The Department of Health, Republic of South Africa and the UK Department of Health hosted a regional conference on Surveillance of Antimicrobial Resistance on the 17th and 18th November, at NICD, Johannesburg, South Africa.
The conference brought together SADC countries to discuss the challenges of AMR surveillance as well as the resources and regional collaborations available to support improvements in laboratory and surveillance capacity.
The conference was opened with welcome speeches from the Director- General of Health, South Africa, Ms Precious Malebona Matsoso and the British High Commissioner, Dame Judith Macgregor. There was also a welcome video by Professor Same Sally Davies, UK Chief Medical officer and Professor Nigel Gibbens, UK Chief Veterinary Officer.
Speaking at the conference Dame Judith Macgregor said:
I am delighted to be here at the start of this important workshop on Antimicrobial resistance surveillance. We have worked very closely with South Africa internationally on this global threat, and this jointly hosted event is just the latest in an important collaboration. I would also like to acknowledge the participants from Kenya, for their Minister also made a telling contribution to the debate as a co-host with the UK, South Africa and others of an AMR side-event at UNGA.
I would like to take a moment to reflect on the work my Government has done with South Africa on AMR, and to recognise the contribution that the DG, Precious Matsoso, has made through her personal commitment and drive. Over this past year the UK and South Africa have worked closely to secure G20 recognition that AMR is an issue that appropriately sits at this table. While medical in its genesis, it is exacerbated by a market failure that needs collective action; South Africa generally, and the Minister for Health specifically, lent their support and backing for the O’Neil report my government commissioned to understand and address this market failure, which helped it land so successfully at the G20 and the UN. And UK and South Africa, with Kenya, joint hosting of the political side event at the UN General Assembly which reviewed the role pharmaceutical industry can combat the threat; the importance of public-private partnerships; and the value of setting measurable goals to monitor progress made by various stakeholders in reducing the threat of AMR.
AMR poses a significant global threat. Antimicrobial drugs (in particular antibiotics) are a cornerstone of modern medical practice, but their inappropriate use - both in medicine and agriculture - increases the risk of resistance and therefore the resurgence of infections and fatalities.
Around 700,000 people already die each year from drug resistant diseases (including drug resistant strains of HIV, TB and malaria). The O’Neill reports I mentioned earlier estimate that by 2050 AMR could be responsible for an extra 10 million premature deaths, with a potential economic cost of $100 trillion of lost output. World Bank research has also shown that global increases in healthcare costs because of AMR could reach $1trillion per year by 2050. Addressing AMR is also integral to the achievement of the 2030 Agenda for Sustainable Development.
In recognition that this is a global problem, we recently saw G20 countries acknowledge the gravity of the threat posed to global health and economic prosperity, and the urgent need to progress international discussions to mitigate rising drug resistance, and to stimulate the development of new antimicrobial drugs. The G20 have asked that OECD work with FAO, OIE and WHO, to report back in 2017 with concrete recommendations on what further action the G20 should take.
These solutions will need to address the economic issues at the heart of the problem of antimicrobial resistance, and in particular the market failure that leads to underinvestment in research and development into new antibiotics. But an effective response will require collective action from all countries using a “One Health” and multi-sectoral approach. This will involve a coordinated response from health ministries, agriculture, development, environment, education, research, foreign affairs, trade and crucially finance ministries too.
I am pleased to see that you may not find yourself sat next to someone from your field but that we actually have both veterinary and human health represented here as well as the agriculture sector. Only a concerted effort by all stakeholders, in particular government and industry, can tackle simultaneously the economic, development, human and animal health challenges involved. Drug resistant infections are not a problem that can be solved by any one country or any one region acting alone. Nor do infectious diseases respect international borders. This is why a joined up, global approach is vital. We must act together and we must act now. This started with the development of the World Health Organisations Global Action Plan and now countries are developing National Action Plans to be finalised for 2017.
Within this, a critical part of the answer is to improve surveillance systems for AMR, hence we are here today. Strengthening AMR surveillance is critical as it is the basis for informing national, regional and global strategies, monitoring the effectiveness of public health interventions and detecting new trends and threats. This will be critical for addressing the threat of AMR. Around 2003 - 2005 in the UK, our surveillance system showed a rapid rise in MRSA infections. We had to implement rapid and robust infection prevention control measures and it took around two years to see a dip in this trend, but it was the focus on surveillance that illustrated the problem to us and gave us an opportunity to act.
The UK recognises the challenge that surveillance poses, particularly in the developing world where the capacity is perhaps more limited with many competing priorities for scarce government resources. So my government has made a £265 million commitment to the Fleming Fund, which we hope will support capacity and capability development for AMR surveillance across the one health sectors. This support will be available to eligible countries within South and South East Asia and to sub Saharan Africa. Within Fleming there will be a real focus on regional collaboration. I hope you can use these sessions to identify existing networks and generate new ideas on how we can use these funds to support that co-operation.
I am pleased that together with partners in South Africa, which includes the National Institute for Communicable Disease as well as the department of Health, we have been able to convene this important gathering of health and policy specialists from across the region. I hope that this event will help share best practice, and also identify areas where strengthened responses would be helpful in this global fight, and possibly where the Fleming Fund might make a telling contribution. And above all as we look to develop the laboratory and surveillance capacity, we must ensure that the data we provide is used properly and has impact. Without that we will not be able to halt the scourge that is AMR.