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Making a global action plan for antibiotics

Every year, 25,000 people die as a result of antimicrobial resistance in Europe. A global action plan for one of the greatest health threats of our time was the aim of a conference held in Oslo on 13th-14th November 2014.

John-Arne Røttingen. Folkehelseinstituttet

Representatives from 40 countries attended the conference arranged by Norway together with six other countries and the World Health Organization (WHO).

Earlier in 2014, the WHO issued the first global monitoring report on antimicrobial resistance (AMR). The conclusion of the report was clear: We are heading into a post-antibiotic era where common infections may claim many lives. Overuse or imprudent use of antibiotics has been a major contributor.

“If we fail to reverse the trend or find alternative solutions to antibiotics, it will become difficult to perform common surgical procedures such as hip replacements and cancer treatments in the future,” says Dr John-Arne Røttingen, Director of the Division of Infectious Disease Control at the Norwegian Institute of Public Health.

It will also be difficult to cure sexually-transmitted infections like gonorrhoea. We have already seen that infectious diseases have become more difficult to treat. A well-known example is how resistant tuberculosis is a major and growing health problem worldwide.

Mr Bent Høie, Minister of Health, has repeatedly stated that if we do not succeed in the fight against AMR, we risk setting modern medicine back many years. Mr Høie will hold a keynote speech during the conference.

Zsuzsanna Jakab .jpg

Ms Zsuzsanna Jakab, WHO’s Regional Director for Europe, will also hold a keynote speech in which she will highlight the global plan of action, and antibiotic resistance as a health challenge at a regional and global level.

"Inappropriate antibiotic use is the major driver of growing antibiotic resistance. While medicines represent 30 to 40 per cent of total health expenditure, countries do not invest in improving their use. If just 1 per cent of the medicines budget was spent on improving the use of drugs we could see a big impact in resistance rate, says Ms Jakab.

"The WHO's first ever Global Action Plan calls for mechanisms and regulations to better use antibiotics and summons all relevant stakeholders around that. Europe has been leading the way in addressing antimicrobial resistance, particularly promoting prudent use of antibiotics."

International efforts crucial

If we are to meet the challenges we are facing, we are totally dependent on a solid international collaboration. Representatives from 40 countries will attend the meeting and several international organizations are invited. Participants will exchange experiences, identify critical knowledge gaps and discuss strategies and actions for prudent use of antibiotics. They will also discuss important measures against the spread of infectious diseases.

The Oslo meeting is the third in the series of four. The last meeting will be held in Sweden in December with the theme of diagnosis and surveillance of antibiotic resistance. The conclusion from the Oslo meeting will be used as input to a global action plan to combat AMR, which will be adopted at the WHO General Assembly in May 2015. There has never been such an action plan before.

Dr Røttingen says the Oslo meeting will be an important opportunity to mobilize support for a global action plan to combat AMR and to discuss how ambitious the action plan can be with international agreement. However, he reminds us that experience shows it will take time to achieve more than the bare minimum of results when 194 UN countries need to agree on a common plan of action.

Norway has an important role

A report published this summer about antibiotic use in Scandinavia shows that the Nordic countries have made progress in limiting the use of antibiotics where possible. Yet Dr Røttingen reminds us that global challenges are also our responsibility.

“It is often too easy to pat ourselves on the back and show how clever we are in Scandinavia. The Oslo meeting will make it clear that this is a common global challenge, and that Norway has an important job to do at home and abroad.”

Even though countries have a common goal of reducing the development of antibiotic resistance, it is important to be aware that the situation in individual countries can be completely different. In some countries, there is both an over- and under-use of antibiotics with the subsequent health problems that result.