By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
To mark this year’s World Antimicrobial Awareness Week (WAAW), WHO is calling on countries in the South-East Asia Region and across the world to intensify whole-of-government, whole-of-society approach to prevent and combat antimicrobial resistance (AMR), one of the Region’s eight Flagship Priorities. Globally, AMR is responsible for around 700 000 deaths annually and impacts progress towards at least four of the 17 Sustainable Development Goals (SDGs), including good health and well-being, reduced inequality, clean water and sanitation, and no poverty.
According to World Bank estimates, by 2050, unless urgent action is taken, AMR is expected to cause at least 10 million deaths annually and cause a 3.8 percent reduction in annual gross domestic product (GDP). AMR could force 24 million more people to extreme poverty by 2030. The world’s poorest people –those living in low- and middle-income countries are disproportionately vulnerable. The message of this year’s WAAW – “Spread Awareness, Stop Resistance” – could not be more urgent.
All countries of the Region continue to take targeted action to prevent and combat AMR, in line with the Region’s Flagship Priority, the Global Action Plan on AMR, and the health-related SDGs.
All Member States are implementing national action plans to address AMR, and most have established a national multisectoral committee on AMR, in addition to a multisectoral AMR working group.
Amid the COVID-19 response, the Region has achieved full participation in the Global Antimicrobial Resistance Surveillance System, and remains the only WHO Region in which all countries carry out the annual Tripartite AMR Country Self-Assessment Survey.
Increasing multisectoral awareness and action is critical to prioritizing action at the human-animal-environment interface – what is known as the “One Health” approach. The Global Tripartite between WHO, the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE), joined more recently by the United Nations Environment Programme (UNEP), is responsible for promoting, coordinating and facilitating One Health activities across the world, based on the Global Framework for Development & Stewardship to Combat Antimicrobial Resistance Roadmap. In all countries of the Region, commitment to strengthen implementation of One Health activities continues to grow, reflected most recently in September 2021, at a bi-regional meeting on increasing responsible and prudent use of antimicrobial agents in agriculture, and in July 2021, at a meeting of the Technical Advisory Group on the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies.
To sustain and accelerate momentum, several priorities must be addressed. First, strengthening awareness among general public and other stakeholders such as those working on human, animal, plant and environmental health promoting rational use of antibiotics and discouraging irrational self-medication which is seen more so during COVID-19 pandemic Community-based initiatives targeting households, workplaces etc. must promote awareness and responsible action on how to prevent AMR. Similarly, capacity-strengthening initiatives for healthcare workers must continue to emphasize the judicious use of medicines and Infection Prevention and Control. Second, AMR cannot be addressed by one or two sectors working in isolation. National committees, task forces and working groups must have in place clear annual plans and coordination mechanisms with specific roles and responsibilities. Third, amid intense fiscal pressures, increased domestic allocations are required.. Fourth, use of data, coupled with Operational Research on specific aspects of AMR in country contexts, must guide programmatic adaptations.
So much is at stake. AMR threatens to send us back to a time when we could not easily treat common infections. It is already making health care more costly, less efficient, causing avoidable morbidity and mortality, and exacerbating health, social and economic inequities. Throughout the COVID-19 response, all countries of the Region must continue to prevent and combat AMR, and accelerate progress towards our Flagship Priorities and the health-related SDGs. As we commence this seventh World Antimicrobial Awareness Week, WHO re-affirms its commitment to support all countries of the Region to spread awareness, stop resistance.