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Experts urge a defensive stance in efforts against antimicrobial resistance

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In a Comment in Nature, CDDEP Director Ramanan Laxminarayan and other experts in antimicrobial resistance suggest that the United Nations should reframe global efforts against antimicrobial resistance by adopting a defensive stance. The suggested focus should be in building the resilience of society and maintaining diversity in the "global microbiome" — only a fraction of which causes human or animal disease.

Referring to the 2015 Global Action Plan on Antimicrobial Resistance, a tripartite effort between the World Health Organization (WHO), United Nations Food and Agricultural Organization (FAO), and the World Organisation for Animal Health (OIE), the authors suggest, "it does not go far enough in recognizing the life support we receive from the global microbiome."

Investments in antimicrobial research and development have focused on creating drugs and diagnostics — innovations that mainly benefit wealthy nations' industries and populations. These antibiotics will ultimately lead to further resistance not only among pathogens but in all parts of the microbiome, including in animals and the environment. The authors suggest, "In any case, waging war on microbes is not tenable–our bodies and planet depend on them."

Key steps in the effort against antimicrobial resistance and worldwide lack of knowledge about it include widespread community education, engagement across nations and industries, formation of civil society coalitions, and recognition of the problem's urgency.

On September 21st, heads of state will meet for the United Nations General Assembly High-Level Meeting on Antimicrobial Resistance, presenting an opportunity to coordinate global action to ensure a future where bacterial infections remain treatable and the global microbiome is respected.

According to Laxminarayan, "The UN meeting is the best opportunity there's ever been to set hard global targets and develop a structure to ensure accountability toward sustainable access to effective antimicrobials for the world's population."

Laxminarayan has previously authored comments related to the upcoming United Nations General Assembly High-Level Meeting on Antimicrobial Resistance.

A comment in Science established a target for the global reduction of antibiotic consumption and recommended an oversight mechanism: http://science.sciencemag.org/content/early/2016/08/17/science.aaf9286

A comment in The Lancet calls on the UN General Assembly to establish a high-level coordinating mechanism to oversee transnational and multisectoral action against antimicrobial resistance: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31079-0/fulltext

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About the Center for Disease Dynamics, Economics & Policy

The Center for Disease Dynamics, Economics & Policy (CDDEP) produces independent, multidisciplinary research to advance the health and wellbeing of human populations around the world. CDDEP projects are global in scope, spanning Africa, Asia, and North America and include scientific studies and policy engagement. The CDDEP team is experienced in addressing country-specific and regional issues, as well as the local and global aspects of global challenges, such as antibiotic resistance and pandemic influenza. CDDEP research is notable for innovative approaches to design and analysis, which are shared widely through publications, presentations and web-based programs. CDDEP has offices in Washington, D.C. and New Delhi and relies on a distinguished team of scientists, public health experts and economists.

Commentary authors: Peter S. Jørgensen, Didier Wernli, Scott P. Carroll, Robert R. Dunn, Stephan Harbarth, Simon A. Levin, Anthony So, Maja Schlu?ter, Ramanan Laxminarayan

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