REPORT TO THE SECRETARY-GENERAL OF THE UNITED NATIONS

KEY MESSAGES IN THIS REPORT

Antimicrobial resistance is a global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals.

• Antimicrobial (including antibiotic, antiviral, antifungal and antiprotozoal) agents are critical tools for fighting diseases in humans, terrestrial and aquatic animals and plants, but they are becoming ineffective.
• Alarming levels of resistance have been reported in countries of all income levels, with the result that common diseases are becoming untreatable, and lifesaving medical procedures riskier to perform.
• Antimicrobial resistance poses a  formidable  challenge to achieving Universal Health Coverage and threatens progress against many of the Sustainable Development Goals, including in health, food security, clean water and sanitation, responsible consumption and production, and poverty and inequality.
• Misuse and overuse of existing antimicrobials in humans, animals and plants are accelerating the development and spread of antimicrobial resistance.
• Inadequate access to clean water, sanitation and hygiene in health care facilities, farms, schools, households and community settings; poor infection and disease prevention; lack of  equitable  access  to affordable and quality-assured antimicrobials, vaccines and diagnostics; and weak health, food and feed production, food safety and waste management systems are increasing the burden of infectious disease in animals and  humans  and  contributing to the emergence and spread of drug-resistant pathogens.

There is no time to wait. Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation.

• Drug-resistant diseases already cause at least 700,000 deaths globally a year, including 230,000 deaths from multidrug-resistant tuberculosis, a figure that could increase to 10 million deaths globally per year by 2050 under the most alarming scenario if no action is taken. Around 2.4 million people could die in high- income countries between 2015 and 2050 without a sustained effort to contain antimicrobial resistance.
• The economic damage of uncontrolled antimicrobial resistance could be comparable to the shocks experienced during the 2008-2009 global financial crisis as a result of dramatically increased health care expenditures; impact on food and feed production, trade and livelihoods; and increased poverty and inequality.
• In higher-income countries, a package of simple interventions to address antimicrobial resistance could pay for itself due to costs averted. In lower- income countries, additional but still relatively modest investments are urgently needed.
• If investments and action are further delayed, the world will have to pay far more in  the  future  to  cope with the disastrous impact of uncontrolled antimicrobial resistance.

Because the drivers of antimicrobial resistance lie in humans, animals, plants, food and the environment, a sustained One Health response is essential to engage and unite all stakeholders around a shared vision and goals.

• National Antimicrobial Resistance Action  Plans  are  at the heart of a multisectoral One Health response, but financing and capacity constraints in many countries need to be urgently addressed to accelerate implementation.
• Strengthening infection prevention and control in health care facilities and farms using available tools and ensuring access to clean water, sanitation and hygiene in health facilities, farms, schools, household and community settings are central to minimizing disease transmission and the emergence and transmission of antimicrobial resistance in humans, animals, plants, food and the environment.
• Strengthening surveillance, regulatory frameworks, professional education and oversight of antimicrobial prescription and use, and increasing awareness among all stakeholders are also significant challenges that need to be urgently addressed to ensure the responsible use of antimicrobials and to minimize resistance in humans, animals, plants, food and the environment.
• Immediately stopping the use of the antimicrobials  on the WHO List of Highest Priority Critically Important Antimicrobial Agents for Human Medicine as growth promoters is an essential first step towards completely phasing out the use of antimicrobials for growth promotion.
• Additional   effort,    investments    and    incentives are needed to spur innovation in antimicrobial medicines, diagnostics, vaccines, waste management tools, safe and effective alternatives to antimicrobials and alternative practices, as well as operational and implementation research, in human, animal and plant health.
• Many people around the world still do not have access to antimicrobials. Ensuring equitable and affordable access to quality antimicrobial agents and their responsible and sustainable use is an essential component of the global response to antimicrobial resistance.
• Stronger political leadership, advocacy, coordination and accountability are needed at all levels to enable a sustained One Health response to antimicrobial resistance. All stakeholder groups – including governments, civil society and the private sector

– need to be engaged and to collaborate in an unprecedented effort across the human, animal, plant, food and feed production and environmental sectors, based on a shared vision and goals.

• The challenges of antimicrobial resistance are complex and multifaceted, but they are not insurmountable. Implementation of the recommendations in this report will help to save millions of lives, maintain economic and other development gains, and secure the future from drug-resistant diseases.

source: http://www.fao.org/home/zh/