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 Lungelo Ndhlovu, [email protected]

The United Nations General Assembly (UNGA) will convene to address Antimicrobial Resistance (AMR), for the second time this year. The previous discussion took place in 2016.

Zimbabwe is one of the 193 countries taking part in this year’s UNGA, which will provide an important forum for high-level discussions on AMR and each member state will be expected to deliver a statement.

To personalise the AMR challenge, individuals impacted by AMR from these countries will have the opportunity to share their stories with world leaders.

During the summit, world leaders will have the opportunity to pledge to undertake specific measures to address the AMR issue. The principal players in the UN system are the World Health Organisation (WHO), Food and Agriculture Organisation (FAO), World Organisation for Animal Health (WOAH) and United Nations Environment Programme (UNEP).

These organisations are expected to collaborate with member states to prepare for the upcoming UNGA high-level meeting (HLM) on AMR.

To effectively address the challenge of AMR globally, collaboration is needed with key stakeholders, including Unicef, the Global Fund, UNAids, cancer institutes, civil society organisations and community engagement groups. Including all key stakeholders in a “leave no one behind” approach will lead to better outcomes.

The facts about AMR are particularly concerning as the most vulnerable groups to antimicrobial resistance include infants, cancer patients, the elderly and people with compromised immune systems, according to the Lancet Series on AMR, which was recently unveiled at the 77th World Health Assembly in Geneva.

According to the World Health Organisation, AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medications.

Antimicrobials, which include antibiotics, antivirals, anti-fungals and anti-parasitics, are drugs used to prevent and cure infectious diseases in humans, animals and plants.

The Lancet Journal reports that of the 7,7 million people who die globally from bacterial infections, 4,95 million are attributable to antibiotic-resistant bacteria; the remaining 1,27 million deaths are from illnesses caused by bacteria resistant to drugs that are currently on the market.

AMR is a global issue that affects individuals of all ages and is present in all nations. However, it is primarily and disproportionately experienced by those who are vulnerable and developing nations, particularly low and middle-income nations. Although it cannot be completely eliminated, it can be controlled as a shared responsibility.

In 2018 and 2019, Zimbabwe experienced a cholera outbreak that was considered a national emergency due to a highly resistant strain. Additionally, resistant typhoid outbreaks were reported in Zimbabwe, and research scientist, Tapfumanei Mashe and colleagues published their findings in both the Lancet and the New England Journal of Medicine.

They demonstrate in the recent Lancet 2024 AMR series that there are interventions that could save more than 750 000 AMR-related deaths in middle-income countries per year.

The plan of actions include boosting awareness of the rising AMR epidemic, including infection prevention and control (IPC) approaches, improving access to clean water and sanitation (WASH), and expanding childhood immunisation coverage. Implementing these techniques will significantly reduce the severity of AMR thereby saving lives.

In view of the anticipated UN resolution on AMR this year, Mashe and colleagues offer worldwide targets for 2030 that are ambitious but realistic, resulting in a 10 percent decrease in AMR-related mortality.

To accomplish this, they recommend a balanced worldwide effort aimed at reducing inappropriate human antibiotic usage by 20 percent and animal antibiotic use by 30 percent and refer to this as the AMR targets of 10-20-30 by 2030.

This year’s UNGA HLM on AMR provides an excellent opportunity to emphasise the serious threat presented by rising AMR and establish a bold goal of ensuring that everyone has access to lifesaving antimicrobials.

Additionally, a number of significant occasions, including the UN General Assembly in September this year, the World Health Assembly last May and the Fourth Ministerial Conference on AMR in November this year present a unique opportunity to reaffirm political commitment and create workable action plans to battle AMR.

It is anticipated that UNGA will also provide an opportunity to galvanise global support for increased investment in AMR research and development, to set ambitious targets to reduce antibiotic misuse and to promote the implementation of effective interventions across all countries, especially those most affected by AMR.

To achieve meaningful progress, the global community must recognise that AMR is not a problem that can be solved by individual countries acting alone.

It requires a co-ordinated, international response that leverages the strengths and resources of all nations. High-income countries have a particular responsibility to support low and middle-income countries in their efforts to combat AMR, providing both financial assistance and technical expertise.

In addition to the direct health impacts, the economic consequences of AMR are profound and dire. If left unchecked, AMR could halt or even reverse economic growth, with an estimated annual GDP loss of approximately US$1 trillion by 2050.

This economic burden underscores the urgency of taking decisive action now. Therefore, investing in AMR research, prevention, and control measures is not just a health imperative; it is also an economic necessity.

Public awareness and education are also critical components in the fight against AMR. People need to understand the importance of using antibiotics responsibly and the dangers of antibiotic misuse.

Public health campaigns can play a vital role in changing behaviours and attitudes towards antibiotics, helping to reduce unnecessary antibiotic use and slow the spread of resistance.

One cannot stress the importance of the healthcare industry in the fight against AMR. Healthcare professionals need to be prepared to apply efficient IPC strategies and to prescribe antibiotics sparingly.

This involves making certain that hospitals have the tools needed to stop the spread of resistant illnesses and that medical staff members are knowledgeable on the most recent AMR policies.

Rapid action is required, and the UNGA HLM with its special AMR session offers a vital chance to guarantee that by maintaining the antimicrobials, millions of lives will be saved by keeping illnesses treatable.