Antimicrobial Drug Resistance: MSF intervention at 67th WHA
World Health Assembly 67 – Agenda item 16.5
In contexts ranging from child nutritional centres in Niger to adult trauma sites in Syria, Médecins Sans Frontières sees first-hand the emergence of high rates of resistant bacteria, including ESBLs and MRSA.
MSF and other treatment providers in developing countries lack access to tools to diagnose bacterial infections with sufficient accuracy, to distinguish bacterial infections from non-bacterial pathogens such as viruses, mycobacteria and parasites, and to distinguish infections caused by sensitive bacteria from those caused by antibiotic-resistant bacteria.
We welcome the lead taken by WHO in developing and coordinating the global action on antimicrobial resistance and would like to highlight where the proposed resolution could be strengthened:
- Defined targets and country-level indicators on reducing the global burden of antimicrobial resistance should be included in order to better measure progress.
- Conservation of current antibiotics is important, so rational drug use must be encouraged, and the supply of quality-assured antibiotics secured. Given that substandard antibiotics are contributing to resistance, the role of WHO to strengthen regulatory capacity in countries should be reinforced.
- Access to key antimicrobials, including later-generation antibiotics, is critical to ensure that patients with resistant organisms receive the correct treatment. A call for mechanisms to decrease prices and ensure affordability should be included.
- Development and improving diagnostic capacity is not sufficiently highlighted as a critical way to improve antibiotic stewardship and ensure rational use. Diagnostics are needed not only for surveillance purposes but also for individual patient management. Current laboratory infrastructure should be strengthened to help deal with the growing epidemic.
- Clearer language on research and development is needed, including a note on the failure of intellectual property to stimulate the necessary private sector investment in antibiotic development, and the need for new models of innovation and new sources of R&D financing to overcome this barrier. Language on R&D diagnostics should state the need for open-source platforms, in order to generate innovation appropriate and affordable for developing countries.