What We DoIssuesGlobal HealthGlobal Health Resource CenterCharting the Course for the AMR Agenda in 2024
Last updated November 28, 2023
Written by: Molly Moss, Global Health Policy Officer, and Camden Malone, Global Health Policy Associate, United Nations Foundation
Each year from November 18 to 24, the world reenergizes its commitment to managing antimicrobial resistance (AMR) through World AMR Awareness Week (WAAW). This annual campaign is designed to promote awareness of the existential threat posed by AMR and encourage best practices among all stakeholders in doing their part to turn the tide on this critical global health threat. The freshly concluded 2023 campaign, which addressed the theme “Preventing Antimicrobial Resistance Together,” emphasized the multisectoral nature of this dangerous phenomenon. It also provided an opportunity to look toward 2024, when the United Nations General Assembly will convene its second high-level meeting on the subject.
Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines. As antibiotics and other antimicrobials become less effective, common infections become harder to treat. Consequently, the risk of disease spreads, and severe illness and death increase. This is true for humans, animals, and even plants, all of which rely on antimicrobials.
According to WHO, AMR is now one of the top ten global public health threats facing humanity. The phenomenon has a well-documented impact on human health (SDG3), directly causing 1.27 million deaths and contributing to a further 4.9 million deaths per year, making antibiotic-resistant infections more deadly than HIV/AIDS or malaria. But AMR is also a serious threat to food security (SDG2) because it increases the loss of animal lives due to untreatable infections and raises the cost of animal health care. By 2050, livestock production could decline by as much as 11% due to AMR. This loss of human and animal lives has dire consequences for the global economy. The economic toll of AMR is expected to result in a GDP drop of at least $3.4 trillion annually by 2030 and push 24 million more people into extreme poverty (SDG1).
As the President of the UN General Assembly, H.E. Dennis Francis, shared last week, AMR is a present and future risk to the SDGs. Yet, solutions for AMR can also be found in the SDG agenda. Progress on the goals yields important benefits for controlling AMR. Improved access to clean water and sanitation (SDG6) is critical to reducing the spread of drug-resistant infections. Each year, hundreds of millions of cases of diarrhea in humans are treated with antimicrobials; universal access to clean water and sanitation could reduce such cases by 60%. Sustainable consumption and production, such as more sustainable food production and appropriate use of antimicrobials in humans and animals (SDG12), are also vital to addressing some of AMR’s root causes. Effective pollution controls on pharmaceutical production, health facilities, and agricultural production will substantially decrease the risk of AMR emergence and spread in the environment.
AMR is a multifaceted challenge that emphasizes the need to forge effective multisectoral cooperation and partnerships (SDG17). The UN has a unique role to play in convening governments, civil society, academia, private sector, and the public to establish collective action solutions for the control and reduction of antimicrobial resistance. Since 2016, the UN has done significant work to galvanize political support to address AMR and is entering a new phase of effort on the issue in 2024.
Over seven years ago in September of 2016, world leaders attended the first-ever UN high-level meeting on antimicrobial resistance. Heads of state and government agreed to take a broad, coordinated approach to address AMR across multiple sectors, especially human health, animal health, and agriculture.
During the meeting, Member States recognized the need for stronger systems to monitor drug-resistant infections and the volume of antimicrobials used, as well as adequate funding to support implementation of AMR response at the national level. To that end, countries pledged to strengthen regulation, promote best practices, and explore innovative approaches to developing new technologies for antimicrobials, diagnostics, and vaccines. A concise, robust Political Declaration adopted during the high-level meeting indicated several future milestones for AMR. Member States committed to develop national action plans (NAPs) aligned with the Global Action Plan on Antimicrobial Resistance—a blueprint developed in 2015 by the World Health Organization, the Food and Agriculture Organization (FAO), and the World Organisation for Animal Health (WOAH, formerly OIE). The declaration also called for mobilization of adequate, predictable, and sustainable funding, which later resulted in the establishment of the Global AMR Innovation Fund, supporting projects to reduce the threat of AMR in low- and middle-income countries.
Significantly, the high-level meeting and its outcome document underscored the importance of embracing the One Health paradigm and harnessing a multisectoral approach to AMR. In 2018, WHO, FAO, and WOAH joined forces more formally at the launch of the Tripartite Joint Secretariat (now the Quadripartite with UN Environment Programme’s entry in 2022) to cultivate a whole-of-UN response to AMR. The Political Declaration also called for the establishment of an Interagency Coordination Group (IACG), which took shape in 2017. Reports published by the IACG prompted further complementary action to cohesively tackle AMR, including the creation of the Global Leaders Group on AMR (GLG) in 2020 and the AMR Multi-Stakeholder Partnership Platform in 2022.
As AMR returns to the limelight in New York next September at a high-level meeting during the UN General Assembly in 2024, there will be new opportunities for countries to commit to clear and bold new targets and practical steps for tackling the issue. Building on previous momentum, the 2024 process will also have to address new complexities related to AMR in the context of a rapidly evolving risk landscape.
The high-level meeting on AMR is timely in the sense that this already-complex issue is becoming increasingly entwined with other cascading crises the world is facing. The acceleration of AMR is part of the larger triple planetary crisis of climate change, biodiversity loss, and pollution and waste. Extreme weather patterns disrupt the natural environment and contribute to the emergence and spread of AMR. Restricted resources, mass-causalities, suboptimal infection prevention control, and environmental pollution from military exercises all severely raise the threat of AMR in conflict settings.
Since AMR transmission is affected by the behaviors of many different sectors and is becoming more deeply connected to other complex crises, intervention from the highest political levels at the UN is indispensable. The high-level meeting in 2024 is an ideal moment to explore collective solutions to improve access to medicines and antimicrobial stewardship, increase financing, and galvanize both a whole-of-UN response to AMR as well as national-level action. In the months ahead of the meeting, stakeholders will have various opportunities to engage with each other and identify key objectives for the meeting. The outputs of this high-level forum are contingent on the spirit of collaboration and the political will to dive deeply into AMR’s many layers.
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.
Camden Malone advances the global health agenda through engagement with UN Member States on a wide range of health policy issues, including universal health coverage, antimicrobial resistance, and pandemic preparedness, prevention, and response. Prior to the United Nations Foundation, Camden worked at the Permanent Mission of Costa Rica to the UN, covering intergovernmental negotiations related to health and human rights. Camden holds a master’s degree in International Affairs from the Colin Powell School for Civic and Global Leadership at the City College of New York; and a bachelor’s degree in History and Political Science from the College of Saint Rose.
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