WAAW 2024: We finally have a political declaration on AMR; it is now time to advance its implementation

The UN General Assembly High-Level Meeting on Antimicrobial Resistance (AMR) and the resulting political declaration have provided a crucial opportunity to spotlight the challenge of AMR, elevate its profile, and promote international cooperation to address one of the defining global health challenges of our time. Perhaps most importantly, the political declaration provides the foundation for revitalised national and global responses to AMR.  

The political declaration includes commitments in critical areas of AMR response including governance, finance, access and coordinated multisectoral response. It also includes formal recognition that low- and middle-income countries (LMICs) disproportionately bear the burden of AMR. 

A major commitment within the declaration is the establishment of an independent panel on evidence for action against AMR (IPEA) by 2025, reflecting the urgent need for a new institution tasked with facilitating the generation and use of the best possible research to guide effective, evidence-informed policymaking. The declaration also calls for each country to develop actionable multisectoral national action plans (NAPs) with national targets and sustainable financial resources by 2030 while also acknowledging the need to leave no one behind and reach the furthest behind first. 

The declaration has the potential to accelerate meaningful global, regional, national and local AMR response with all stakeholders having a role to play in its successful implementation. For the AMR Policy Accelerator, an innovative university-based think tank established to provide rigorous policy research, customised advisory services and capacity strengthening for evidence-informed policymaking, it’s an opportunity to step up and ensure our offerings support national governments as they interpret the declaration and develop NAPs that are equitable, effective and impactful.  

Developing and implementing actionable multisectoral action plans can be a challenge for many countries, especially those with limited financial resources. The declaration outlines that while 178 countries currently have multisectoral NAPs, only 68 per cent are implementing them, 52 per cent of countries have functioning multisectoral coordinating mechanisms, and 11 per cent of countries have dedicated funding in their national budget for NAP implementation. The Accelerator supports countries by providing evidence-informed advice on One Health Governance, and through the Smart Choice Process — a facilitated country-led process that brings together relevant stakeholders to systematically and transparently prioritise AMR interventions for effective multisectoral NAPs. 

Developing national targets for NAPs is also a challenge for many countries. Countries cannot simply adopt the global target set out in the declaration — a 10 per cent reduction in global deaths associated with bacterial AMR by 2030. For each country, local realities will need to be considered to identify the relevant markers of progress. Success may need to be measured more qualitatively, looking at progress of One Health Governance, and NAP implementation before a reduction in deaths associated with bacterial AMR can be measured meaningfully. A context-specific perspective on impact, which can be enabled through AMR Policy Accelerator offerings, can provide countries with a sense of progress and foster a more inclusive vision of success that can serve as a catalyser for financing. 

For the AMR Policy Accelerator, the political declaration is also an opportunity to continue bridging national AMR responses to the global agenda. We provided evidence-informed options for an IPEA design, examining lessons learned from other scientific panels, such as the Intergovernmental Panel on Climate Change. As the development of an IPEA is now set in motion as a result of the political declaration, we will continue to advise international organisations and countries to ensure IPEA can contribute to equitable and evidence-informed AMR policies as a global public good. 

By prioritising equity, facilitating country-led NAP development, informing the development of an effective IPEA, contributing to the AMR policy ecosystem, the Accelerator hopes to contribute to a future of sustainable antimicrobial access and use for all. 

Geneviève Boily-Larouche is the Managing Director of the AMR Policy Accelerator at the Global Strategy Lab. Mathieu Poirier is the Director of the Global Strategy Lab, York Research Chair (Tier II) in Global Health Equity, and Assistant Professor of Social Epidemiology at the School of Global Health

Views expressed are the authors’ own and don’t necessarily reflect those of Down To Earth