TWN Info Service on Health Issues (May18/06)
28 May 2018
Third World Network

Civil Society groups meet to tackle anti-microbial resistance

Dear friends and colleagues,

Members of the Antibiotic Resistance Coalition (ARC) and other civil society partners held a strategy meeting and workshop in Geneva on 7-9 May 2018. The ARC is a coalition of NGOs and individuals committed to addressing the anti-microbial resistance crisis.  It was formed in 2014 and this was their second major meeting and workshop.  The meeting was co-organised by the South Centre, the Third World Network and ReACT, which are three members of the ARC. 


Below are three short reports on the ARC workshop, a dialogue between the NGOs and the WHO, and a dialogue between the NGOs/ARC and a sub-group of the Inter-Agency Coordinating Group (IACG).  The two dialogues were held as part of the ARC meeting.  

The reports below are taken from the ARC Newsletter (May 2018).

With best wishes,

Third World Network

Thirty civil society groups convene to chart next steps

for a concerted effort to tackle AMR

On May 7-9, 2018, members of the Antibiotic Resistance Coalition (ARC) and other civil society partners convened in Geneva for a three-day conference, “Charting A Future Free from the Fear of Untreatable Infections: A Civil Society Agenda,” organized by the South Centre, Third World Network and ReAct. The meeting brought together representatives from over 30 civil society organizations spanning five continents.

The conference was an opportunity for groups working around the world to discuss key issues surrounding AMR that have emerged since the formation of ARC in 2014 and to develop next steps as a coordinated global civil society effort. Participants heard from partners leading efforts in the field globally and with expertise on a number of intersectoral topics ranging from monitoring for accountability and mobilizing providers to food production supply chain interventions and AMR in the environment.

Each day, participants also had the opportunity to discuss ways in which the civil society network of ARC and beyond could mount a collaborative strategy going forward. These conversations touched on the important role of civil society in supporting priority-setting and resource allocation for National Action Plans, coordinating the One Health approach to tackling AMR, ensuring sustainable innovation and access, and enabling stewardship and access throughout healthcare delivery.

A cross-cutting theme that emerged from the discussions and breakout sessions was the importance of emphasizing access, both as a twin goal to stewardship and as an integral component of the end-to-end R&D process necessary for sustainable access. Conflict of interest issues and mismarketing of antibiotics across the healthcare delivery and food production sectors were touched upon multiple times, highlighting civil society’s role in advocating for independent and transparent professional education for medical students, healthcare professionals, veterinarians and farmers. Participants also underscored the need for evidence-based guidelines for disease prevention, treatment and antibiotic use in the human, animal and environmental sector.


ARC members and civil society allies host a consultation with

the IACG on issues of innovation, R&D and access

Subgroup 4 of the Interagency Coordination Group (IACG) on AMR, whose work has focused on R&D, innovation and access, met with members of the Antibiotic Resistance Coalition and civil society partners. (The IACG was set up by a decision of the UN General Assembly in 2016 to produce a report to recommend actions on AMR].

Members of the IACG Subgroup 4 provided a summary of their work over the past year, but noted that they had not arrived at recommendations. On behalf of civil society, Dr. Anthony So, Director of ReAct’s Strategic Policy Program, then shared key messages for the IACG’s consideration. He reiterated upfront the importance the principles of delinkage, affordability, effectiveness, efficiency and equity as guides to the subgroup’s work, as they are central to the United Nations Political Declaration on AMR which gave rise to the IACG.

Fulfilling the goals of sustainable innovation and access requires transparency about R&D costs, clinical trial data, and prices, fair return on public investment, and R&D that takes an end-to-end approach, by which upstream incentives are coupled with access and stewardship measures downstream. Yet, as Dr. So explained, those now proposing IP extensions and transferrable IP exclusivity do so contrary to the principle of delinking the drug company return on investment from price and quantity of antibiotics sold. Such IP incentives increase the cost of antibiotics, often fail to ensure affordability or availability of products, and do not encourage antibiotic stewardship.  The problems of affordable access and antibiotic availability are not limited to low- and middle-income countries.

Dr. So also emphasized the importance of operationalizing delinkage through an end-to-end approach that involved stakeholders in the healthcare delivery system, not just drug companies, to ensure access and effective stewardship over antibiotic use. Civil society groups urged IACG Subgroup 4 to consider the value of investments, not just in new antibiotics, but also in diagnostics, vaccines, complementary technologies, and in the innovation of practice both in the human and animal sectors.

In the discussion that followed both presentations, participants underscored that R&D and access should not be seen as separate, but rather that R&D must be needs-based, and access integral to the R&D process. Concern was raised over why access was not considered core to the IACG Subgroup 4’s work from the start given that “access” is mentioned no fewer than 14 times in the UN Political Declaration on AMR that gave rise to the IACG. Civil society groups also asked how the IACG’s recommendations would dovetail with the WHO Development and Stewardship Framework.

Finally, civil society groups focusing on food animal production issues asked that the IACG Subgroup 4 look into innovation of farming practices as a strategy to reduce antibiotic use.

This consultation illustrated the need for timely engagement of civil society in the IACG process. Civil society groups can provide input on a breadth of issues and inform R&D priorities based on their awareness of needs, access challenges and the reality on the ground. Civil society can also facilitate the IACG’s reach to a diversity of actors including advocacy groups, consumer groups, academia, health professionals and food system groups.


ARC members and partners give input to the AMR global agenda

during the fourth annual WHO-NGO dialogue

South Centre, Third World Network and ReAct hosted the fourth annual WHO-NGO dialogue in Geneva. At the invitation of the Antibiotic Resistance Coalition, representatives from the WHO AMR Secretariat joined ARC members and civil society allies for a three-hour discussion around the Secretariat’s ongoing efforts to tackle AMR.

First, Dr. Marc Sprenger, Director of the WHO AMR Secretariat, provided an update on the implementation of the Global Action Plan and National Action Plans on AMR since last year’s WHO-NGO dialogue. Then, Peter Beyer, Senior Advisor for Essential Medicines and Health Products, gave an overview of WHO’s progress in advancing the Global Development and Stewardship Framework related to human health and in applying its AWaRe model as a tool to foster access and appropriate use.

Third, Liz Taylor, Technical Officer for the AMR Secretariat, discussed progress on National Action Plans, including plans to provide support to countries and monitor country progress. Finally, Dr. Awa Aidara-Kane, Coordinator of the Foodborne and Zoonotic Diseases Unit of the Department of Food Safety and Zoonoses, laid out the next steps for advancing and implementing the WHO Guidelines on use of medically important antimicrobials in food-producing animals.

Organized in tandem with the ARC and civil society conference, Charting A Future Free from the Fear of Untreatable Infections: A Civil Society Agenda, this fourth annual WHO-NGO dialogue included over thirty civil society organizations from around the world in person. The goal of this convening was to encourage an open discussion with the WHO to enable ARC members and civil society allies to hear firsthand of the important work that WHO has undertaken to tackle AMR and to share expectations, concerns and inputs to the WHO’s ongoing efforts.

Based on the previous days’ breakout session discussions, participants highlighted several challenges around R&D and stewardship, the need for broad support for the WHO guidance on antibiotic use in food animal production, access and affordability of antibiotics, and the role that CSOs can play in advancing these issues.

The reports above were published in the ARC Newsletter, May 2018.