134th WHO Executive Board meeting – Agenda item 10.6: Antimicrobial resistance
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 others 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 resolution could be strengthened:
- There is growing recognition that AMR requires an intersectoral engagement but coordination at national level is difficult. Language supporting inclusive coordination of antimicrobial stewardship at all levels should be included.
- Defined targets and country-level indicators on reducing the global burden of antimicrobial resistance should be included in order to better measure progress.
- 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 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 R&D 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.