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No. 50, 22 June 2021

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Highlights of the UN High-Level Dialogue on Tackling AMR

On 29 of April 2021, the United Nations (UN) General Assembly held a High-Level Interactive Dialogue on Tackling Antimicrobial Resistance (AMR). The purpose of the dialogue was to strengthen political commitment, take stock of progress, recommit to actions, and build back better from COVID-19. The dialogue also aimed at presenting practical steps to address current challenges to tackle AMR "as part of future pandemic preparedness through a One Health approach while supporting the delivery of the SDGs."[1] The High-Level Dialogue is part of the discussions that have been held at the United Nations to highlight the AMR issue. In 2016, the UN held the High-level Meeting on AMR which adopted a political declaration to advance actions on AMR.[2]  
H.E. Mr. Volkan Bozkir, President of the 75th Session of the UN General Assembly, opened the High-Level Dialogue, stressing that antimicrobial resistance is one of the biggest health challenges of our time and to ignore it is at our peril. He also noted the importance of addressing AMR to ensure effective delivery of the Sustainable Development Goals (SDGs) and build back better from COVID-19. 
Ms. Amina J. Mohammed, the UN Deputy Secretary-General, made a statement observing how this is a critical moment to take stock of progress and to revigorate action on AMR. She stressed that raising levels of AMR are threatening gains in global health, food security, economic growth, and sustainable development. She also emphasized that no health system will be sustainable without access to affordable antibiotics that work. 
H.E. Ms. Sheikh Hasina, Prime Minister, People's Republic of Bangladesh, Co-chair of the One Health Global Leaders Group on Antimicrobial Resistance, provided a statement stressing how crucial it is to address the challenges of AMR for preventing future pandemics. She emphasized the need to implement the Global Action Plan on AMR (adopted by the World Health Assembly in 2015) as well as the 2016 UN political declaration on AMR, and to formulate AMR national action plans. She further underlined the need for integrated multisectoral action plans on AMR, including a collective action plan by the international community at both regional and global levels, focusing on low and middle-income countries. She also emphasized the need for equitable access to affordable and effective antibiotics and the critical need for sustainable financing for addressing AMR.
H.E. Ms. Mia Mottley, Prime Minister, Barbados, Co-chair of the One Health Global Leaders Group on Antimicrobial Resistance, explained that the Global Leaders Group's objective is to be an independent global advisory and advocacy group to maintain urgency, public support, and visibility of the AMR challenge in the international agenda. She also underlined the need to advocate for political action on AMR.  She stressed that AMR is a pandemic that threatens to reverse a century of medical progress. Therefore, it is necessary to secure sustainable financing, take stock of the progress made and build forward better. The challenges of AMR are complex and multifaceted but are not insurmountable. She also called on global leaders to be champions in the fight against AMR and of the integration of actions on AMR into future pandemic responses and preparedness plans. She finished her intervention by emphasizing the need for effective language, effective communication, and effective political leadership.  
The High-level segment also had the participation of the heads of the Food and Agriculture Organization (FAO), the World Health Organization (WHO), the World Organisation for Animal Health (OIE), and the UN Environment Program (UNEP). The four organizations spoke about the challenges of AMR for food security, health systems, animals, and the environment. Other interrelated environmental issues were also emphasized, such as climate change and biodiversity loss. They also noted the need to continue working within a One Health perspective and, therefore, to work together to mobilize change. An emphasis was also made in learning from COVID-19 and the need to continue supporting the implementation of the One Health national action plans. 
After the High-level section, the first part of the dialogue addressed AMR in the context of COVID-19. Mr. Sherwin Bryce-Pease, UN Bureau Chief of the South African Broadcasting Corporation (SABC), moderated the segment. In the introduction of this part, he referred to AMR as the silent tsunami. As the world grapples with the devastating impacts of the pandemic and looks towards the future, it is a critical opportunity to include actions against AMR in the recovery plans. He also emphasized the SDGs as the guide. 
The first presenter of the segment was Ms. Henrietta Fore, Executive Director, United Nations Children’s Fund (UNICEF). She pointed out that COVID-19 is a reminder of how easily an infectious disease can spread across the globe. She emphasized the need to strengthen pandemic preparedness dramatically and the need to do it across sectors and as a global community and ensure a One Health approach that puts preparedness first. She also mentioned the need to strengthen key elements of health systems, including diagnostics, surveillance and access to treatments. Finally, she called on the UN agencies to join forces and apply lessons from the fight against COVID-19 to addressing AMR. 
The second panelist, Dr. Seth Berkley, Chief Executive Officer (CEO), Global Vaccine Alliance, pointed out the danger of inappropriate use of antibiotics for viral infections during COVID-19 while at the same time, many people, particularly in developing countries, are not having access to needed antibiotics. Both things will likely increase the spread of AMR. He called for expanded access to immunization that helps in preventing infections and therefore reduced antibiotic use. 
The next speaker, Sir Jeremy Farrar, Director, Wellcome Trust, spoke on the importance of preparedness and the need for robust health systems. He also emphasized the need for equitable access and how this continues to be a challenge, particularly in the COVID-19 context.  He also pointed out that COVID-19 is a cruel reminder of how devastating untreatable infections can be and their impact on lives and economies. He also underlined that AMR complexity should not be the reason for inaction. Therefore, there is a need to strengthen global health capacity for epidemics and build infrastructure that is not only for emerging threats but also with AMR at the center. He also emphasized that high-income countries must provide financial and technical assistance. In addition, there is a need for all countries to invest in research and development for new antibiotics and ensure equitable access. 
Dr. Mirfin Mpundu, Director, ReAct Africa, explained that in his work with African countries, the greatest challenge to addressing AMR at the country level was implementing the One Health AMR National Action Plans (NAPs), moving them from paper into action. Some of the challenges for implementation include political will, multisectoral collaboration, underfunded NAPs, and weak health systems that are unable to respond to AMR and COVID-19. He also pointed out that the lack of systemic views and fragmentation forces countries to seek small funding from different sources that sometimes make it hard to coordinate. Furthermore, time-bound projects may become a challenge for the sustainability of actions to tackle AMR. He also called for increasing the engagement of civil society organizations (CSOs) as crucial stakeholders in the One Health response to AMR at all levels. 
Dr. Ramanan Laxminarayan, Director, Center For Disease Dynamics, Economics and Policy, started his intervention by describing the crisis in Delhi, India, regarding COVID-19 and underlined how it has shown us that we are connected and that crisis can happen anywhere. He remarked that antibiotics are the most prescribed medicines globally and that lack of access to antibiotics kills more people than drug resistance. He further pointed out that more work needs to be done in ensuring how to bring drugs to market at low cost because, otherwise, the prices of the new drugs will be too high and will become inaccessible for people who need them. Developing new antibiotics is an urgent need, but not antibiotics that are so expensive that they can't be afforded. He also stressed the need to look at AMR as a One Health issue. 
Dr. Carlos Correa, Executive Director, South Centre, explained that the South Centre works primarily with governments but that in AMR, it has wide collaborations with CSOs because they are a critical actor. He emphasized that the fight against COVID-19 is important but should not reduce the critical nature of AMR. He also underlined that AMR should be looked at not only from a public health lens but also as a development issue, and this includes current production systems and how to reform them. He pointed out that UN agencies have provided critical guidance and the need to accelerate the implementation of NAPs. Furthermore, he emphasized the role of CSOs and the importance of South-South cooperation in addressing AMR, including the need for more collaboration between developing countries and for global solidarity. The unequal distribution of COVID-19 vaccines has shown that solidarity has not happened in practice. For addressing AMR, it will be critical to have global solidarity. 
The High-Level Dialogue also highlighted the global progress on AMR, including the vision of the Global Leaders Group, and provided critical experiences at the country level regarding the implementation of NAPs. The High-Level Dialogue also took stock of the vital issue of ensuring sufficient and sustainable AMR financing, including assessing the current state of funding and the need to scale it up. 
The High-Level Dialogue on its closing segment presented the Call to Action on Antimicrobial Resistance (AMR). The Call was part of the efforts of the Group of Friends on Tackling AMR. The aim of the Call is "strengthening One Health and multisectoral actions to tackle antimicrobial resistance (AMR), learn from the COVID-19 pandemic to address the growing threat of AMR, which has been referred to as a 'silent tsunami' and deliver on the 2030 Agenda for Sustainable Development."[3]  Over 100 countries have endorsed the Call and among the proposed actions it aims to keep AMR high on the political agenda, strengthen and accelerate implementation of previous commitments to tackle AMR and "make tackling AMR an integral part of programmes addressing pandemic preparedness, health systems strengthening, universal health coverage, the environment, patient safety, infection prevention and control, promotion of sustainable food systems, food safety and food security, and include AMR in country-led UN Sustainable Development Cooperation Frameworks."[4] The Call to Action also includes several points on AMR financing and the next steps for AMR work in the global agenda. 
The mobilization of financing to support developing countries in the implementation of NAPs remains one of the biggest challenges in the AMR agenda. As part of the recovery plans in the context of COVID-19, developing countries will need even more support to ensure their health systems are strengthened and that they have the adequate financial, human and technical resources to keep the needed antimicrobials available and accessible.

[1] The full description of the event is available from and the video recording is available from
[2] See the South Centre analysis on the political declaration on AMR: Viviana Munoz Tellez, “The Value Added of the United Nations General Assembly High-Level Political Declaration on Antimicrobial Resistance”, Policy Brief, No. 45 (Geneva, South Centre, October 2017). Available from
[4] Ibid.

Author: Mirza Alas is Programme Officer of the Health, Intellectual Property and Biodiversity Programme (HIPB) of the South Centre.
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