Lessons from COVID-19: Strengthening Antimicrobial Stewardship Prior and During Pandemics
By Dr Rasha Abdelsalam Elshenawy
The COVID-19 pandemic has had a complex impact on the silent pandemic of antimicrobial resistance (AMR). While increased antibiotic misuse and disrupted antimicrobial stewardship (AMS) programs exacerbated AMR in some settings, heightened awareness and improved infection prevention measures implemented to control COVID-19 provided valuable lessons on sustaining these practices in the fight against AMR. This brief highlights lessons learned from the pandemic, such as the importance of access to antimicrobials and the urgent need for resilient and sustainable AMS integrated into pandemic preparedness, strengthening infection prevention and surveillance systems, enhancing access and use of diagnostics, and promoting a One Health approach. By leveraging these lessons, policymakers can build more resilient health systems, maintain the effectiveness of antimicrobials and be better prepared for future pandemics, particularly in developing countries. Immediate action is essential to protect public health and combat AMR effectively.
To prevent another COVID-19, the Pandemic Treaty must deliver real legal commitments on equity, technology transfer and benefit-sharing. Negotiations are falling short—consensus can’t mean dilution. A democratic vote is needed.
Las nuevas pandemias son inevitables. ¿Cómo podemos estar mejor preparados para ellas y, sobre todo, cómo podemos evitar los errores e injusticias cometidos durante la pandemia de COVID19? Actualmente se están llevando a cabo negociaciones para formular un tratado internacional vinculante sobre prevención y preparación que garantice respuestas más justas a futuras pandemias. Este libro pretende ser una contribución crítica a estos debates en curso.
¿Cómo garantizar un acceso equitativo a los medicamentos y diagnósticos cuando la mayoría de ellos se producen en un número reducido de países? ¿Cómo explicar que la financiación actual de la cooperación sanitaria esté en manos de un pequeño grupo de países y fundaciones del Norte? ¿Cómo reforzar el papel de la Organización Mundial de la Salud, que actualmente desempeña un papel secundario en la coordinación de las políticas de salud pública? ¿Por qué se ha sustituido el concepto de «medicamentos esenciales», gran avance de la política de salud pública, por el de «contramedidas médicas», término más acorde con el afán de lucro del sector privado?
Autor: Germán Velásquez, Asesor especial sobre políticas y salud, South Centre de Ginebra
De nouvelles pandémies sont inéluctables. Comment mieux s’y préparer et surtout comment éviter les erreurs et injustices commises durant la pandémie du Covid-19 ? Des négociations sont en cours pour formuler un traité international contraignant sur la prévention et la préparation pour des réponses plus justes aux futures pandémies. Ce livre se veut une contribution critique aux débats en cours.
Comment garantir l’accès équitable aux médicaments et diagnostics, alors que la majorité d’entre eux sont produits dans un petit nombre de pays ? Comment expliquer que le financement actuel de la coopération en matière de santé se retrouve entre les mains d’un groupe réduit de pays et fondations du Nord ? Comment renforcer le rôle de l’Organisation mondiale de la santé, qui ne joue plus qu’un rôle mineur dans la coordination des politiques de santé publique ? Comment se fait-il que le concept de « médicaments essentiels », une avancée majeure dans les politiques de santé publique, soit remplacé par celui de « contre-mesures médicales », un terme qui s’accorde plutôt à la logique de profit du secteur privé ?
La préparation aux futures pandémies nous oblige à nous interroger : comment préserver l’intérêt général, la défense des droits de l’homme et la santé publique ?
Auteur: Germán Velásquez est conseiller spécial en matière de politique et de santé au South Centre à Genève.
The United Nations High-level Meeting on Antimicrobial Resistance on September 26, 2024: Uniting to Enable the Global Response to the Silent Pandemic
By Viviana Munoz Tellez
The “silent pandemic” of antimicrobial resistance (AMR) is getting worse and requires a global response built on international cooperation and solidarity. On 26 September 2024, the United Nations (UN) General Assembly will hold a second High Level Meeting on Antimicrobial Resistance. The dedicated meeting is a new effort to bring urgent attention by leaders for increased action on the growing risk of untreatable infections becoming more widespread and of increasing mortality.
Ongoing Negotiation of a Pandemic Accord: South Centre’s Intervention to WHO Intergovernmental Negotiating Body to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response
18 September 2024
We are pleased to be participating in the morning open sessions of the World Health Organization Intergovernmental Negotiating Body’s 11th meeting for the negotiation of a pandemic instrument. See our intervention on 18 September 2024.
Equity and Pandemic Preparedness: Navigating the 2024 Amendments to the International Health Regulations
By Nirmalya Syam
The amendments to the International Health Regulations (2005) (IHR) agreed upon in May 2024 are important for strengthening global health emergency preparedness and response. The negotiations resulted in the IHR amendment now recognizing the importance of equity, including equitable access to health products, enhancing IHR core capacities, and mobilizing financing. The amendments note the role of the World Health Organization (WHO) in facilitating timely access to necessary health products by removing barriers and supporting local production and distribution. However, the WHO authority to effectively act in those areas is limited. The IHR as amended will establish a Coordinating Financial Mechanism to provide predictable and sustainable financing for its implementation, particularly in developing countries.
Despite some advancements, the amendments fall short of imposing concrete obligations on developed countries to facilitate timely access to health products and financial support and transfer of technology to developing countries. Overall, the amended IHR represent a significant step toward a more equitable global health framework, setting a precedent for future international health instruments, including the proposed pandemic treaty.
The Vaccine Industry After the COVID-19 Pandemic: An International Perspective
By Felix Lobo
The purpose of this report is to analyze the impact that the COVID-19 pandemic has had on the vaccine industry from an international perspective. The objective is to learn from the experience and contribute to the design of better tools for future vaccine development and manufacturing, as we must be prepared for future emerging infectious diseases with the potential for global expansion. This industry makes fundamental contributions to global social welfare, but from a business point of view it is complex and difficult to manage, and from an economic point of view it is an industry that does not fit the paradigm of competitive market efficiency with notorious market failures.
We examine the impact of the pandemic on innovation and the scientific, technological and industrial development of vaccines and find that certain elements of the industry’s structure have changed, while others have remained. We also summarize the lessons learned from the deployment of some public policies to boost supply and drive demand, paying particular attention to the inequity in the global distribution of vaccines and to the COVAX program. We conclude that some of the policies have been very effective, while others have not fully achieved their objectives. From the achievements and limitations, lessons can be drawn for the reformulation and expansion of global public policies that would stimulate R&D, manufacturing, distribution and access.
Constraints to and Prospects for Sustainable Livestock Sector Practices in Argentina with Emphasis on Antimicrobial Usage
By David Oseguera Montiel
Antimicrobial resistance (AMR) is a top threat for global health and development as it has the potential to become the next pandemic. Agriculture roughly accounts for three-quarters of all the antimicrobial usage. Modern animal husbandry systems use antimicrobials for disease prevention and growth promotion. Regulations and restrictions regarding antimicrobial use in agriculture vary across the regions of the world. This paper explores the situation of the Argentina livestock sector with regard to antimicrobial use. Argentina is renowned as a global food producer, notably for its grain and livestock production potential. This paper analyzes the constraints to and prospects for transitioning towards a more sustainable livestock farming production in Argentina by relying less on antimicrobials and without compromising productivity. The livestock sector in Argentina has embarked on the intensification of farming, especially beef farming, in the last thirty years. Farming intensification generally requires the use of greater quantities of antibiotics. Alternative sustainable intensification is necessary to overcome antimicrobial overuse. Various factors, including economic, social, and cultural, shape consumption patterns. The Argentine farming sector needs to focus on these context-specific situations, which will drive animal food production.
Compulsory Licensing as a Remedy Against Excessive Pricing of Life-Saving Medicines
By Behrang Kianzad
The COVID-19 crisis intensified decade-long debates on the interaction between intellectual property rights (IPRs), competition law and access to affordable life-saving treatments and vaccines. Compulsory licensing of patented medicines is a tried-and-tested method to expand access, particularly in a situation of “national emergency or other circumstances of extreme urgency” within the meaning of Article 31(b) of the TRIPS Agreement. Some legislations, such as European competition law, offer a toolbox for curbing the exercise of IPRs if they would be found in conflict with certain competition rules, such as rules prohibiting excessive pricing by dominant undertakings. The paper analyses the interface between intellectual property law and competition law in general, moving on to the settled case law of the Court of Justice of the European Union (CJEU) on this matter. It provides a general overview of legal and economics arguments related to excessive pricing prohibition and the main case law of European competition law on the matter and discusses whether compulsory licensing as a remedy against excessive pricing of patented life-saving pharmaceutical products can be a viable and appropriate remedy. Finally, the paper offers policy recommendations relating to compulsory licensing based on excessive pricing.
A critical week for global health with the 77th session of the World Health Assembly. For decision, the future of the pandemic instrument and IHR amendment negotiations.
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