Countries intensify their efforts to combat antimicrobial resistance
Countries are taking important steps to combat antimicrobial resistance (AMR), but there are still serious shortcomings that require urgent action, warns a joint report published today by the United Nations Food and Drug Administration. and Agriculture (FAO), the World Organization for Animal Health (OIE) and the World Health Organization (WHO).
The document analyzes the progress made in 154 countries and reveals the existence of great divergences. Some - including many European countries - have been working on AMR policies in the human and animal sectors for more than four decades. Others have recently begun to take measures to contain this growing threat. Progress in the development and implementation of action plans is greater in high-income countries than in low-income countries, but all countries have room for improvement. No country indicates having large-scale prolonged capacity in all sectors.
The report analyzes the surveillance, education, monitoring and regulation associated with the consumption and use of antimicrobial drugs in human health and animal health and production, as well as in plants and the environment, as recommended in the World Health Plan of Action. WHO published in 2015.
Among the positive conclusions, it is worth highlighting the existence of an operational surveillance system to identify drug-resistant infections in human health in 105 countries, and a system to track the consumption of antimicrobials in 68 countries. In addition, 123 countries have policies to regulate the sale of antimicrobial drugs, including the requirement of having a prescription for human use: a key measure to control excessive and undue use. But the implementation of these policies is uneven, and non-regulated medicines can still be purchased in places like street markets, with no limit on their use.
The report highlights specific areas - especially in the animal and food sectors - which urgently need more investment and measures. For example, only 64 countries follow the recommendations of FAO, OIE and WHO to limit the use of highly relevant antimicrobials to stimulate growth in animal production. 39 of these countries are high income, the majority located in the WHO European Region. In contrast, only 3 countries in the WHO African Region and 7 countries in the WHO Region of the Americas have taken this important step to curb the emergence of antimicrobial resistance.
A total of 67 countries have at least current legislation to control all aspects of production, licensing and distribution of antimicrobial drugs for use in animals. But 56 countries lack a national policy or legislation on quality, safety and efficacy of antimicrobial products used in animal and plant health, and their distribution, sale or use, or can not confirm whether those laws are in force.
There is also a notable lack of measures and information in the environmental and plant sectors. Although 78 countries have regulations to avoid environmental contamination in a generic way, only 10 of them have comprehensive systems to guarantee regulatory compliance of all waste management, including regulations that limit the dumping of antimicrobial waste into the environment. This is insufficient to protect the environment from the hazards associated with the production of antimicrobials.
"This report reflects the existence of a growing global drive to combat antimicrobial resistance," said Ranieri Guerra, WHO Deputy Director General of Antimicrobial Resistance. "We urge governments," he added, "to acquire permanent commitments in all sectors - human health, animal health, plant health and the environment - since otherwise we run the risk of having to stop using these valuable medicines."
"Helping low- and middle-income countries follow the recommendations on responsible and prudent use of antimicrobials in animals is an urgent priority," said Matthew Stone, Assistant Director-General of the World Organization for Animal Health (OIE). "Implement specific OIE international standards, have adequate national legislation and strengthen veterinary services, are essential measures to help all parties interested in animal health to help combat the threat of antimicrobial resistance," he concluded. Stone.
"FAO applauds the adoption of concrete measures in many countries for the responsible use of antimicrobials in agriculture," said Maria Helena Semedo, Deputy Director General of FAO. "However," he added, "they must do more to reduce the unregulated and excessive use of antimicrobials in agriculture. We urge them especially to phase out the use of antimicrobials to stimulate growth in animal production, whether terrestrial or aquatic. "
According to this study and other sources, the three organizations (FAO, OIE and WHO) are aware that 100 countries have national action plans on AMR and other 51 countries are developing them, but more efforts are needed to ensure their implementation . Only 53 countries have a fully operational multisector working group, although other 77 have constituted one of these groups. Only 10 countries identify sources of funding for all measures in the plan and many middle and lower income countries may need long-term development assistance to implement their plans effectively and sustainably. On the positive side, of the 10 main chicken, pig and cow producing countries that responded to the AMR survey, nine of them have at least one national action plan, and most have operational plans with a monitoring mechanism.
About the report
The global study on the progress of countries in the fight against AMR is part of the monitoring of the implementation of the Global Plan of Action on Antimicrobial Resistance, approved by the Member States of WHO and FAO and the Member Countries of the OIE in 2015.
The three organizations jointly publish and publish the survey and the report analyzes the data from the second year of the survey.
The 2018 survey collected responses from 154 countries (from the 194 WHO Member States contacted). The responses of all countries during the two years are published in an open access database, which allows for a country level analysis with civil society and other interested parties.
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