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Advancing Priorities on Antimicrobial Resistance

Transatlantic Cooperation to Advance Priorities of the United Nations Resolution on Antimicrobial Resistance.

Posted On: November 2, 2016

By Jimmy Kolker and John F. Ryan, TATFAR Co-Chairs

photo of TATFAR Co-Chair, Jimmy Kolker (US)
TATFAR Co-Chair,
Jimmy Kolker (US)

photo of TATFAR Co-Chair, Jimmy Kolker (US)
TATFAR Co-Chair,
John F. Ryan (EU)

Dear colleagues:

On September 21st, the 71st United Nations General Assembly (UNGA) convened a High-Level Meeting (HLM) on Antimicrobial Resistance (AMR), which facilitated significant dialogue on country-specific commitments and actions to combat AMR. Importantly, the United Nations and Member States called upon each other to engage in cooperative, multi-sectoral, and ‘one-health’ approaches to confront the escalating crisis of antimicrobial resistance.

As a prime example of this call to international collaboration, Secretary Sylvia Burwell (U.S. Department of Health and Human Services) said, “We know that ultimately, we are stronger when we build bridges and break down walls…That is why we value TATFAR….Global challenges present opportunities for global resolve…we have the opportunity to work together, face this threat, and protect the health of our people.”

In light of this statement and TATFAR’s well-established objective to “contribute to an effective global dialogue and uptake of best practices [on AMR],” we are pleased to draw your attention to two recent publications from TATFAR.

On 30 August Clinical Infectious Diseases gave advanced access to a forthcoming publication from TATFAR on economic incentives for antibacterial drug development: Economic Incentives for Antibacterial Drug Development: Literature Review and Considerations From TATFAR. Due to the continual decline of pharmaceutical companies investing in new antibiotic development and the rise in antimicrobial resistance, there is an urgent need to examine market mechanisms that are appropriate to encourage small, medium and large companies to reinvest in this space.

This review from TATFAR provides a summary of the various models that have been proposed and highlights positions posed by several policy documents, peer reviewed publications, organization proposals, and government sponsored reviews. The findings support a form of a de-linkage model and a combination of push and pull incentive mechanisms. This level of consensus could culminate in global coordination of incentives that strike a balance of rewarding innovation and ensuring appropriate antibiotic use.

In June 2016, the taskforce released Report on Recommendation 18 [PDF – 249 KB] that provides an update of the status and outcomes of work to identify key knowledge gaps in understanding the transmission to man of antimicrobial resistance arising as a result of the use of antimicrobial drugs in animals.  It also outlines TATFAR’s phase III (2016-2020) actions and implementation priorities. Establishing an international panel of experts, Recommendation 18 sought to identify key knowledge gaps in:

  1. understanding the transmission to humans of antimicrobial resistance that arises as a result of the use of antimicrobial drugs in food-producing animals, and
  2. developing effective intervention measures to prevent this transmission, including alternatives to antimicrobial drugs.

Within a year of announcing this considerable endeavor, the panel identified six high priority knowledge gaps, including the need for:

  • Better understanding of transmission of AMR bacteria from food-producing animals to humans, notably through food consumption;
  • Enhanced information on antibiotic use in animals;
  • Improved assessment of the impact of antibiotic use in food-producing animals on human and animal health;
  • Coordinated approaches for integrated surveillance of AMR in zoonotic bacteria; better and more comprehensive data on AMR in zoonotic pathogens and indicator bacteria from humans;
  • Need for continued efforts to develop and apply standardized in vitro AMR susceptibility testing methods and use validated breakpoints for interpreting and reporting data; and
  • Impact of use of alternatives to antimicrobials on AMR.

In addition to advancing the scope and agenda of TATFAR’s work for the current implementation period (2016-2020), the completion of Report on Recommendation 18 actualized a major deliverable of the United States’ National Action Plan for Combating AMR under the objective of “conducting research to enhance understanding of environmental factors that facilitate the development of antibiotic resistance.”

Antimicrobial resistance is a grave threat to human health and necessitates the development of an international, unified, and multisectoral approach to better understand the science of AMR and to develop more effective, evidence-based solutions. Safe food and a sustainable environment are important to human health.  We are excited at the release of Report on Recommendation 18, as it shows the level of interest in and engagement from the many stakeholders, including the agriculture industry, who are working to promote and protect the health of animals and humans, and to hinder the advance of drug-resistant microbes.

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