Drug-resistant infections

MSF Statement at the 72nd WHA: Follow-up to UN High-Level Meeting on Antimicrobial Resistance (Agenda Item 11.8)

72nd WHO World Health Assembly – May 2019
Médecins Sans Frontières (MSF) statement on agenda item 11.8:
Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues: Antimicrobial resistance, Document A72/18

Speaker: Dušan Jasovský

In our projects around the world, MSF faces serious challenges preventing, diagnosing and treating drug-resistant infections.

To ensure good antimicrobial stewardship, optimally treat patients and limit resistance, more must be done to strengthen IPC programmes, ensure available, timely and accurate diagnosis, and guarantee affordable access to existing antibiotics – all of which must be underpinned by investment in skilled human resources and education. We welcome WHO’s support for developing National Action Plans, but support is now needed for implementation.

Interruptions in the supply of antibiotics pose a significant challenge globally, including for MSF. We welcome the IACG’s call for governments or regional entities to establish production facilities or contract manufacturers to ensure sustainable production and supply of antimicrobials.

R&D must be driven by patient needs, target the specific pathogens people face in developing countries, be adapted for use in resource-limited settings, and be accessible and affordable for all people in need. A paradigm shift is needed in the way we finance, regulate and develop antibiotics. We must focus on quality over quantity and embrace ideas such as public-purpose ownership to develop what the public needs.

We welcome the diagnostics landscape analysis being conducted by WHO. Further work is needed to evaluate diagnostics’ clinical value and  provide countries with guidance on which tests to prioritise as well as implementation support.

The Global Antimicrobial Resistance Surveillance System should be strengthened by allowing non-state actors to supply data directly from countries that are struggling to collect and report. Efforts to monitor consumption and use of antibiotics are also critical.

The resolution should address conflicts of interest and call for stronger pharmaceutical industry regulation. Of the 100 companies in one AMR coalition, 96 still link sales bonuses to increased sales of antibiotics.

World Health AssemblyWorld Health Organization Drug-resistant infections Statement
Photograph by UN Photo/Eskinder Debebe Photograph by UN Photo/Eskinder Debebe

Médecins Sans Frontières (MSF) statement on agenda item 11.8: Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues: Antimicrobial resistance, Document A72/18

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Tackling multidrug resistance in Mosul

Drug-resistant infections Video Iraq

In April 2018, MSF opened a post-operative care hospital in this city, to provide services for people injured by violent or accidental trauma during the recent conflict. Soon after the activities started, data showed that more than one out of three patients were affected by antibiotic resistance. MSF had to adapt to the situation quickly and to build more isolation rooms in order to provide its patient with the adequate care and insure their recovery. Today, the hospital is one of the only structures in the country providing them with optimized antimicrobial therapy.

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Iraq: Antibiotic resistance in Mosul

Drug-resistant infections Feature story Iraq

Antibiotic resistance (ABR) is a major health issue and can affect anyone, of any age, anywhere.  It is caused by the overuse or misuse of antibiotics. Antibiotic resistance (ABR) is a looming challenge for MSF’s work around the world and especially in Middle-East.

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MSF's response to consultations by the IACG on antimicrobial resistance

The September 2016 UN Political Declaration of the High-level Meeting on Antimicrobial Resistance established an Interagency Coordination Group on Antimicrobial Resistance (IACG) tasked with providing practical guidance for effective global action to address antimicrobial resistance and reporting back to the UN Secretary-General in 2019.

The IACG will present a final report to the UN Secretary-General ahead of the 73rd General Assembly in 2019. In preparation for this the IACG held two consultations, one in the summer of 2018 based on a series of discussion papers, and a consultation on the final report in February 2019. MSF Access Campaign provided written comments on four of the 2018 discussion papers, as well as the final consultation in 2019.

antimicrobial resistance World Health Organization Drug-resistant infections Technical brief innovationresearch and development (R&D)
o diagnose all bacterial diseases which are affected children. The laboratory also includes a blood bank. In 2013, more than 1,600 bags had been collected of which 16% provided by volunteer donors. On 14 June 2014, MSF organized, in partnership with the Ministry of Health, various promotional activities to promote voluntary blood donation, on the occasion of the World Blood Donor Day. Photograph by Aurelie Baumel

Five technical briefs available to download

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68th WHA: MSF Intervention on Antimicrobial Resistance

WHO 68th World Health Assembly, 2015
Provisional agenda item 15.1. Antimicrobial Resistance

Speaker: Dr Arlene Chua

MSF has documented very resistant bacteria in our projects ranging from child nutritional centres in Niger to adult trauma centres in Syria. However, there remains a tremendous gap in our ability to diagnose and understand the burden of resistance because of the lack of diagnostic tools adapted to the contexts where we work.   We have started to use polymyxin, considered to be the last line of antibiotics for multi resistant infections.

The GAP is an urgent first step towards addressing the systemic challenges causing and resulting from AMR. MSF urges WHO and Member States to provide the resources needed to fulfil this plan and to coordinate efforts to combat AMR. This should include mechanisms for accountability and evaluation.

WHO and Member States should take the following actions:

  • Provide resources to implement infection control measures at all levels of health care, beyond education and training.

  • Monitor and address important data on appropriate and inappropriate use of antibiotics, including information on access to antibiotics for patients who truly need them.
  • Ensure affordable access to key vaccines for all LMICs to reduce disease burden and the need for antibiotics.

  • Revise registration policies for old antibiotics being revived for multidrug resistant bacteria, harmonising recommended dosing, and promoting manufacturing of quality-assured products.

  • Promote development of point-of-care and rapid diagnostic tests for resource-limited settings.

  • Support the call for innovative mechanisms for R&D of new antibiotics, with the immediate establishment of a new product development entity ensuring that the cost of R&D is de-linked from the price of resulting products and that use of new products is governed by a public health framework that ensures conservation while securing affordable access to those in need in line with the GSPA and CEWG report.

Now is not the time for business as usual.

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