Scholars call for Paris Accord-style global agreement to combat
emergence of 'superbugs'
New paper says the world urgently needs a co-ordinated response to antimicrobial resistance

Date:
March 24, 2022
Source:
York University
Summary:
Public health experts have long been concerned by the emergence
of so- called 'superbugs' -- existing bacterial, viral, or fungal
pathogens that have evolved to evade the antibiotics, antivirals
and antifungals developed to kill them. The scope and severity
of antimicrobial resistance (AMR) and the urgent need for a
co-ordinated global response are the subjects of a new paper,
co-authored by 25 scholars.



FULL STORY ==========================================================================
In December 2021, as the world prepared to enter the third year of the
COVID-19 pandemic, 194 member countries at the World Health Organization unanimously agreed to pursue a global agreement governing future
worldwide responses to infectious diseases. The goal is to prevent the
next pandemic, or at a minimum, to effectively contain it with minimal
cost to human lives and national economies.


========================================================================== COVID-19, like the 1918 influenza and 2009 H1N1 pandemics, was caused by a
new virus. But public health experts, including those at York University,
have long been concerned by the emergence of so-called "superbugs,"
existing bacterial, viral, or fungal pathogens that have evolved to
evade the antibiotics, antivirals and antifungals developed to kill them.

The scope and severity of antimicrobial resistance (AMR) and the urgent
need for a co-ordinated global response are the subjects of a new paper, co-authored by 25 scholars -- from York and Oxford, among several others
-- and published today in the American Journal of Public Health.Titled "Governing Global Antimicrobial Resistance: 6 Key Lessons From the Paris Climate Agreement," the paper emerged out of a collaboration between York
and Oxford University, including consensus workshops held in May 2019
at the Oxford Martin School in the U.K. The authors argue that the six
lessons from the Paris Accord should form the basis of any multi-country agreement or action plan on AMR.

A recent paper published in The Lancet provides new evidence that
the global scale of superbugs that emerge is already much higher than previously estimated, killing an estimated 1.27 million people each year.

"Every single use of an antimicrobial treatment -- every time an
antimicrobial is prescribed by a doctor or administered en masse to
livestock -- increases the chance that microbes will develop permanent, irreversible resistance to the medicines that we use to stop their
spread," says the study's lead author, Isaac Weldon, a CIHR-funded
PhD candidate in political science at York's Faculty of Liberal Arts & Professional Studies.

"As we say in the paper, every single antibiotic treatment or
antimicrobial consumed has potentially global implications. Resistant
microbial pathogens that spread throughout the world would
essentially cause untreatable pandemic diseases. And that would require non-pharmaceutical inventions like lockdowns, masking, contact tracing
and isolation to contain them -- everything we just went through for
the past two years." Here are the six elements of the Paris Climate
Agreement that Weldon and his co-authors argue should be applied to the
global governance of AMR:
1. A collective global goal to mobilize political attention and
benchmark
global progress. For the Paris Agreement, the world united behind
the goal of keeping global average temperatures below 1.5 C above
preindustrial levels. A similar benchmark is needed for AMR,
the study's authors argue.

2. A focus on social and economic transformation. Offloading
responsibility
from governments to individuals is insufficient, the authors
write; instead, policies should acknowledge that antimicrobials
have effectively become invisible infrastructure underpinning our
health, food and labour systems.

3. National AMR action plans that are regularly reviewed and
expanded. As
with the Paris Agreement, the authors suggest, countries should
be legally required to specify their AMR goals, regularly monitor
progress, and increase their commitments at regular intervals.

4. An annual forum involving multiple stakeholders.The annual
Conference of
the Parties to the United Nations Framework Convention on Climate
Change could be a model for an equivalent forum for countries and
NGOs to discuss AMR.

5. Regular and recurring re-evaluation of the best available
science. The
authors call for the creation of an analogue to the
Intergovernmental Panel on Climate Change, which regularly revisits
and re-evaluates existing measures and advises on evidence-informed
adjustments.

6. An international legal framework. Treaties are rare in global
health,
according to the authors, but the transnational nature of the AMR
crisis means a robust, binding international legal framework is
required to hold all actors accountable.



========================================================================== "Binding rules imposed on all countries are necessary because any single country's effort to control AMR is doomed to fail without the co-ordinated effort of the world," Weldon says. "Even if Canada were to impose the
perfect AMR regime, all it would take to undermine it is one passenger
arriving on one airline flight with a resistant pathogen from another
country without such a regime.

"So, in the absence of universal standards and accountability, a single
country like Canada would be imposing a cost on itself by going it alone
on AMR. It would make its economy less competitive; it would make things
harder for doctors, farmers, and corporations that have come to rely on antimicrobials with little guarantee of success. It's almost a non-starter
-- why would Canada impose these costs and constrain itself against other countries who aren't taking the initiative to address AMR? But with a coordinated global effort, the opportunity to create healthier societies,
save countless lives, and preserve the effectiveness of antimicrobials
for future generations makes the equation a no-brainer. Global cooperation
here is the key." The AMR study emerged from consensus workshops convened
by the Global Strategy Lab, an interdisciplinary research lab based at
York and Ottawa U, and the world's only WHO-affiliated Collaborating
Centre on Global Governance of Antimicrobial Resistance.

"This publication showcases the exciting work happening at York on
the global health policy measures needed to achieve the Sustainable
Development Goals (SDGs). In this case, through an active research
partnership with the University of Oxford," says the Global Strategy
Lab's director, Steven J.

Hoffman, a professor of Global Health, Law, and Political Science at
York's Faculty of Health and Osgoode Hall Law School and the Dahdaleh Distinguished Chair in Global Governance & Legal Epidemiology.

"A lot of times, research is about identifying problems, but this study
was about solutions. What specific steps must countries take collectively
to ensure more equitable access to antimicrobials, conservation of
current effective antimicrobials, and innovation in the development of
new antimicrobial treatments? The fact that the paper is short, running
to only five pages, testifies to the remarkable degree of consensus that
the scholars worked hard to achieve during the workshops at Oxford.



==========================================================================
"It also shows what that our doctorial students, like Isaac, the lead
author, are capable of, the difference they can make. Sometimes we're
too focused on professors, and we forget about the important research contributions of PhD students." The study was funded by the Wellcome
Trust, Oxford Martin School, and the Social Sciences & Humanities Research Council of Canada.

More about the Global Strategy Lab: The Global Strategy Lab is a
bi-campus interdisciplinary research lab that brings cutting-edge
science and scholarship to bear on how global institutions, instruments
and initiatives are designed to better address the most pressing global challenges. Directed by Dr. Steven J. Hoffman and based at York University
and the University of Ottawa, the Lab advises the world's governments
and public health organizations on how to design laws, policies and institutions that address transnational health threats and make the
world a healthier place for everyone.


========================================================================== Story Source: Materials provided by York_University. Note: Content may
be edited for style and length.


========================================================================== Journal Reference:
1. Isaac Weldon, Susan Rogers Van Katwyk, Gian Luca Burci, Dr Giur,
Thana C.

de Campos, Mark Eccleston-Turner, Helen R. Fryer, Alberto Giubilini,
Thomas Hale, Mark Harrison, Stephanie Johnson, Claas Kirchhelle,
Kelley Lee, Kathleen Liddell, Marc Mendelson, Gorik Ooms, James
Orbinski, Laura J. V. Piddock, John-Arne Ro/ttingen, Julian
Savulescu, Andrew C.

Singer, A. M. Viens, Clare Wenham, Mary E. Wiktorowicz,
Shehla Zaidi, Steven J. Hoffman. Governing Global
Antimicrobial Resistance: 6 Key Lessons From the Paris Climate
Agreement. American Journal of Public Health, 2022; 112: 553_557
DOI: 10.2105/AJPH.2021.306695 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220323160651.htm

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