Thursday, September 26, 2024
9:00 a.m. EDT
Venue: Press Briefing Room, S-237, United Nations Headquarters, New York
[Moderator]
Good morning, everyone, and a very warm welcome to those of you in the room and online. We are here this morning to speak about the High-Level Meeting on Antimicrobial Resistance. And I urge you, when we get to questions, to focus on that topic, please.
We have the Prime Minister of Barbados and the principals of the four organizations which together form the Quadripartite on the podium. And let me first introduce Her Excellency Minister Mia Amor Mottley, Prime Minister of Barbados, to open the meeting and make her comments. She represents also the Global Leaders Group.
She’s the chair of this group, which was established in November 2020. It consists of global leaders and prominent personalities from across the One Health spectrum, representing environment, agriculture, human health, and plant health. Prime Minister?
[Hon. Mia Amor Mottley, SC, MP, Prime Minister of Barbados]
Thank you very much. Good morning, everyone. Thank you for joining this media briefing on this High-Level Meeting for Antimicrobial Resistance today and the political declaration that we are hoping to sign off on.
I speak to you, as you’ve heard, as chair of this group since November 2020, and it seems as though it was just yesterday that we started and we set the target of meeting 2024 for a high-level summit follow-up. Today, as you can see, I’m joined by the leaders of three of the organizations and the representative of FAO. We have with us Dr. Tedros from WHO. We have with us Dr. Subbara, who has now become the new Director General of the World Organization of Animal Health since the 1st of August of this year. And of course, my dear sister, Inge Andersen, who is head of the United Nations Environmental Program. And then Mr. Thien-Sinh is representing the Director General of the FAO, who had, regrettably, to go and could not be with us today. I’ve probably referenced EMA more than most things, maybe not as much as the climate crisis, but almost. And it is because it is already taking a million lives a year directly, and is responsible indirectly for just under another four or so million. This is one of the major causes for death in our countries as we speak.
But the worst part of the news is that it will be the number one cause of death by 2050. This, therefore, is a press conference, not for us with grey hair so much, but for the young people of the world, because they’re the ones who will have to face the possible threat of a reversal of a century of medical progress in what we dub the silent, slow motion pandemic. We use pandemic and we associate it with COVID, and we’re talking now about MPOCs, and God we hope that that does not take root any further.
But all along has been this silent, growing pandemic of antimicrobial resistance, and predominantly it is driven by the overuse and misuse of antimicrobials generally. And the truth is, think about it, many of us get antibiotics, we use it for a few days, we don’t use it for the full course as prescribed by doctors. We may take them and throw them in the bathroom or in the sink and then it goes into the environment.
So we have to change behavior at the individual level, and that is a fundamental purpose first and foremost for this high level summit and the political declaration, to begin to effect change. In addition, AMR is also closely linked to crises of climate, biodiversity loss, destruction of nature, pollution and waste. A lack of access therefore to appropriate antimicrobials and poor quality health care, water, sanitation and hygiene, all of this contributes.
So you begin to see, we’re not talking about something simple. And that’s the way my heart bleeds for those who are young in this world. Because if we don’t get our act together, imagine what happens if you get an infection from going in a garden or having a baby or going to the dentist.
These are the things that can bring your life to an end within 48 to 72 hours if the particular antibiotics that you’re using is not effective. And I challenge every one of us in here to reflect on someone who we know who we’ve lost because of a hospital-aided infection, or because the antibiotics just simply did not work, and the whole process of going through each one to see which one is appropriate. I’m not a doctor, but I’m told by those who know that in this world, the last major, in 2020, in the year 2000, we had over 20 firms doing research for new antibiotics.
Today there are four. And one of the reasons for the significant decline is in fact the inability for us to be able to get the funding and for it to be economical for the kinds of financial returns that Big Pharma clearly wants to see. Because if you are using and selling drugs for diabetes or heart condition, people will use them over for years.
When you’re using antibiotics, what’s the course? Seven days? Fourteen days?
So you see that the returns are simply not there. But this is the most classic example I can find of a global public good. Because if we don’t find the money to do the research and to be able to bring about the relief through new antibiotics that are effective, then we are going to see more and more and more people die.
So I really want to say that this high-level meeting is a landmark event. Yes, we had a session in 2016, but since then we’ve continued to build momentum and build awareness. Are we anywhere near where we need to be?
Absolutely not. And that is why this summit is necessary, high-level meeting is necessary, in order to be able to drive home the point that one, let us pause and let everybody know what we’re dealing with. This is a global issue in every household, in every community, in every family, in every hospital, in every clinic.
Secondly, that we need to find the money to do the research, but we also need to find the money to help those countries that are low or even some middle-income countries who may be fiscally challenged because of the poly-crisis, the climate, the last pandemic, all of the different other issues that countries are facing today. We need to find funds to also assist those countries at the bottom to be able to prepare themselves better and to ensure that their institutional systems are ready for this. And then thirdly, we need to have an engagement with those people who are helping to continue to cause a problem or to contribute to the issue.
And in particular, at the level of industrial enterprises, we need to make sure that we are doing the right thing and following the right practices to minimize the exposure that there is, particularly as it relates to the management of livestock and the management of commercial agriculture, and then the extent to which water and the environment is affected as a result of the runoffs. So the Global Leaders Group, I want to thank my co-chair, first formerly the Deputy Prime Minister of Malta and then now the current Minister of Health in Malta, both of whom have worked strongly with me in terms of co-facilitating. I want to thank my own Minister of Health, who also has had to chair for me when I was not available.
I’d like to thank the rest of the Global Leaders Group who have been diligent in their efforts. And as I said, this started in the deep, dark days of COVID. So we really applied ourselves from then.
And then, of course, I want to thank the permanent representative of both Malta and Barbados and their staff for ensuring, both Vanessa and Francois, for ensuring that we have reached this point safely today to give us something on which to agree in this political declaration. We must have greater accountability from all of us, not just governments for sustainable financing, but better governance mechanisms and surveillance of AMR at the level of countries, hospitals, with respect to practices in agriculture, with respect to practices across our environment. And I want to thank these organizations, but more importantly, the leadership of these organizations, Inge, Dr. Tedros, Dr. Soubiran, and I thank our dear brother who is not with us, but Mr. Pianse, you will communicate our gratitude to him for allowing us to be here today. I want to make the point that the cooperation between these four institutions, in the way in which I’ve seen it in the last few years, is not regular and common, not only in the international community, but at the national level. And the fact that the leadership of these organizations have allowed us to be here safely is not only something to commend them for, but it’s to be a model for future cooperation in the management of complex issues, because human beings are not single issue people. And therefore, more often than not, we require a breaking down of silos and cooperation and the definition of win-win.
Thank you, Dr. Tedros. I’m not sure who goes next, so I hand back to you, sir.
[Moderator]
Thank you, Prime Minister, and thank you very much to Ambassador François Jackman and Ambassador Vanessa Fraser for being here also this morning. Dr. Tedros from WHO, please.
[Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO)]
Thank you. Thank you to all members of the press for joining us. Her Excellency, Prime Minister, thank everybody.
And I would like to use actually this opportunity and let me begin by expressing my deep appreciation to Prime Minister Mottley for her outstanding leadership on this critical global health issue. The key ingredient in moving the needle on any issue is political commitment. And Prime Minister Mowtley has demonstrated that commitment herself and advocated for it with other leaders.
So, Prime Minister, please accept on behalf of all organizations here our respect and appreciation. As you know, later this morning, we expect 193 member states of the United Nations to approve the political declaration on antimicrobial resistance. If approved, the declaration is a strong signal from countries that they are committed to addressing this global threat.
Today, AMR is one of the most urgent global issues, global health threats, killing over a million people a year. AMR could unwind 100 years of medical progress, making infections that are easily treatable today a death sentence. Despite the rapid spread of resistance, we are facing an alarmingly dry pipeline for new antibiotics.
No country is immune to this threat, but low and middle income countries bear the greatest burden. The declaration includes a target to reduce global deaths associated with bacterial AMR by 10 percent by 2030. Of course, WHO is supporting countries to respond to the threat of AMR, but achieving the target set in the declaration requires action beyond the health sector to protect and promote the health of animals, plants and our environment.
That’s why WHO, FAO, WHOA and UNEP are working together closely in the quadripartite with a one health approach. WHO is committed to formalizing the quadripartite joint secretariat as requested in the declaration. We’re also committed 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 commend member states for their commitment to addressing this threat and for their hard work in negotiating this declaration. We urge all countries to take immediate action on the commitments in the declaration and WHO stands ready to support them to do that. And Werner, back to you.
[Moderator]
Thank you, Dr. Tedros. May I ask Madam Andersson from UNEP to take the floor, please.
[Ms. Inger Andersen, Under-Secretary-General of the United Nations and Executive Director of UN Environment Programme (UNEP)]
Thank you very much and good morning to members of the press. Let me start out by thanking you, Prime Minister, for your extraordinary leadership and, of course, the government of Malta, first the Deputy Prime Minister and the Minister of Health for that co-support. And initially, we should mention, of course, Madam Prime Minister from Bangladesh, who was also part of the journey, Cheikh Hesina, part of the journey at the beginning.
So let me just begin by saying that just last week, the Lancet published new information that shows that this deadly AMR resistance could potentially lead to 40 million deaths attributable to AMR and 160 million associated with AMR in just the period, the 25 years between 2025 and 2050. And the impacts of AMR on health care, as you’ve just heard, systems is very significant. The productivity and agricultural production is very significant and could obviously cost trillions annually.
So we are actually in deeper trouble than we might have thought, because these numbers from the Lancet are higher than those we at UNEP had issued a couple of years ago. So the international community is already acting on this deadly threat, and we have seen increased ambition through the Global Leaders Group convened by Madam Prime Minister. And crucially, work on AMR involves human health, animal health and plant and environmental sector under the One Health approach.
And that is, of course, why these four agencies on this podium are working together. But at this point, what we need now is for leaders to speed up what they have begun, speed up awareness, speed up effective prevention, speed up the management of AMR at the national level, at the regional level and at the global level. And the environment plays a larger role than people might think of, because in the origins, development, spread and transmission of AMR, it often goes through an environmental pathway.
So we have to stop antimicrobials and AMR leaking into nature from municipal waste, from wastewater, from agricultural discharge, from pharmaceutical production, from hospitals, from farms and from overuse on crops of antimicrobials. So to do that, we need to strengthen integrated water management, sanitation and hygiene, push the pharmaceutical sector to change incentives and subsidies, and ensure adequate waste and wastewater containment and treatment. This is an issue across especially the Global South, where we do have pharmaceutical production, but not adequate wastewater management and treatment.
We have to also ensure and really get the focus on reforming the food and agriculture sector to limit antimicrobials and reduce the discharges from crops, terrestrial and aquatic, including aquaculture, animal production facilities. And obviously, since we are rather selfish species, to back the healthcare sector to improve high quality healthcare at treatment of water quality, sanitation and wastewater, etc. So these actions and more have to be at the highest level of government awareness.
We have to communicate clearer and ensure that policies and laws and international standards are aligned with these priorities. And we need to be very clear that subsidies that push us in the wrong directions are the wrong subsidies. They are subsidizing indirectly the growth of antimicrobial resistance.
That is why the One Health approach is so particularly important. So today’s declaration, assuming we will have it gaveled shortly, at the only second high level meeting at the United Nations General Assembly dedicated to AMR reaffirms the commitment of the world to tackling this. And I should recall that the fourth ministerial conference on AMR scheduled to be hosted in Saudi Arabia in November, will be another chance to increase this commitment, because we have to build on what we know, strengthen what we can see to save millions of lives, to safeguard animal health, to protect the environment, and to boost food safety and security.
Thank you.
[Moderator]
Thank you very much. May I ask Dr. Soubeyran from the World Organization for Animal Health for her perspective, please.
[Dr Emmanuelle Soubeyran, Director-General of the World Organisation for Animal Health (WOAH)]
Good morning, everybody. This political declaration is an important step forward for us, as my other colleagues said. It brings action enough to improve our current response to contain AMR. And regarding investment, we are confident on the commitment from member states to facilitate sustainable funding through international cooperation. And funding is necessary to put in place all the actions that are described in this declaration. So this 100 million US dollar target support for at least 70% of countries having achieved funded national action plan by 2030, will catalyze actions and lead to positive result. We have a fund which is called AMR-MPTF, multi-partner fund, which is a financing mechanism, which has already proved in 14 low and middle income countries to successfully support the scaling up of national action plans on AMR. So it promotes one health approach to contain AMR, as well as the development of a global level initiative. Since 2019, it ensures optimal coordination across sectors within countries. And this AMR-MPTF, this fund leverage the technical expertise of the Quadripartite in support of country’s priority, coordinates policy advice, technical assistance and capacity strengthening programs. Thus, having this commitment in the declaration is very important for us.
And as a director of the World Organization of Animal Health, I want to insist on the importance also not to forget animal health sectors and veterinary services. I would also like to say that we really welcome the commitment on the final declaration, especially those prioritizing prevention regarding animal health and vaccines. When available, vaccines can be robust allies to prevent diseases that could otherwise lead to the use of antimicrobials.
And WOA remains committed to help support access to high quality vaccine and the effective implementation of biosecurity, good animal husbandry practices, appropriate diagnostic tools and development of alternative to antimicrobials. And we will work with countries to define animal vaccination strategies, according to the WOA priority list, and also continue to facilitate the implementation of WOA’s international standard, especially on vaccine manufacturing and quality control. You know, the animal health sector plays a key role in the efforts to curb AMR by promoting a more responsible use of antimicrobials.
Since 2015, we have seen the number of countries reporting quantitative data on antimicrobial multiplied by three. And there are nearly now 130 of our members have to have a quantitative baseline of antimicrobial use in animals, which is very important in order to measure the progress if we want to use and that’s what we wanted. But that’s what is the commitment that is in the declaration to reduce the use of antibiotics, antimicrobials in in livestock.
So we have seen significant action, notably by reduction antimicrobial use in animal globally, by regulation, by awareness, by trainings, but we need to accelerate and invest more. And further reductions will bring economic benefits. And that’s something very important to say to the sector.
And we just released the eco AMR series report estimates that by achieving a global 30% reduction in livestock antimicrobial use within a five year time period can lead to a cumulative increase in global GDP by 100 to 20 billions US dollar from 2025 to 2050. Therefore, the commitments, we welcome the commitments to meaningfully reduce the quantity of antimicrobials use globally in the agri food systems. Nowadays, 76% of members still using antimicrobials as growth promoters have not carried out a risk assessment.
The statistical analysis finding from the eco AMR series suggests that countries using antimicrobials for growth promotion in livestock have an estimated average of 45% higher antimicrobial use than countries that do not use growth promoters. That’s why WHO encourages competent authority to enact relevant legislation and regulation to enhance responsible use of antimicrobials in compliance with our international standards. And we also encourage exploration and promotion of sustainable alternatives to animal productivity, as indicated in our vision paper released last year.
[Moderator]
Thank you very much. And finally, my turn to Mr. Tiensen from FAO for the agricultural perspective.
[Mr. Thanawat Tiensin, Assistant Director General, Food and Agriculture Organization (FAO)]
Thank you very much. Good morning, members of the place. Let me join our principal from WHO, UNEP and also WOAH to express our appreciation to the leadership, visions and inspirations of Your Excellency, Prime Ministers, and also the government of Malta. And also I would like to take this opportunity to express our sincere thanks to the co-facilitators, ambassadors of Bebedos and Malta for leading the process. And today I stand before you to speak about antimicrobial resistance in agri-food system. The agri-food system are not merely a source of nutrition.
They are the backbone of food security, economic stability, social well-being and environmental sustainability. Let me make it clear. 2.5 billion farmers depend on agri-cultures in agri-food system, including livestock production, aquaculture and plant productions to provide the world with healthy, nutritious and safe food. Without effective antimicrobial to combat infections in our animal plants, we jeopardize not just our food security but also global health, economic prosperity, biodiversity and the integrity of our ecosystem. As you know that today we talk a lot about One Health approach. At FAO, One Health is one of the priority area of FAO strategic framework.
And at the end of this month, at FAO, we will continue to discuss at FAO Committee on agri-cultures, how to scale up One Health in agri-food system for global health and food security. And that’s why regarding the AMR, we need an evidence, we need the data. And also we’re talking about how we’re going to reduce the need of antimicrobial at the farm level.
Recently, FAO just launched the Renault Farm Initiative, reduce the need on farm for sustainable agri-food system. And we expecting that by 2030, we will be able to reduce the global antimicrobial use in agri-food system. But we need your support.
But we need your commitment, and the commitment and support from the leaders, from head of state, and also private sectors, producers and farmers, will help us to achieve our goal. Thank you very much.
[Moderator]
Thank you very much for the FAO perspective. We have very little time, maybe for two questions. Can I ask in the floor if in the room if there are any questions to Prime Minister Motley or the principals?
If not, then online. I do not see any online either. Closing from you, Prime Minister.
[Hon. Mia Amor Mottley, SC, MP, Prime Minister of Barbados]
I think that it is important for us to remember that the political declaration will do two key things. One, the establishment of an independent science-based panel. And we have all seen the absolute, utter importance of that when it came to giving us the information on the climate, particularly with the many deniers that we have.
And remember, we may buck up some serious industrial lobbies in terms of change in behaviour. So it is important to have that independent science-based panel. The second thing is that we set a very, very modest target for fundraising to support the low and middle-income countries of $100 million.
This is nothing to do with the research that is necessary by the pharmaceutical companies for alternates to the antimicrobials that we have. And even when they find something to ensure equitable and affordable access on the part of the global population for whatever is eventually found. I’m not a doctor, but I’m told that with every new discovery of our new antibiotic, its effectiveness has been shorter and shorter from the previous ones.
So I think these are important facts for the media to help us get out there. And then forgive me if I just use this opportunity also to thank highly who was my support and lifeline during this process up until a few months ago, and we welcome JP. And then, of course, my own office, my Permanent Secretary, Alice Jordan, and Mr. Smith, Dane Smith, and Dr. Ford, who have been supporting us on this journey, because this is not the effort of any one person, one country, or one grouping. And the example of the quadripartite approach should tell you that we need everybody to make a change in this. Thank you.
[Moderator]
Thank you very much, Prime Minister. You actually summarized very well some of the questions also and comments online were what the thoughts are about the targets and commitments. I think we heard from all the sectors here at the podium that they are very satisfied and they have an action plan that they need to develop to implement these strong commitments and targets over the next few years until the review meeting in 2029.
So I thank the Prime Minister and the principals very much. They all have to go to the meeting now where the declaration will be approved. And thank you very much to everyone that attended and the 45 or so people online as well.
Thank you. That concludes the briefing.
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