Concerned parties from around the world gathered Thursday at the Ritz-Carlton in the Red Sea city ahead of the 4th.^th Global Ministerial Conference on AMR for a session focusing on non-governmental actors – non-governmental organizations, the private sector, academia and others – to work across sectors to address “one of the most pressing global health threats and development challenges”.

The conference is expected to bring together representatives of 57 states, including 48 ministers and deputy ministers, and more than 450 participants from leading international organizations and civil society organizations, including UN offices and agencies.

The goal is to move from “declaration to implementation” through multi-sectoral partnerships in the fight against antimicrobial resistance, which has had disastrous consequences for health, economies and societies, especially in low- and middle-income countries.

A silent pandemic

When bacteria, viruses, fungi and parasites stop responding to antimicrobial drugs, it is known as antimicrobial resistance. Drug resistance increases the risk of disease transmission, serious illness, disability and death by rendering antibiotics and other antimicrobial drugs ineffective and making it more difficult or impossible to treat infections.

In the political declaration adopted by the General Assembly, world leaders agreed to reduce the estimated five million human deaths associated with AMR annually by 10 percent by 2030. They also called for sustainable national funding and $100 million in catalytic funding for to help achieve a target for at least 60 percent of countries to have funded national action plans on AMR by 2030.

It also formalized the Quadripartite Joint Secretariat on Antimicrobial Resistance, comprising the United Nations World Health Organization (WHO), the United Nations Development Program (UNEP) and the Food and Agriculture Organization of the United Nations (FAO), together with the World Organization for Animal Health (WOAH), as the central coordinating structure to support the global response.

Saudi Health Minister Fahad Al-Jalajel has emphasized the need to adopt a “One Health” approach that systematically addresses the obstacles that hinder progress as AMR affects both humans, animals and the environment. “The meeting in Jeddah is a crucial opportunity to strengthen our collective global response to the risks of this growing, silent pandemic,” he has said.

The meeting will address priorities including monitoring and management, capacity building, financing, governance, innovation, research and development.

Political commitment at the highest level

Pakinomist is in Jeddah to cover this global conference and spoke with Kathrine Urbaez, executive director of the Geneva-based non-governmental organization (NGO), Health Diplomacy Alliance.

The Alliance focuses on advocacy and diplomacy to advance global health issues. She told us that the COVID-19 pandemic has proven the critical importance of ‘One Health’ policies and of creating collaboration and awareness across sectors and stakeholders.

Ms. Urbaez emphasized the need to move from commitments to practical actions, adding that the General Assembly’s political declaration and the Jeddah Conference are major steps in the right direction, and what is needed is to ensure that the political momentum continues. The CEO insisted that it is possible to implement commitments if there is the political will to do so, and establishing “a monitoring and accountability mechanism” is key.

She added: “We need to look at antimicrobial resistance from a really holistic global health perspective. I think it’s important to involve politicians at the highest level, not just ministers of health, environment, agriculture or finance. We really need political commitment to advance AMR policies and engage in the one health approach.”

More than a health threat

The complexity of the problem, lack of funding and political will in some nations “with the competing health issues that governments have to contend with” have made it difficult to move from policy documents to action, according to Julian Nyamupachitu, deputy director of ReAct Africa, a global network that works to catalyze efforts against AMR primarily in low- and middle-income countries.

As countries review and weigh new national plans, Nyamupachitu said ReAct Africa is helping them prioritize activities that are more practical and use tools available to them to help inform their policy-making, such as the WHO’s cost and budget tool.

The deputy director said the policy statement was an improvement on its 2016 predecessor, but it would have been “good to see commitments and not just targets” for funding.

She said the theme of “moving from declaration to implementation” is very timely and she hoped to see a serious commitment from the ministers in Jeddah.

“I think there has been increased awareness. They have appreciated the statistics that have been shared. This is actually a global health threat that not only affects the health sector, not only affects agriculture, the environment and the animal sector, but it is actually also a financial problem”, she added.

‘The antibiotic market is broken’

Michiel Peters is the secretariat representative for the AMR Industry Alliance, which includes companies and industry organizations within research and development (R&D), pharmaceuticals, generics, biotech and diagnostics. He also represents the wider private sector on the AMR Multi-Stakeholder Partnership Platform Steering Committee, which was established and facilitated by the four organizations supporting the global response.

Mr. Peters said that antibiotics are “fundamentally different” than any other product brought to market “where your aim would be to sell as much of it as possible”. He said with antibiotics, the goal is to get “the right drug for the right person when they need it”which is not always a lucrative business. He also noted that antibiotic development requires a “incredible amount of time and investment” and in many cases the drugs do not reach the market, and so “the antibiotic marketplace is broken”.

Peter’s added that there is a serious lack of public funding and incentives for antibiotic research and development, but the bigger concern is that “The scientists who actually needed to do the science in the labs are leaving this field”, in contrast to diseases such as cancer, where research is strong.

The private sector representative said that much progress has been made since the first high-level meeting on AMR took place in 2016, but there is still so much more to be done and “No one can solve this problem alone”.

He said the Jeddah Conference and the Multi-Stakeholder Partnership Platform Plenary, running parallel on the closing day, are both very important to watch “not just what we can put on paper, but what we actually have to do”.