Ghana hosted the Call to Action and led the global response on Antimicrobial Resistance (AMR).

Critical gaps in action to address the rise and spread of drug-resistant superbugs are putting recent progress in peril. Health representatives from national governments and agencies, civil society, the private sector and global philanthropies will meet in Ghana next week, to focus on ambitious action, but also warn that despite pockets of country-level innovation, international progress is stalling.

Government ministers, scientists, industry and civil society leaders are meeting in Accra, Ghana, for the second international Call to Action on antimicrobial resistance (AMR), focussed on global, coordinated action to halt the spread of superbugs. According to the World Bank, by 2030, a further 24 million people in lower and middle-income countries (LMICs) will be pushed into poverty if effective action is not taken.

Faced with the heaviest burden of disease, LMICs are leading the way using pioneering activities to tackle superbugs. Tackling AMR requires a multisector approach – referred to as One Health – due to the interconnected nature of human, animal and environmental health. Reflecting this cross-cutting nature, groups from across governments, communities and sectors have come together to develop innovative solutions aimed at reducing illness and death caused by superbugs.

Antimicrobial resistance - or AMR – occurs when antibiotics and other medicines used to prevent and treat infections cease to be effective (including for diseases such as malaria, TB, HIV and medical procedures such as organ transplants, cancer treatment, caesarean sections). This is a global issue that needs urgent attention from all sectors – human, animal and environmental health.

10 million people are at risk of dying annually from AMR-associated causes by 2050, with majority of these deaths looking to occur in Africa and Asia.

Congratulations to Ghana for hosting the Call to Action and leading the global response on AMR. UK proud to be working together on this as another example of our shared values and ongoing partnership.

In the UK, we are implementating our national strategy. On the global stage we are advocating for action, funding innovation and research including through the £50m Gobal Innovation Fund, and supporting low and middle income countries tackle AMR, through the £256m Fleming Fund and DFID’s wider support to health, water and sanitation.

In Ghana, the UK has supported the development of an AMR National action plan (launched in April 2018); as well as field testing for AMR and support to veterinary laboratories.

Going forward, HMG’s Fleming Fund will provide support to tackle AMR in Ghana and support six Fleming Fund Fellows. The Commonwealth Fund on AMR Stewardship is also an exciting partnership being announced tonight which will link pharmacisists in the NHS with Ghana institutions. I’m delighted that Ghana is a regional hub for the Fleming Fund in W Africa, this is testament to your action domestically and globally on AMR.

More generally, UK support to health systems and services in Ghana (and other countries) has helped tackle AMR by:

• Reducing the demand for antibiotics - through better quality of care including hygiene, improved sanitation, and vaccination.

• Increasing the number of effective antibotics - through developing new drugs, better diagnostsis of illness to match the treatment, research in agriculture.

Dr Jeremy Farrar, Director of Wellcome, said:

People are dying today, all around the world because of drug resistant infections. These infections threaten the whole of modern medicine. Surgery, safe child birth and treatment for cancer all become impossible if we cannot prevent and treat infections. We are at a pivotal moment for AMR.

In some areas we have made some progress which should be celebrated, but in many areas progress has stalled. It takes governments, industry, doctors and whole communities to help make the world safe from superbugs, and we must ensure the political momentum is there to push us further and faster towards this goal.

Interventions that have already been shown to be cost effective at the local level will be presented at the event to inspire leaders and connect the groups to other countries where the programmes could also work. These ideas include:?

• An initiative in Tanzania to reduce inappropriate use of antibiotics through a network of accredited outlets called Accredited Drug Dispensing Outlets (ADDOs). Trained drug dispensers now work across Tanzania to sell appropriate antibiotics, educate people and reduce the incidence of drug-resistant infections across the country.?

• In India, the ‘Superheroes Against Superbugs’ initiative is spreading awareness of antibiotic resistance to young children through comics, storytelling and role play. Through workshops, the team are helping to start a better conversation about the proper use of antibiotics and encouraging children to spread these messages to their parents and wider community.

• In Ghana, the Christian Health Association (CHAG) is improving pharmaceutical service and healthcare through improved access and appropriate use of quality-assured medicines in church health systems. They are also tracking hand hygiene practices, hospital-acquired infections and the general attitudes, knowledge and practices towards AMR.

A recent report from the World Health Organization (WHO) does however point to progress– 93% of countries surveyed are developing or have developed a national action plan, a tool established to ensure countries are making a robust plan to address AMR, up from 85% the previous year. However, only 38% of countries have implemented this plan, and 15% of countries have no plan at all, highlighting that there is still a significant way to go if we are to turn the tide on AMR.

Philip Smith, Department for International Development (DFID), Ghana Country Director said:

Anti microbial resistance is one of the world’s greatest threats to human health. I’m proud that the uk government and Ghana are working together on this important issue. This is a great example of the enduring partnership between uk & Ghana.

Kwaku Agyeman-Manu (MP), Minster for Health, Ghana, said:

Antimicrobial resistance is a developmental issue that seeks to threaten and wipe out all the majority of the gains of the Sustainable Development Goals (SDGs). Everyone must take action; big country or small country, rich or poor because we are all at risk.

Ghana is pursuing this health security threat and making sure this is followed under One Health Agenda because it is the right thing to do, especially so when His Excellency the President of the Republic Nana Addo Dankwa Akufo-Addo is a co-advocate for the SDGs.

Pursuing the Agenda 2030 by leaving no one behind becomes meaningless if we do not pay attention not just on the development of action plans, but through effective implementation of the plans and strategies for accountable governance and also keeping the momentum on antimicrobial resistance. This second Call to Action is a call for commitment and also to ensure that all the ‘voices’ are heard and their inputs also shapes recommendations for monitoring strategies and activities.

The Call to Action event in Accra on November 19 and 20 is co-hosted by the government of Ghana, Thailand and the UK, along with the Wellcome Trust, World Bank and the UN Foundation in partnership with the Inter-Agency Coordination Group (IACG) on Antimicrobial Resistance It is the second time the event has been held, following the event in Berlin in 2017. Since then, much great work has been done, but progress is fragile and not where it needs to be to effectively tackle the problem of superbugs.

By May 2019, the Inter-Agency Coordination Group (IACG) on Antimicrobial Resistance will submit their report to the UN Secretary General. This includes making recommendations on how to better coordinate action across sectors and countries, as well as serving as a vehicle for building political momentum and future governance, and mobilising a broad base of stakeholders. The UN Secretary General will then report back to the UN General Assembly in 2019. When AMR was tabled at the UN General Assembly in 2016, it was only the fourth time in history of the UN that a health topic had been discussed at the UN General Assembly, representing the severity of the issue for every country around the world.