Experts call on UN to implement four-part global action plan to increase access to effective antibiotics

Today some of the world's foremost experts on antibiotic resistance called on the United Nations General Assembly to decisively act to reduce the growing number of deaths due to limited access to effective antibiotics. Writing in the Lancet, they call on those attending the upcoming High-Level Meeting of Heads of State in September in New York City to use the opportunity to create and implement a four-part global action plan, similar in scope and ambition to the plan created in 1996 to address the AIDS crisis.

This is only the third time in its history that the UN General Assembly will use its High-Level Heads of State meeting to deliberate on a health issue that threatens the health of populations worldwide. This is also the first time that a One Health issue, a concept which involves the health of humans, animals and the environment, is being discussed at this high-level forum.

"Since antibiotics are used widely in livestock, humans and in the environment, the problem of antibiotic resistance can be tackled only by involving all of these sectors," said Ramanan Laxminarayan, Director of the Center for Disease Dynamics, Economics & Policy, and a lead author of the call to action. "The United Nations is the appropriate forum for countries to set goals and commit themselves to global collective action to ensure that our children and grandchildren are able enjoy the benefits of effective antibiotics."

Millions of people do not have ready access to effective antibiotics, and many current antibiotics are losing their effectiveness. Antibiotic resistance is responsible for over 700,000 deaths worldwide, including 214,000 sepsis-related deaths of infants within four weeks of birth, according to a commentary piece published in the Lancet today.

According to Laxminarayan, many deaths are caused by insufficient access and delays in getting antibiotics. Antibiotic resistance-related deaths are being reported in all countries and at all income levels. UN organizations, countries, civil society, non-governmental organizations, industry and development agencies must work collaboratively to change how the global community treats bacterial infections. Laxminarayan gave a TED Talk on antibiotic resistance in September 2014.

Laxminarayan and his co-authors are calling on the UN General Assembly to establish a UN High-Level Coordinating Mechanism on Antimicrobial Resistance (HLCM) that will also require the involvement of organizations such as UNICEF, UNDP, UNEP, UNESCO, and the World Bank. The effort would have four core responsibilities:

• Launch a global advocacy campaign to raise awareness about the lack of access to antibiotics and drug resistance
• Monitor and evaluate defined, enforceable targets to reduce the number of deaths globally due to lack of access and inappropriate use of antimicrobials in humans as well as animals
• Mobilize resources from donors, aid agencies and countries to effectively finance the effort, and
• Support and coordinate multisectoral action to implement the World Health Organization's Global Action Plan on Antimicrobial Resistance alongside national efforts to improve access to effective antimicrobials

The UN meeting in September offers a rare opportunity to change how the global community responds to this health crisis that will become exponentially more deadly in all countries without any sustainable, coordinated action.

"The UN General Assembly discussions in September present an unprecedented opportunity for the world to advance its response to rising drug-resistant infections," said Lord Jim O'Neill, chairman of the Review on Antimicrobial Resistance. "The authors are right that the UN must play a central role in the fight against a global health problem that could undo much of the progress the world has made against disease and poverty. Over the next few months we should all continue to push for a robust and ambitious set of commitments at the UN which will see this problem being tackled head on."