Sep 24, 2019 - Health

U.S. pushes global effort to fight antibiotic resistance at UN meeting

Photo of HHS Secretary Alex Azar at a podium speaking

Alex Azar speaks at an August 29 press conference. Photo: Tasos Katopodis/Getty Images

While praising "real progress" in the fight against growing antimicrobial resistance, HHS Secretary Alex Azar challenged individuals and private and public organizations around the world to renew efforts to end the "scourge of AMR" while speaking Monday at the UN General Assembly.

Why it matters: At least 23,000 Americans and 700,000 people globally die every year from AMR infections — but this number is believed to be on the low end. A recent UN report warned that AMR could kill up to 10 million people worldwide per year by 2050 if action isn't taken.

What's new: In the year since the U.S. government and its partners launched the AMR Challenge, there's been progress made, Azar said.

  • The CDC collected nearly 350 commitments from 33 countries to escalate efforts via government and private sector to lessen antibiotic resistance.
  • These commitments are from drug and health insurance companies, food animal producers and purchasers like McDonald's and Yum!, doctors and hospitals, government health officials, and other leaders from around the world.

Case in point: Azar noted the example of Premier, a large U.S. health care organization of 4,000 hospitals and 175,000 medical providers that "was able to lower the rate of a particular health-care associated infection [Clostridioides difficile] by 46% in 500 hospitals since 2015 — through coaching calls, site visits, webinars and a new website focused on AMR."

But, but, but: Azar and health officials from other countries emphasized that despite some progress, the problem continues to worsen as dozens of pathogens become resistant to treatments.

Meanwhile, a study out last week in Science developed a geospatial model using data from 901 point-prevalence surveys around the world between 2000 and 2018 examining rates of antibiotic resistance in animals and food products in E. coli, Campylobacter spp., non-typhoidal Salmonella, and Staphylococcus aureus.

  • Study co-author Ramanan Laxminarayan says they found there was a triple increase in antibiotic resistance risk in food animals from 2000–2018, particularly in low or middle-income countries like India, China and Brazil.
  • Many of these countries have just recently started monitoring and raising awareness of the problem, but farmers tend to overprescribe antibiotics to promote animal growth, causing AMR.
  • "Do we really want to enable [the] factory farming of animals at the cost of animal and human health?" Laxminarayan asks.

The bottom line: Other experts in the field tell Axios they agree there's an urgent need to focus on the AMR Challenge's "one health" approach to target humans, animals and the environment.

  • Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, tells Axios there are two main arms to combating AMR: preventing AMR from developing via good stewardship of current antibiotics and other methods, and "developing a robust pipeline of new antibiotics."
  • Greg Frank, director of the advocacy coalition Working to Fight AMR, agrees, adding that it's important for President Trump and Congress to "lead this fight — by incentivizing the development of new, lifesaving antibiotics" before more drug companies go out of business.
  • Laxminarayan, who also sits on the U.S. Presidential Advisory Council on Combating Antibiotic Resistant Bacteria, says "if you're going to solve this, it has to be [through the] one health issue — for humans and animals together."

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