Antimicrobial resistance (AMR) is a major threat to global health and the world economy, and poses a unique challenge to humanity. All countries – regardless of their economic situation, the strength of their health systems or the level of antibiotic consumption – will face disastrous consequences if the spread of AMR is not contained. Global and community solutions are needed to prevent overuse of antibiotics; ensure that all people, regardless of where they live, have access to the antimicrobials they need; and to find new vaccines, diagnostic tests and, above all, antibiotics that are affordable and effective against drug-resistant diseases.
AMR occurs when disease-causing pathogens (including bacteria, fungi, parasites, or viruses) develop defense mechanisms to the drugs designed to treat them making these resistant pathogens difficult or even impossible to treat. This resistance is the inevitable result of antimicrobial use and an example of natural selection in practice. The more antimicrobials are used, the less effective they become. Rising levels of AMR are a sign that natural selection is taking place more rapidly than innovation in developing new antimicrobials. If this is to be reversed, the world must innovate more, but also slow natural selection – by eliminating excess use of all antimicrobials; only using second- and third-level treatments when absolutely necessary; and ensuring appropriate access to treatments.
The importance for countries to develop and implement national action plans
Developing national action plans (NAPs) is an essential first step for countries to establish an effective response to combat AMR. At the Sixty-eighth WHA in 2015, Member States committed to have NAPs in place by May 2017. In February 2016, WHO, in collaboration with FAO and OIE, developed a manual for developing NAPs on AMR and a set of accompanying tools. The three organizations have been working closely with stakeholders to provide technical support to countries for the effective development of their NAPs.
Moving from planning to implementation
Ensuring political commitment, engagement and support has been a challenge as understanding of AMR and the importance of developing and implementing NAPs is still somewhat limited. The identification of best practices continues to play an important role as the world is still learning what works best in particular contexts and WHO is sharing expertise and developing communities of practice to support countries with ongoing efforts. Inter-sectoral action, and the complexity of coordination within and across sectors, continues to be a challenge, particularly as countries shift towards NAP implementation.
Global Action Plan for Antimicrobial Resistance
At the Sixty-Eighth World Health Assembly in May 2015, WHO Member States endorsed a global action plan through resolution WHA68.7 to tackle antimicrobial resistance, including antibiotic resistance, the most urgent drug resistance trend.
The AMR global action plan contains five major strategic objectives:
The global action plan, which takes into account the commitment, perspectives and roles of all relevant stakeholders is a plan in which everyone has clear and shared ownership and responsibilities. The endorsement of the plan reflects a global consensus that AMR poses a profound threat to human health.
One Health Approach
Addressing the rising threat of AMR requires a holistic and multisectoral (One Health) approach because antimicrobials used to treat various infectious diseases in animals may be the same as or similar to those used in humans. Resistant bacteria arising in humans, animals or the environment may spread from one to the other, and from one country to another. One Health recognizes that the health of humans, animals and ecosystems are interconnected. It involves applying a coordinated, collaborative, multidisciplinary and cross-sectoral approach.
The WHO, FAO and OIE speak with one voice and take collective action to minimize the emergence and spread of AMR. The aim is to:
Senior Advisor to the Director General, Special Representative of the Director General on AMR
World Health Organization
Chief Veterinary Officer
Food and Agriculture Organization of the United Nations
Deputy Director General
World Organisation for Animal Health
International Council of Nurses
World Farmers Assocation