World Leadership Dialogue proposal For the World Congress on Public Health, Rome, 12-17 October 2020 Session Title: Averting antimicrobial resistance: why leadership matters Organised by: European Centre for Disease Prevention and Control (ECDC) and the World Federation of Public Health Associations (WFPHA) Contact: Barbora Kinross, ECDC: [email protected] Short description and main messages: This session highlights why leadership across various sectors matters for the prevention and control of antimicrobial resistance (AMR). It will feature global public health leaders, whose interventions can only be stronger and more impactful if complemented by strong leadership in all sectors and at various levels. Views from economics, governance and of championing at national level will be shared with the audience. Objectives: To advocate for strong leadership in AMR prevention and control, across all sectors; To showcase remaining hurdles and potential solutions to addressing them; To resonate a sense of urgency for high-level attention to AMR globally. Moderators: Bettina Borisch – WFPHA and Karl Ekdahl – ECDC Proposed speakers: 1. Andrea Ammon – Director, ECDC: set the scene on EU/EEA & cross border health threat by Antimicrobial resistance (AMR) 2. Ramanan Laxminarayan – Director, Centre for Disease Dynamics, Economics and Policy – (CDDEP), Washington (DC), USA; and Chair, Global Antibiotic Research & Development Partnership (GARDP): focus on the role of costs of not dealing with AMR and savings if something is done 3. Dame Sally Davies – Master of Trinity College, Cambridge, United Kingdom: focus on governance at the global level and how to motivate countries to move forward when there are clear implications for sectors such as infrastructure or pharmaceutical industry profit 4. Martha Gyansa-Lutterodt, Director of Pharmaceutical Services, Ministry of Health, Ghana: focus on the example of work at national level in Ghana Important note: All speakers confirmed their availability. While Dame Sally Davies confirmed her attendance, she has a time constraint and must be back by 12 noon on Thursday 15 October 2020 in UK. Format: 60 min moderated discussion (3 min intro, 3 questions asked to the panellists (10 min/question), 25 min Q&A with the audience, 2 min closing) Concept: Key questions/ messages: 1. Where are we in terms of AMR globally and what are we doing well that has already resulted in a change? (each speaker would be asked to pick one and elaborate) 2. What are the remaining challenges? (each speaker would be asked to pick one and elaborate) 3. Would there be simple solutions or practical ways to address these challenges? How to best harvest and utilise the scientific evidence at strategic national or global levels? (each speaker would be asked to pick one and elaborate) Abstract: Averting antimicrobial resistance (AMR): why leadership matters AMR is driven by overuse and misuse of antimicrobial agents – mainly antibiotics – and by differences in the implementation of hygienic and sanitation measures to prevent transmission of microorganisms with AMR. Microorganisms do not respect species barriers or geographical borders. AMR is a global, one-health issue affecting humans, animals, plants, food and the environment, on all continents. In 2015, the World Health Assembly adopted a Global Action Plan on AMR. In 2017, the European Commission adopted its European One Health Action Plan against AMR. In 2019, the United Nations Interagency Coordination Group on AMR highlighted the urgency of the AMR situation globally and the need to act now to secure our future from the threat of AMR. Global antibiotic consumption rates in humans increased by 39% during 2000-2015, driven by a large increase in low- and middle-income countries while it remained stable in high-income countries overall. The Independent Review on AMR estimated that, globally, today’s 700,000 deaths from AMR every year could amount to 10 million by 2050 if nothing is done to control AMR. In food animals, global antibiotic consumption is high and expected to increase by 67% in 2030 compared to 2010, driven by the demand for animal protein for humans and shifting in production practices. Consequently, AMR in bacteria from food animals will further increase and impact animal health, and eventually human health. In the European Union/European Economic Area (EU/EEA), antibiotic consumption in humans decreased in many countries during 2009-2018, but this has not yet resulted in a change for the EU/EEA overall. Consumption of last-line antibiotics in humans is still increasing in many EU/EEA countries, most likely because of the need to treat an increasing number of patients infected with multidrug-resistant bacteria in these countries. In food animals, antibiotic consumption in the EU/EEA decreased by about 30% during 2011-2017, driven by large decreases in some of the highest consuming countries. In Europe and other parts of the world, countries are increasingly developing national AMR plans and start actions for the surveillance, prevention and control of AMR, but progress must be accelerated. The European Centre for Disease Prevention and Control (ECDC) has invited global leaders who will discuss challenges in responding to the AMR crisis and will share their experiences from a public health, economics, global governance and national policy point of view on practical solutions to avert AMR globally. .