7. oktober 2024

Reflections on the UNGA’s Political Declaration on Antimicrobial Resistance: A Landmark Moment for Global Health

Article by; Arshnee Moodley, Associate Professor, Department of Veterinary and Animal Sciences. Joint appointee as AMR Team Lead at The International Livestock Research Institute, Nairobi, Kenya https://www.ilri.org/

Having just returned from New York, where I had the incredible privilege of attending the United Nations General Assembly (UNGA) High-Level Meeting on Antimicrobial Resistance (AMR). As I sit back and reflect on this experience, it was monumental and deeply personal. Not only for the global recognition and commitment to address AMR—but also personally having spent more than 20 years working on this issue. 

However, getting to this moment was far from straightforward. The final declaration, while ambitious, reflects the delicate compromises required to bridge the North-South divide on global health. 

The Challenges Leading to Agreement

As with any major political declaration, reaching consensus on how to mitigate AMR in 2024 was shaped by the world’s current geopolitical climate. Unlike in 2016, when the first Political Declaration on AMR was adopted unanimously, this time the process was markedly more difficult. The divide between high-income and low- and middle-income countries was pronounced, where health equity remains a sensitive topic. Especially following the COVID-19 pandemic, which highlighted global disparities in access to diagnostics, vaccines and treatments.  During the AMR negotiations, the Global South emphasized the urgent need for financing mechanisms and equitable access to new antibiotics, vaccines, and diagnostics. For many LMICs, AMR is not just a health issue—it is a development issue that deepens existing social and economic inequalities. The Declaration acknowledges this. 

The One Health Approach: Controversies and Misunderstandings

Another major challenge was the “One Health” approach. Although One Health is widely accepted in scientific circles, the concept became a point of contention at the political level. Some countries were concerned about its potential economic implications for food production and exports. Despite these challenges, the final declaration commits to tackling AMR through a One Health approach, signaling a critical step forward in addressing the root causes of AMR. This is a victory for those of us who champion for this cross-sectoral way of working. 

What the Declaration Means for LMICs and Scientists Like Me

From the perspective of LMICs, the Declaration’s has a strong focus on equitable access to antimicrobials, vaccines, and diagnostics, which is particularly significant. Here, the burden of AMR is the greatest, yet the resources to combat it are often scarce. As a scientist who works extensively in these settings, the Declaration feels like a long-overdue acknowledgment of the challenges we face daily—challenges like limited access to effective antimicrobials, scarcity of diagnostics, and the struggle to implement stewardship programs in fragile veterinary health systems. The Declaration promises countries, regardless of income status, will be equipped with tools, governance structures, and funding needed to tackle AMR head-on. 

Personal Reflections: In the Room Where it Happened

Being in the room when the declaration was confirmed was a profound experience and I couldn’t help but reflect on how far we’ve come. Twenty years ago, AMR was a topic that rarely entered high-level political discussions. Today, it is recognized as a global threat on par with climate change and demanding immediate and coordinated action. But the real work begins now. The commitments made in New York must be translated into action. The road to 2030, when many of the targets set out in the declaration are meant to be achieved, is long and fraught with obstacles, especially in countries where human and animal health systems are fragile, and AMR is just one of many pressing issues. 

Key Commitments and Takeaways

For those of us working at the intersection of AMR and agri-food systems, several key commitments from the declaration stood out:

  1. Disease Prevention: The emphasis on animal vaccination strategies, with a goal for all countries to have defined plans in place by 2030, is a game-changer. This is crucial for reducing the need for antibiotics in livestock, a major driver of AMR.
  2. Science-based Solutions: The creation of an independent panel by 2025 to provide scientific evidence for tackling AMR is a critical step in ensuring that future actions are grounded in sound science.
  3. Equitable Access to Veterinary Tools: One of the most significant commitments is to ensure the timely supply of affordable veterinary medicines, vaccines, and diagnostics, especially for LMICs, where access to these tools is often limited. 

Looking Ahead

As I settle back into my routine in Denmark, I can’t help but feel a sense of accomplishment but also responsibility. The political declaration is a significant milestone, but let’s hope that the momentum leading up to and from New York carries forward, and that by 2030, we can look back on this declaration as the turning point in the global fight against AMR. For now, I return to my work with renewed energy. 

Emner