The pre-71rst WHA event was organized by WAAAR May 19th at the World Council of Churches (WCC) in collaboration with the Geneva NGO Hub, G2H2.
The AMR session took the form of Round Tables with extensive discussions with the audience. Among the speakers: Dr Jean Carlet, President WAAAR, architect of France‘s AMR plan, chair ANTARTICA (AMR in ICU Coalition), Dr Marc Sprenger, Director WHO AMR Secretariat, Dr Mirfin Mpundu, ReAct Africa, Executive Director of the Ecumenical Pharmaceutical Network (EPN) Kenya, and member of STAG (WHO Advisory Tech. Group), Mireille Martini, Finance Watch, Sustainable Finance Research and Advocacy Officer, and High level Commission on Carbon pricing advisor (Stern/Stiglitz Commission), Dr Awa Aidara Kane, Coordinator, Foodborne and Zoonotic Diseases, & AGISAR, WHO.
About fifty representatives of not-for-profit international NGOs attended, among whom DNDi, Third World Network, the People's Health Movement, Medicus Mundi, Medico, the World Federation of Mental Health, and so forth, as well as the WCC Health director Dr Mwai Makoka, representatives from the inter-governmental organization South Centre, representatives of academia and a few students (University Bocconi, Milano, Italy), retired WHO staff, or the Wellcome Trust.
The podium included international experts in AMR. Yet, rather than a series of presentations by prestigious well chosen experts, the format was one of discussions with the people on the round table as well as a back and forth with the audience.The answer was : Jim O’Neill.
Many salient questions and issues were brought up, such as can any epidemic be dealt with without taking into consideration the determinants of health?
What came through in the dialogue confirmed the importance of the initial questions: in fact, it appears that in spite of the massive presence of antimicrobial resistance in the media and in medical circles (we noted the extravagant place of AMR in the recent ESCMID congress in Madrid were 13 000 infectious disease physicians and specialists attended and AMR was inover half all sessions!) the dominant perception is that AMR remains basically the challenge of producing new and better drugs, and finding the money to pay.
Meanwhile the emergence of AMR from the environment, so well described in the UN Environment Program recently, the links with the food chain, or the spread of AMR because of neglect of hygiene in health systems are little known.
We found what we suspected: people are surprised to hear about lack of hygiene in health, to them it is a problem of 'them over there'... or a localized occurrence.
We showed the beginning of a video made my angry staff in the Bamako, Mali, main tertiary hospital. (https://player.vimeo.com/video/135319492), as a provocative debate starter.
At the same time, the 'lack of money' is overall wrongly seen as an issue, as people don't understand money creation, today in the hands of private banks and not in the public domain as was the case in former times.
Hence the NGO milieu is always (wrongly) thinking: where are the pennies?
Thanks to the presence of an economist, specialist of the financial sector, Mireille Martini, co-author of the 2015 French government report on the Energy Transition and member of the Stiglitz Commission, the issues of climate change as well as financial regulation were discussed, albeit not in details.
Dr Marc Sprenger made the strong point that solid health systems must be built and access to primary health care systems become effective for any possibility of controlling AMR.
Dr Awa Aidara Kane highlighted the need to insure a proper food chain, which includes antibiotic stewardship in husbandry as well as proper waste management.
Dr Mpundu (backed by Dr Mwai, WCC), head of the Ecumenical Pharmaceutical Network, and representing REACT Africa (the Sweden Upsala University action group on AMR) explained to the audience that besides public services and private for profit care, there is also the extraordinary contribution of Faith based organisations (FBOs) in the delivery of care for most of Sub-saharan Africa, such as 70% in Nigeria. Dr Mpundi recently participated (as we also had in WAAAR, Geneva) in a South Centre major private gathering on AMR, 2 weeks earlier, during which the IACG presented a surprising report on R&D, highlighting the “failure of the market” as regards antibiotics. The IACG had surprised the audience by presenting the issue of R&D as merely one of finding funding to remedy a ‘market failure’.
Dr Jean Carlet, president of WAAAR, and a life long author and activist on the crucial issue of antibiotic resistance, author of major initiatives to bring about coalitions of AMR, spoke on the crucial need to preserve antibiotics, and the term itself ‘to preserve antibiotics’ had been his chosen title for the 2015 national AMR plan of France which he had chaired and brought together.
The event concluded on the importance of civil society not-for-profit engagement to improve public financing for the WHO core function, as well as in insuring that the backbone of any health endeavor: strong health systems well staffed, gets the support and the investments it needs.
The chair Garance Upham deplored the absence of Baba Aye, of Public Services International, from the podium as he was down with malaria on a return trip from Africa.
The participants were then invited to share ideas freely in a delicious cheese, chocolates and wine tasting buffet (for which WAAAR was thanked in general and two active help must be thanked: Dominique Appert and Mariame Upham-Sano.
In the audience, Jeremy reminds the audience of that work, and answers the riddle from the podium: “Who was the leading personality in AMR who said that a handful of American pharmaceutical giants had spend more in buybacks of their own stocks over five years than would have been needed to fund the 23 measures needed to combat AMR?
The answer was : Jim O’Neill.
Garance Upham reminded the audience that The AMR Review had been the most thorough examination of the AMR issues, covering, notably, the need for Infection prevention and control (Chapter 6) and an annexe by the London School of Economics showing a 60% reduction in antibiotic use and millions of lives saved if just 4 countries would organize so their population would have access to safe water: Brazil, Nigeria, The Philipines and India !