What We DoIssuesGlobal HealthGlobal Health Resource CenterCountries Deliver New Commitments to the Fight Against AMR
Last updated October 2, 2024
Written by: Molly Moss, Global Health Policy Officer, United Nations Foundation
In the last week of September, thousands of dignitaries, diplomats, and civil society representatives gathered in New York to discuss the world’s most pressing challenges at the 79th Session of the United Nations General Assembly. Alongside issues like sea level rise and nuclear disarmament, the escalating crisis of antimicrobial resistance (AMR) was spotlighted through the UN High-Level Meeting on AMR, which took place on September 26. The daylong meeting was the culmination of a multi-month process among governments to negotiate and conclude a political declaration. The declaration generates and affirms several commitments to spur sector-specific and cross-sectoral action on AMR in the years ahead.
The 2024 Political Declaration on AMR features several concrete and actionable commitments to drive progress on this important agenda between now and 2029, when the next High-Level Meeting (HLM) will take place. While all political processes on health convened at the United Nations Headquarters in New York aim to produce a strong and action-oriented outcome document, many circumstances must work together to make this a reality.
This year’s process benefitted from a strong starting point in 2016, when the first HLM and political declaration on AMR prompted the creation of several new global governance mechanisms. Although it was eight years ago, the comparatively high level of ambition expressed through that process set a strong foundation for this year’s work.
Also like in 2016, there was strong leadership from the co-facilitators that steered Member States through the process. The ambassadors of Barbados and Malta were deeply engaged in understanding this complex issue. They tabled concrete policy solutions that built upon the legacy of Mexico’s work in 2016 and integrated the latest evidence on AMR. Their strong leadership was perhaps the most important ingredient in producing a strong outcome, as they drafted an ambitious initial text and ably guided the UN membership through lengthy negotiations.
A committed group of civil society experts was the third component that fostered a strong outcome. Those observing the intergovernmental process were motivated to influence the work, and through various channels, these stakeholders telegraphed clear messages to Member States about the urgency of this issue and the need for robust policy measures to address the crisis.
Against this backdrop, Member States were highly engaged throughout the preparations and negotiations of this political declaration, and while consensus was not achieved through the typical diplomatic process, negotiations concluded with a strong sense of agreement on the substance of the declaration.
Through this document, which is signed by heads of state and government, countries committed to reduce AMR mortality by 10% by 2030. While the declaration is not designed to provide a roadmap to reach this target, it includes many practical provisions to strengthen the multilateral cooperation toward this end. More technical guideposts will emerge through the development of a new Global Action Plan, which the declaration requests to be developed by 2026.
The declaration reinforces the value of the UN system in supporting countries to address this dynamic crisis, which threatens to derail broader progress on sustainable development by disrupting food security and economic growth, and deepening inequalities. The political declaration invokes a whole-of-UN response to AMR by formalizing the partnership of Quadripartite organizations (the World Health Organization, the Food and Agriculture Organization, the World Organisation for Animal Health, and the UN Environment Programme). It also invites new collaboration with other UN entities on antimicrobial resistance (including the UN Development Programme, the World Bank, UNICEF, and the World Customs Organization). This comprehensive model is unique in the UN system, and in her remarks during the High-Level Meeting, Prime Minister Mia Mottley of Barbados commended the of leadership of the Quadripartite organizations as an important model for the UN system to apply elsewhere.
Through the declaration, the Quadripartite is also invited to establish an independent panel to collect and synthesize data to support evidence-based decisions and policies. The establishment of this highly anticipated new mechanism will complete a trio of governance recommendations that were made in 2019. In a modest but important first step, the European Union pledged €2.5 million to support the start-up of the panel.
Another notable provision calls for a diversified group of donors to contribute $100 million to the Multi-Partner Trust Fund to support reaching the target of at least 60% of countries having funded National Action Plans by 2030. While this dollar amount is also very modest in comparison to the financing needed to build capacity for AMR at the country level, it is unusual for countries to use a political document like this to make hard financial commitments.
While the political declaration delivered practical new commitments from governments, it is not a panacea. The provisions related to animal health and the environment are considerably less robust than those related to human health. And now that the document has been approved, the hard work of mobilizing resources to implement the vision of the declaration is a daunting next step.
Despite being signatories to a strong and actionable political declaration, heads of state and government were noticeably absent from the High-Level Meeting, which is a forum designed for their participation. Apart from Prime Minister Mottley – an outspoken AMR champion who gave remarks in the opening segment – the only other head of state to attend the meeting was the Prime Minister of St. Kitts and Nevis. This is a dramatic drop-off compared to the high-water mark of 2019, when 26 heads of state and government spoke during the High-Level Meeting on Universal Health Coverage. This year’s high-level representation also fell below last year’s meetings on pandemic prevention, preparedness and response (13 heads of state) and universal health coverage (10 heads of state).
There was low participation among other groups as well. While civil society organizations had been closely following the intergovernmental process over the past several months, many of them were ultimately unable to participate in the meeting, despite there being a pathway for doing so. Approved participants were notified less than 5 business days before the HLM, and many stakeholders faced impossible visa timelines, exorbitant last-minute travel costs, and other logistical challenges that prevented their participation.
Countries will come together again in early October to officially adopt the political declaration in a regular meeting of the General Assembly. At this juncture, Member States may disassociate from paragraphs of the text, which means those paragraphs are not agreed by consensus and will not be used as the basis for future policy work on this issue.
The discourse on AMR will continue among countries and other stakeholders at several forums that convene toward the end of 2024. AMR is set to be a key theme at the upcoming World Health Summit in October and the Fourth Global High-Level Ministerial Meeting on Antimicrobial Resistance in November. World AMR Awareness Week, an annual campaign to raise awareness about AMR, is also set for November 18-24. Each of these moments creates opportunities for stakeholders to articulate the next steps in converting the political declaration into coordinated action to tackle this existential danger.
In September, the UN Foundation, with funding from the Wellcome Trust, launched the AMR Messaging Guide. This evidence-driven resource aims to promote coherence and complementarity in AMR communications. With messaging distilled from over two dozen key asks from leading organizations, the guide offers compelling statistics and action-oriented insights and recommendations from across the community of AMR experts. The guide was developed out of the Message Matrix, which was created in consultation with a diverse array of partners who participated in our AMR Communications Coalition in recent months.
Molly Moss covers policy issues related to global health governance, antimicrobial resistance, and Universal Health Coverage. Molly manages the Foundation’s official relations status with the World Health Organization and also supports engagement on health issues among UN Member States in New York. Prior to the UN Foundation, Molly worked for the Center for Global Health at the University of Colorado, focusing on immunization, pediatric infectious disease research, and research ethics. During her time at the University of Colorado, Molly earned her Master of Public Health in community and behavioral health. She holds a bachelor’s degree in medical anthropology from Hampshire College.
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