridging the development gap all while protecting environment.
Engaging all sectors, partners and stakeholders, public and private is essential to combating AMR. The whole of government and whole of society approach is required. Excellencies, I commend all delegations for their coming together to make bold commitments and set important targets across sectors including health, including human health, animal health, agriculture and the environment as well as in governance, financing and surveillance. I recognize the political declaration as a strong blueprint for accelerating action against AMR. I especially applaud its call for a whole of society and whole of government approach which aligns with a key component of my theme for the 79th session, unity and diversity. We must build on this political will with resources and accountability to ensure effective implementation. Excellencies, based on our current progress we are on track to turn our pledges into action and deliver results for our global constituents. It is important to translate our declarations into concrete action with the support of the quadripartite organizations.
Let us together rise to meet this challenge and secure a safer, healthier future for all. Thank you and I wish you a successful high-level meeting. I now invite His Excellency Robert Ray, President of the Economic and Social Council at his 2025 session to make a statement.
[H.E. Mr. Robert Rae, President of the Economic and Social Council]
Thank you very much, Mr. President. This is my first public opportunity to congratulate you on your election as President of the General Assembly. You and I have an open secret of your long relationship with Canada and your fact you’re living in my hometown of Ottawa and it’s wonderful to have you with us and I’m delighted that you’re here.
Dear friends, I want to join in the congratulations to my colleagues Francois Jackman and Vanessa Frazier for their leadership and co-facilitation on what is a challenging issue and I think we all understand that it took a lot of work and flexibility and willingness to engage on all sides to produce this political declaration. I also want to extend special acknowledgement as others have done and no doubt will do to Prime Minister Mottley. This is an issue that she and I discussed in Barbados two years ago and she let me know why it was a subject of great personal concern to her.
I think we all understand and she’s coming into the room as I’m speaking so I just want to say that Mia it’s wonderful to see you here and your passion which is well known to all of us has helped to build the public recognition of the extent of this problem. Simply put, our reliance on certain ways of dealing with disease and dealing with the challenges of life have now created their own problem and we know what it is but dealing with it is not easy because it requires as the president has said so well it requires the movement of whole the whole of society of how we do things, how we raise animals, how we protect public health, how we ensure that we put the health of humans as well as animals at the forefront of what we’re trying to do.
[Translator for H.E. Mr. Robert Rae, President of the Economic and Social Council]
And the work we are doing we’re doing it at the same time as we have a profound division amongst our members and inequality which affects entire societies and inequality which means that people do not have access to all of the technology that they need as always to deal with the problem but as was said by the president earlier there are five million people who die because of this problem and that is why it impacts everyone.
[H.E. Mr. Robert Rae, President of the Economic and Social Council]
Our greatest strength in the face of a global health threat such as antimicrobial resistance which we all refer to as AMR is one word and that is solidarity. It is a solidarity that requires wealthier countries to understand that poor countries do not have the same access to technology as we do. It is imperative that we understand a need to share capacity and the capacity that must be present in every corner of the world for us to be able to address this question and that’s why the economic and social framework of this discussion quite apart from the technical discussion that’s required is so important for us to make sure there’s access to antimicrobials and alternative therapeutic treatments that are consistently of high quality. We need affordable and effective diagnostics to ensure we’re providing the right treatment for the right disease at the right time.
We also need prevention and control measures to address the risk and the spread of infections and immunization strategies to reduce the need for antimicrobials in the first place. It’s a comprehensive strategy that’s required and we know that that climate change and the environment play a significant role in the development and the spread and transmission of AMR. I know my colleague from UNEP will be talking directly about this question. As I said, as we look at increase in temperatures and historic climate events, these create the conditions in which microorganisms can thrive and that only exacerbates the challenge and the problem which is why there has to be so much joint action and great effort on the part of all involved.
Wish you well in your endeavors. I can assure you that ECOSOC remains ready, willing, and able to give this issue the prominence and the focus that it requires. We wish you well in your deliberations today.
If I leave it’s because the la diplomatie c’est pas la guerre. And there’s another train going and sometimes we have to catch the next train. But thank you very much for the opportunity to speak and thank you for allowing me to share some words with you today.
Thank you.
[H.E. Mr. Philemon Yang, President of the General Assembly]
I thank the President of the Economic and Social Council. I now invite Her Excellency Amina Mohammed, Deputy Secretary General of the United Nations, to make a statement.
[Ms. Amina J. Mohammed, Deputy Secretary-General of the United Nations]
Thank you. President of the General Assembly, President of ECOSOC, who’s just left the station, excellencies, dear colleagues, I welcome this opportunity to address the critical issue of antimicrobial resistance, AMR, and I thank His Excellency Mr. Francois-Jacques Mann and Her Excellency Ms. Vanessa Frazier for their unwavering efforts to shine the spotlight and bring member states together around this important agenda.
Congratulations. Our deep appreciation goes to Her Excellency Prime Minister Mia Mockley for her steadfast and personal leadership as chair of the Antimicrobial Resistance Global Leaders Group. Dear colleagues, AMR is a complex and an existential danger.
The World Health Organization has named AMR as one of the top 10 threats to global health and development. It has profound implications for the environment, for food security, animal health, and human health. Already, AMR is directly responsible for 1.3 million deaths a year, one in five children, without a step change in action before 2030. Antimicrobial resistance will reduce global life expectancy by almost two years. These are not just numbers. They represent lives that are lost, families that are shattered, and futures that are stolen.
The worst is that they are preventable tragedies. AMR is a major challenge to sustainable development. This is a crisis that costs the world an estimated US$800 billion a year in health care costs and productivity losses, and that threatens to reverse decades of medical progress.
It is deeply intertwined with poverty, food and nutrition, environmental degradation, inadequate water and sanitation, and a lack of access to essential health services and medicines. Vulnerable populations worldwide, particularly in the Global South, shoulder the heaviest burden of the AMR crisis. Addressing antimicrobial resistance is a health, a socioeconomic, and an environmental necessity.
It is equally a moral imperative. Excellencies, friends, we must take a one health response and tackle this crisis as a whole, and move to the sustainable use and production of antimicrobials, preserving these extraordinary medicines for generations to come. The political declaration from the first high-level meeting on AMR in 2016 was a crucial step, which generated significant momentum.
Since then, over 90% of countries now have multisectoral national plans to combat AMR. The path forward is clear. But countries face obstacles in implementation. Chief among them is finance.
The vast majority lack dedicated funding to address gaps and make corrective actions where needed, and this must change. The institutions and capacities must be primed to deliver an effective cross-sector and multi-level response, from grassroots and community to national, regional, and global levels. It will also be vital to engage partners across the board, from the private sector and civil society, to farmers associations and consumers, to patients, practitioners, given the multi-dimensional nature of the crisis.
Let me also underscore the importance of the research community. That must be a partner of first choice, for without science, we will surely lose the battle. This is essential.
Excellencies, the political declaration today paves the way for a robust response to AMR, and I’m calling on member states to be bold in implementing it, with actions that are inclusive, equitable, and coordinated, actions that target sustainable and diversified financing of the AMR response, and actions that support health systems that address the need of all populations for safe and also systems that support nutritious food, fresh air, clean water, particularly in the Global South.
As we stand in solidarity today, let us elevate the political significance of AMR challenge, reignite the urgency, work together to deliver its benefits for people and for our planet. Thank you.
[H.E. Mr. Philemon Yang, President of the General Assembly]
I thank the Deputy Secretary General of the United Nations. I now invite Dr. Tedros Adhanom Ghebreyesus, Director General of World Health Organization, to make a statement.
[Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization]
Thank you. Your Excellency, Philemon Young, President of the General Assembly, I would also like to join other speakers in congratulating you for your election. Your Excellency, Prime Minister Mia Mottley, Your Excellency Robert Rai, Deputy Secretary General Amina Mohammed, fellow quadripartite principals, AMR survivors, and civil society partners, Excellencies, dear colleagues and friends.
Let me begin by expressing my deep gratitude to Prime Minister Mottley of Barbados for her leadership on antimicrobial resistance and on global health more generally. Thank you, Your Excellency, for everything you have done to elevate this critical issue on the global agenda. Please join me in giving her thank you.
Thank you so much. Alexander Fleming won the Nobel Prize for his accidental discovery of penicillin almost 100 years ago, but he also knew about the threat of antimicrobial resistance and warned the world about it. In his Nobel lecture in 1945, Fleming said, I quote, it’s not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, end of quote.
If he were if he were today, he would probably say, I told you so. AMR is one of the most pressing threats to health and development of our time. AMR could reverse decades of medical progress, making common infections, routine surgeries, cancer treatment, and organ transplants far riskier and even life threatening.
This is not a hypothetical risk for the future. It’s here and now. In 2019 alone, 1.3 million deaths were directly attributable to antibiotic resistant infections. Vulnerable populations, particularly children, are disproportionately affected. No country is immune to this threat, but low and middle income countries bear the greatest burden. Despite the rapid spread of resistance, we are facing an alarmingly dry pipeline for new antibiotics.
The irony of AMR is that it’s fueled by the overuse of antibiotics. And yet, more people die from lack of access to antibiotics. The threat of AMR cuts across the health of humans, animals, agriculture, and our environment.
And so must its solution. That’s why WHO, FAO, WHOA, and UNEP are working together closely in the quadripartite with a one-held approach. Since the first high-level meeting on AMR in 2016, we have made progress.
We have strengthened global governance, and most countries have developed and are implementing national action plans to tackle AMR. But more work and money are needed to stay ahead of this growing threat. Only 11% of countries have allocated budget to implement their plans. I commend member states for the political declaration you have approved today, the clear commitments you have made, and the confidence you have placed in WHO and the quadripartite.
WHO welcomes the target you have set to reduce global deaths associated with bacterial AMR by 10% by 2030. We also welcome the request to normalize the quadripartite joint secretariat on AMR. And we look forward to establishing an independent panel on evidence for action against AMR by next year, and to updating the global action plan on AMR by 2026. I urge all member states to take immediate action on the commitments you have made today, and WHO stands ready to support you.
And before I close, I would like to thank Ambassador Francois Jackman and Ambassador Vanessa Fraser for their leadership in the negotiation of the political declaration. Together, we can protect these powerful medicines and the people whose lives depend on them now and in the future. I thank you.
And Mr. President, back to you.
[H.E. Mr. Philemon Yang, President of the General Assembly]
I thank the Director General of the World Health Organization. I now invite Ms. Inger Anderson, Executive Director of the United Nations Environment Program, to make a statement.
[Ms. Inger Andersen, Executive Director of the UN Environment Programme]
Thank you very much, President. And let me recognize you and congratulate you on your election. Let me also recognize the DSG, who obviously has many tasks to take care of.
We will understand another train is waiting. But let me also recognize the amazing and fantastic Prime Minister Mia Mottley. Madam Prime Minister, your tireless leadership, your cajoling, your mastering of the substance, and always keeping a laser focus of results is what has gotten us here.
We’re in your debt, Madam. And let me also, of course, recognize my fellow warriors from other agencies, and last but not least, AMR survivors. This high-level meeting of the United Nations General Assembly is dedicated to AMR. And it’s a real important milestone, because at this point, we are going to raise the bar, raise the awareness about this growing and deadly threat. And this meeting comes not a moment too soon. Now, you may have seen just last week an article by The Lancet. This Lancet article estimates that almost 40 million attributable deaths to AMR and 160 million associated with AMR between just 2025 and 2050, just over a span of 50 years, if we do not take action.
And from 2050 onwards, this will place, as we heard, a continuing burden on 10 million deaths a year attributed to AMR. So frankly, this is much more horrific than we might have thought. And of course, AMR, as we heard from Dr. Tedros, impacts healthcare systems, but also productivity of agricultural production, and it will cost trillions. So now is the time to step up and take action across a series of sectors.
This is the first high-level meeting since 2016, and we have seen increased ambitions. We’ve established the One Health Quadripartite Partnership. We’ve established the Global Leadership Group, chaired by Her Excellency Mia Mottley.
And crucially, work now on AMR combines human health, animal health, and the environmental sector under the One Health approach. That’s the only way to go. But now this high-level meeting presents an opportunity for leaders to speed up the adoption of effective prevention and management of AMR at the national, regional, and global levels.
That could save lives, safeguard animal health and food safety, and food security, and of course, protect the environment. So Excellencies, we can’t deliver these results without understanding the role that environment plays here in the origins, development, and spread of AMR. Prevention is key to stop antimicrobials, and AMR is leaking into our environment from municipal waste water, from municipal waste, as well as wastewater, from pharmaceutical production, from hospitals, from farms that overuse and intensify crop production sprayed with antimicrobials. Around 56 percent of wastewater released into the environment has little or no treatment, and it is crucial to integrate water management, water sanitation, and hygiene. The pharmaceutical sector can strengthen inspection systems, change incentives, and importantly, we can change subsidies and ensure adequate waste and waste management containment.
The food and agriculture sector can take preventive action to limit the use of antimicrobials and to reduce the discharge from crops and terrestrial and aquatic marine animal and fish production facilities. And the healthcare sector can improve access to high quality, high water sources and sanitation, install hospital-specific wastewater treatment systems, and ensure the safe and sustainable disposal of antimicrobial medicines. This will take investments, this will take political determination, this will take leaders.
These actions and more must be at the highest level, with policies, with laws, and with regulations to reduce effluent releases that risk AMR development and spread, with international standards, with alignment of subsidies and investments, and with research, and above all, with a collaboration across all sectors. Strengthening the One Health approach is critical. We from UNEP are proud to accompany member states in this regard, and we will continue to marshal our science, our innovation, and our commitment in support of this action.
Thank you.
[H.E. Mr. Philemon Yang, President of the General Assembly]
I thank the Executive Director of the United Nations Environment Program. And I invite Ms. Emmanuelle Soubeyran, Director-General of the World Organization for Animal Health, to make a statement.
[Dr. Emmanuelle Soubeyran, Director-General of the World Organization for Animal Health]
Thank you, Mr. President, Honorable Philemon Young, Honorable Haminaji Mohamed, Prime Minister Mottley, Honorable François Jackman and Vanessa Frazier, Excellencies, dear Quadripartite colleagues, distinguished participants. Back in 1952, animal health leaders stated in Paris, practitioners must not use antibiotics at the discretion of their fantasy, but following rules that they have been set by experience, as inappropriate use can harm a method that has saved numerous human and animal lives. These words remain relevant today.
They remind us of the vital role of antimicrobials and the risk of resistance when misused. AMR is no small issue. Drug-resistant bacteria could claim over 39 million lives by 2050.
In addition, we recently launched, in the recently launched ECO-AMR series report, highlights that drug-resistant pathogens could jeopardize food security for over two billion people globally, more specifically on livestock. If no action is taken, the impacts of AMR on livestock could reduce global GPD by 40 billion U.S. dollars per year. But achieving a global 30% reduction in animal antimicrobial use within five years can raise GPD in 2050 by 14 billion U.S. dollars. Thus, the World Organization for Animal Health welcomes the political declaration which aligns with our four priorities. First, prevention. Prevention begins with good husbandry practices, biosecurity measures.
These, combined with improved access to high-quality vaccines, can reduce the need for antimicrobials. We welcome your commitment to define animal vaccination strategies with clear implementation plans. We will support our members in implementing international standards on vaccine manufacturing and quality control, and we’ll update the priority list of diseases of which vaccines could reduce antimicrobial use.
Second, surveillance. Today, nearly 130 members have a quantitative baseline of antimicrobial use in animals. Reporting those data is crucial to enable database decision-making for sustainable interventions.
International standards and guidelines are constantly updated to support your effort on food-producing animals, of course, but also companion, leisure, and working animals. Third, cross-sectorial collaboration. We welcome your commitments on a coordinated multisectorial response as an effective implementation on a One Health approach, with a focus on prudent and responsible use of antimicrobials across sectors.
The use in animals of highest priority antimicrobials to human health has been globally reduced to 16%. Regulation, awareness campaign, trainings, public-private partnership have allowed such development, but we strongly encourage all of you, all of our members, to accelerate along this line. So the important gaps still observed in the compliance with our international standards are closed.
Fourth, last but not least, funding. We welcome the commitment to fund at least 60% of national action plans by 2050. The Quadripartite stands committed working with all partners to improve access to resources to the sectors and regions that need them the most.
We also welcome commitment on the value of investing in animal health sector systems. The role of animal health and veterinary services is key in this issue, thus it is crucial to invest in this sector. The consequences of inaction are dire.
Economic devastation, food insecurity, and the loss of millions of human and animal lives. The time to act is now by investing in the present to secure our future together. And don’t forget that animal health is everyone’s health.
Thank you.
[H.E. Mr. Philemon Yang, President of the General Assembly]
I thank the Director-General of the World Organization for Animal Health. I now invite Mr. Thanawat Tiensin, Assistant Director-General of the Food and Agricultural Organization of the United Nations, to make a statement.
[Mr. Thanawat Tiensin, Assistant Director-General of the Food and Agriculture Organization of the United Nations]
Thank you, Mr. President. Your Excellencies, President of ECOSOC, Your Excellencies, Deputies, Secretary-General, Your Excellencies, Prime Minister Abebedo, Chair of the Global Leaders Group on Antimicrobial Resistance, Principal of the Quadripartite Organizations, AMR Survivors, Excellency, Distinguished Representative, Ladies and Gentlemen, I make these opening remarks on behalf of FAO Director-General Dr. Chu Dong-Chu. It is an honor to address you today at the opening of the United Nations General Assembly High-Level Meeting on Antimicrobial Resistance, AMR. I would like to extend my deepest gratitude to former President Francis for his exemplary leadership throughout the term of his presidency. I also wish to warmly welcome and thank His Excellencies, Mr. Philmon John, President of the General Assembly, for hosting this. There is no health without safe and nutritious food, and no food without healthy, sustainable, resilient, and inclusive agri-food system. In 2016, UN Member States recognized AMR as the greatest and most urgent global risk through the adoption of the political declaration on AMR. AMR threatens humans, animals, and plant health, with profound consequences for food production, ecosystem, and our economic and social well-being. The rapidly growing global populations, coupled with climate change and rising threat of AMR, demand a rethinking of our approach to food production. We must reduce the need for and use of antimicrobials and set the highest standard for animals and plant health. While progress has been made over the past eight years, much work remains.
For nearly 79 years, FAO has been unwavering in our missions to ensure safe and nutritious food for all, to eradicate hungers and poverty, and to uphold the Sustainable Development Goals, SDGs. We are committed to working with all stakeholders to sustainably transform agri-food systems in line with FAO’s strategic framework, which champions better production, better nutrition, better environment, and better life. Our efforts to tackle AMR are guided by FAO’s action plan on AMR 2021 to 2025.
We support Member States in developing and implementing their national action plan on AMR. FAO initiatives such as the International FAO Antimicrobial Resistant Monitoring System, called INFARM, and the Farmers’ Field School Program are driving innovation in agri-food systems. FAO recently launched the Reduce the Need for Antimicrobials on Sustainable Agri-Food Systems, known as RenoFARM initiative, a global 10-year program which aims to reduce reliance on antimicrobials and promote best practices at the farm level. On behalf of the Cordypatite, FAO proudly hosts the AMR Multi-Stakeholder Partnership Platform, a crucial global governance structure on AMR. This escalating threat of AMR demands collective action to an integrated One Health approach that encompasses human, animal, plant, and environmental health. Excellency, ladies and gentlemen, today’s meeting is a pivotal opportunity to renew our shared commitment to tackling AMR. I urge Member States to agree on equitable and inclusive political declaration that addresses the AMR challenges through a One Health lens. In closing, I express profound gratitude to all individuals, organizations, and Member States contributing to this effort, with special thanks to Ambassador Vanessa Fraser and Ambassador Francois Jackman for their exemplary leadership and co-facilitators. Together, let us ensure that life-saving antimicrobials remain effective for generations to come, for better production, better nutrition, better environment, and a better life for all, leaving no one behind.
The time for action is now. Let us not miss this opportunity. Thank you.
[H.E. Mr. Philemon Yang, President of the General Assembly]
I thank the Assistant Director of the Food and Agriculture Organization of the United Nations. I now invite Mr. Juan Pablo Uribe, Global Director for Health, Nutrition, and Population of the World Bank Group, to make a statement.
[Global Director for Health Nutrition and Population at the World Bank]
Thanks so much, Mr. President, and it’s an honor to be here with all of you today. At the World Bank, we recognize AMR as a global health threat that poses a major development challenge. Given its disproportional negative impact in particular on low- and middle-income countries, it threatens global security, human capital, and economic development.
Addressing this issue requires a comprehensive approach that spans multiple sectors, including agriculture, health, and water and sanitation, among others. It involves coordinated efforts across both private and public domains, and must be implemented at various levels from global and regional to national, subnational, and local. Despite these complexities, the urgency can’t be overstated and requires immediate actionable steps, as well as strong political leadership for coordinated efforts.
The World Bank has identified 20 intervention areas across health, agriculture, and the water sectors to develop sustainable systems addressing AMR at the national and regional levels. For example, in agriculture, it is about judicious antibiotic use. In healthcare, a focus on patient safety by following best practices.
In pharmaceutical and biotech firms, we’ll also be key in developing new antibiotics and rapid diagnostic tests for informed prescribing. Of course, let’s not forget appropriate access for antibiotics. All of this, of course, requires strong and sustained commitment and investments, as has been pointed out by others.
The World Bank stands ready to work with countries and the global community through our financing, our analytical and knowledge work, and our partnerships. We have committed $2.9 billion for AMR across 47 operations in 40 countries. Further, the pandemic fund invested almost $400 million in grants across 19 projects in its first funding round, supporting stronger AMR surveillance.
One Health approaches have been integrated into 80% of the projects being financed. Moving forward, we will continue to scale investments in AMR through our IDA and IBRD portfolios and broker partnerships through IFC, our private sector window. The pandemic fund will continue to be a critical partnership to crowd in more resources along with our financing.
Our knowledge initiatives will contribute to the growing body of evidence, such as the socioeconomic impact and the framework for action that outlines key concrete interventions. We will provide ministerial teams with technical assistance and ensure that AMR is better understood by all. We won’t do this alone, and we cannot do it alone.
We will strengthen our collaboration with partners like FAO, like the World Organization for Animal Health, like the United Nations Environmental Program, and, of course, with the World Health Organization to ensure our client countries have access to the latest data, the best technologies, and the most effective solutions. Whether it’s improving labs, or training health workers, or supporting Sentinel sites, or enhancing food security, or engaging local farmers to improve their understanding of zoonotic transmissions, or strengthening water and sanitation systems, or promoting regional collaboration for more effective disease surveillance and response strategies, we are committed to supporting countries at all stages of readiness. In sum, let’s confront directly and together this grand pandemic. Thanks, Mr. President.
[Mr. Jerome Walcott (acting Chair)]
I thank the Global Director for Health, Nutrition, and Population of the World Bank Group, and it is now my pleasure to invite Her Excellency, Mayor Amor Mottley, Prime Minister of Barbados and Chair of the Global Leaders Group on Antimicrobial Resistance, to address the meeting.
[H.E. Ms. Mia Amor Mottley, Prime Minister of Barbados, Chair of the Global Leaders Group on Antimicrobial Resistance]
Thank you very much, Mr. Chair and distinguished delegates and heads of agencies all. Let me adopt the words of everyone who has spoken thus far, because you have so appropriately outlined all of the challenges and, indeed, reflected the political will we must have to move forward. This is an important meeting, and let me, at the outset, thank you for your kind words, but to say that they’re not for me.
They are for all of the people who have worked behind the scenes, whose names are many, but I hope that a record will be placed as to their efforts. I want to thank the members of the Global Leaders Group as well, Leadership Group. We started this journey with Sheikh Hasina from Bangladesh, and then the Deputy Prime Minister of Malta, Chris Hearn, and we continue today now with the Maltese Minister of Health working side by side.
I’d like to thank Ambassadors Jackman and Fraser and their teams for their excellent work in allowing us to be able to work with the various delegations to get the declaration that we have here today. It is not a given that this could have happened, and therefore, in today’s very, very difficult and challenging world, particularly with geopolitics trumping so much, the achievement of this political declaration is a major achievement. This declaration eloquently describes and proves what we know needs to be done, and it is an impressive blueprint for action, but it does impose on us work, and the truth is the hard work starts tomorrow.
We have to be able to raise the funding for the National Plan of Action. We’ve set a very, very modest target of a hundred million dollars, and I hope that we can reach out to the leaders within the private sector, the pharmaceutical industries, the meat industries, all of the various players, because as I’ve said very often with climate, unless they have a plan to live on a different planet, then we have to define the win-win solution for us all, because this is very clear that this silent pandemic, slow motion pandemic, literally will become responsible for the largest number of deaths by 2050 if we do nothing. The reality is that we cannot claim the world’s attention for one day. This must now be imbued in the sensitivities of all of our citizens, all of our families, and particularly our young people whose battle this must be.
I believe that almost everyone in this room knows someone who has died from a hospital-aided infection or for whom antibiotics simply just has not worked. When I started this journey, I did not know that it would become personal for me and my family, and I pray that no family has to experience what we did with respect to the loss of someone purely because of the ineffectiveness of antibiotics to be able to deal with infection. This will make going to the dentist, as you heard from Dr. Tedros, or having an operation, or going into the garden and getting a cut very, very much a life-threatening issue for some, purely because of the ineffectiveness of the antibiotics. So, the public education and public sensitization program must go beyond governments and ministries, must not have a siloed approach with health, agriculture, and environment operating singularly. But the example of the quadripartite leadership, which is not only a good example for us here, but in almost every other aspect of what we are facing as global challenges, ought to be emulated by others at the national level. The hard work as well means that we have also to recognize that the raising of the hundred million dollars is just for national plans, but the big, big, heavy lift is what must be raised in order to encourage research.
We have gone from 20 companies in the year 2000 doing antibiotics research to four, and the world cannot depend only on the effort of four. Because the economics of antibiotics does not work simply because of the limited course of tablets that you take as compared to other forms of medication, I believe that this is one of the most perfect examples that we can find to be able to force us in the direction of the establishment of the designation of this level of research within the context of pandemic preparedness and prevention as a global public good, and therefore requiring dedicated financing that goes beyond simply what is immediately available within the context of the particular sector at this point in time. I hope therefore that the World Bank, in the general discussion as to its own reform and its movement towards the financing of global public goods and the guardian of the global public commons, will be able to see appreciable progress in its reform efforts so that this can be one of the early beneficiaries, not just the climate crisis, because as you heard from the Deputy Secretary General, this is as much an existential crisis as climate. I want to therefore end by saying that AMR is not simply an acronym.
These are investments that we are making in our future, in our children, in our infrastructure, in how we take care of animals, in how we deal with our businesses, in how we work on our farms, in how we work in our hospitals, in how we prepare for the pandemic. And that may be a word that causes PTSD in today’s world, but if you think we had PTSD from COVID, try PTSD from AMR over the course of the next 30 years. Let this be owned, not by governments, but by the people of the world, because they are the ones who, one by one by one, are exposed to infection and for whom our use of antibiotics safely and effectively and other alternates to antimicrobials will be a lifesaver.
I want to thank all who are participating today and ask us simply, let us make the commitment not to let this be another perfunctory debate on that we continue just to say we participated, but let us raise the awareness and build for a common future where all of us protect each other against the risk of this awful, silent, slow motion pandemic. Thank you.
[Mr. Jerome Walcott (acting Chair)]
I join the Prime Minister of Barbados and the Chair of the Global Leaders Group on Antimicrobial Resistance. I now invite Ms. Gabriella Balasa, antimicrobial resistance survivor, to make a statement.
[Ms. Gabriella Balasa, AMR Survivor]
Good morning all. Antimicrobial resistance is the greatest threat to my life. I was, my name is Ella Balassa, and I was born with cystic fibrosis, a genetic disease that causes a battle to rage inside my lungs against antibiotic-resistant bacteria.
This disease makes me highly susceptible to infections and I’m running out of antibiotics to treat them. Cystic fibrosis causes naturally occurring mucus in the lungs to become thick and sticky, trapping bacteria from the air I breathe in, causing infections, ultimately leading to deteriorating lung tissue and a shortened life expectancy. To suppress these bacterial infections, I’ve had to use countless cycles of antibiotics throughout my life, intravenous, oral, and inhaled antibiotics.
And over time, these antibiotics have lost their effectiveness and the bacteria have gained resistance. In 2019, I faced the most severe drug-resistant infection that I’ve had. My doctors had prescribed me the strongest antibiotics that we have available to us today, colistin, but after weeks of treatment I was not having any relief in my symptoms or improvement.
I was coughing endlessly, I was using supplemental oxygen all the time, I was unable to breathe walking just a few feet, and my lung function was 18 percent. I was a shell of an existence. The bacteria were stronger than the strongest antibiotics that we have.
I felt helpless, defeated, and I didn’t know if I was going to survive. Fortunately, I did have the opportunity to try an experimental treatment called phage therapy, which helped to treat that acute infection I was facing. But this near-death experience made me want to share my experience and bring greater awareness to this silent pandemic, because my story is just one of many.
My health condition means that I’m at a lifelong risk of infections, and this is something that I will never escape from. But the more that I’ve learned about AMR and the more stories that I’ve heard of others experiencing harrowing experiences, the more I realized just the enormous scale of this issue. Any one of us can develop an infection at any time, and because of drug resistance, we’re increasingly seeing these treatable infections becoming untreatable.
We’ve seen amazing breakthroughs in science and medicine over these past decades, but if we don’t act now against AMR, we’re going to see an exponential increase in the rate of infections that are causing prolonged suffering, destroying livelihoods, and taking people’s lives. So we must think differently and collaboratively. Researchers, medicine manufacturers, policymakers, investors, and the general public must strategize effective ways of bringing novel antimicrobials and diagnostics therapies while promoting stewardship on the community level.
There also needs to be effective measures in place for ensuring access to novel therapeutics and antimicrobials for those that need it the most all over the world. As a member of the World Health Organization’s task force of AMR survivors, I am committed to sharing my experience, raising awareness, and humanizing this problem. I lived my whole life in constant fear of an infection, and until my battle is over, I call to everyone all over the world to unite.
I urge all of you as world leaders to please act proactively against AMR. Create necessary policies, bolster investment into treatments and technologies, and convene resources, assemble stakeholders. We are running out of time. Don’t let AMR continue to be the greatest threat to my life, and allow it to take the lives of many, many others.
Help to create a future where AMR isn’t the greatest threat to our globe. Thank you.
[Mr. Jerome Walcott (acting Chair)]
I thank Ms. Balassa, heads of state and government, excellencies, distinguished delegates, distinguished participants. We have just heard the last speaker for the opening segment of this high-level meeting. I thank all eminent speakers once again for their participation and insightful interventions.
As our special guests depart the podium, kindly remain seated. The plenary segment of the high-level meeting will begin momentarily.
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