Novel Antimicrobials and AMR Diagnostics 2019

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UN IACG released draft recommendations

The UN IACG has now released its draft recommendations. Until Februar 19, all stakeholders are invited to comment. A meeting in London will take place February 7.

The UN Interagency Coordination Group on Antimicrobial Resistance has published its draft recommendations.

It was established in 2016 and the IACG’s mandate is to provide practical guidance for approaches needed to ensure sustained effective global action to address antimicrobial resistance; and to report back to the UN Secretary-General in 2019.

The full text of the IACG announcement is available here: https://www.who.int/antimicrobial-resistance/interagency-coordination-group/public-discussion-draft-recommendations/en/

Some of the major recommendations include the message that innovation and sustainable financing are among the key issues which needs to be addressed globally to combat AMR efficiently. With regard to innovation,

  • The recommendations emphasize "that current efforts to support research into and development of new antimicrobials, diagnostics, vaccines, waste management tools, and safe and effective alternatives to antimicrobials across the One Health spectrum remain inadequate and need to be intensified with sustained investment and increased scientific engagement and collaboration.
  • The IACG notes "that the unclear market potential for antibiotics, diagnostics and vaccines discourages innovation, primarily due to the high cost of research and development and low success rates for new compounds, as well as uncertainty of revenue in terms of price and volume of new products. Accordingly, additional, sustained investments and collaborations are needed on the part of governments, the private sector and civil society to accelerate research and development, pull new products through to market and ensure effective stewardship."
  • The IACG recognizes "the need to develop and provide financial and non-financial market incentives for research and development to address antimicrobial resistance and recommends that these incentives should be aligned with defined research and development needs and priorities and appropriately targeted to address bottlenecks and market barriers across the product life cycle from fundamental research to registration and equitable and affordable access and stewardship."
  • The IACG also highlights existing work done by CARB-X, GARDP, IMI, JPI-AMR and CEPI.
  • The IACG underlines "that additional funding combined with financial and non-financial incentives is particularly required to bring innovative products from fundamental research to registration and implementation, including to accelerate clinical trials in humans and experimental work in animals and plants, and to enhance the role of small and medium enterprises in research and development."

With regard to sustainable financing,

  • The IACG admits that "financing is a critical bottleneck to advancing the global response against antimicrobial resistance. These recommendations emphasize the need for innovative approaches to mainstream antimicrobial resistance-related activities and leverage resources from existing funding streams, as well as to mobilize new funding. The recommendations further underline that domestic financing commitments by national governments are essential to advance priority actions and ensure long-term, sustainable responses to antimicrobial resistance."
  • The IACG emphasizes "the need for increased investment in the global response to antimicrobial resistance. It urges existing and future financing mechanisms in human, animal and plant health, as well as food production and the environment - including Gavi – the Vaccine Alliance, the World Bank, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Global Financing Facility, Multilateral Climate Funds, Unitaid, as well as future financing streams for Universal Health Coverage and other priority development issues, and their donors - to give antimicrobial resistance greater priority in their resource allocations. It further calls upon public, private and philanthropic donors in human, animal and plant health, as well as food production and the environment, to increase funding to contribute to addressing antimicrobial resistance, including to support implementation of National Antimicrobial Resistance Action Plans."

In addition, the IACG is in favor of creating a new "One Health Global Leadership Group for Antimicrobial Resistance" that would be "composed of a small group of current and former Heads of State, Ministers of Agriculture, Health and Environment, Heads of the Tripartite agencies, other UN and international agencies, Heads of Regional Banks and other prominent global leaders and eminent persons representing human, animal and plant health, as well as food production and the environment." This would pave the way for a long-term visibility of AMR on the global agenda.

For this reason, the IACG recommends "that the One Health Global Leadership Group should establish and support a constituency-based body with diverse representation (e.g. governments, private sector and civil society representing human, animal, plant and environment health, as well as agriculture and food production) to develop and implement a shared global vision, narrative and targets."

Among several task, the group should 

  • Identify priorities for research and development and facilitate implementation research in a One Health context;
  • Define the financial needs and gaps for the global response to antimicrobial resistance, including the costs of inaction and anticipated returns on investment

In addition to this new group the IACG also proposes

  • the establishment of an "Independent Panel on Evidence for Action against Antimicrobial Resistance in a One Health context to monitor and provide Member States with regular reports on the science and evidence related to antimicrobial resistance, its impacts and future risks, and recommend options for adaptation and mitigation."

The Panel should help "to provide robust and authoritative assessments of the science, data and evidence related to antimicrobial resistance across all sectors, asses its impacts and future risks and recommend options for adaptation and mitigation to governments and all stakeholders in the form of periodic reports".

This Panel might be the AMR-focused equivalent of the "The Intergovernmental Panel on Climate Change" (IPCC), the United Nations body for assessing the science related to climate change.

Now, all stakeholders in the AMR field are requested to provide feedback to these recommendations. It should be sent to iacg-secretariat@remove-this.who.int as soon as possible, and not later than 19th February 2019.

On 7th February, the IACG and Wellcome Trust want to discuss with the private sector about the draft recommendations in a meeting in London. To attend, please contact iacg-secretariat@remove-this.who.int.