Antimicrobial resistance: implications for achieving the Sustainable Development Goals

In 2015, the United Nations (UN) outlined their Sustainable Development Goals (SDGs): a series of targets which aim to significantly and tangibly ameliorate global social, economic, and environmental conditions by 2030.[1] The development and spread of antimicrobial resistance (AMR), however, seriously jeopardises this project, in particular the realisation of SDG 3. This goal pledges to improve standards of global public health:

We commit to accelerating the progress made to date in reducing newborn, child, and maternal mortality by ending all such preventable deaths before 2030. […] We will equally accelerate the pace of progress made in fighting malaria, HIV/AIDS, tuberculosis, hepatitis, Ebola, and other communicable diseases.[1]

Antimicrobials have played an important role in maternal and child healthcare as well as in the prevention and treatment of infectious diseases. As such, these health-related sustainable development aims are considerably less attainable with the growing threat of AMR.

The UN’s Every Woman Every Child initiative listed them as one of their thirteen ‘life-saving commodities’, suggesting that 1.22 million neonatal deaths could be prevented if common barriers to the distribution of injectable antibiotics were overcome.[2] Another report estimated that more than 30,000 women die each year from infections caused acquired whilst giving birth, meanwhile infections kill over 400,000 newborns.[3] These risks are particularly evident in low- and middle-income countries (LMICs), some of which have maternal mortality rates up to nineteen times higher than the rest of the world.[4] Child mortality rates have dropped by 47% in the last 15 years, however these improvements would be severely damaged by the rise of AMR, especially in LMICs.

Increased resistance to communicable diseases (HIV/AIDS, tuberculosis, and malaria, among others) is another serious global health issue, in particular preventing the achievement of SDG 3. In 2014, for instance, 500,000 people developed a multidrug resistant form of tuberculosis, whilst drug resistant HIV was detected in 60% of cases in sub-Saharan Africa.[5] Again, AMR would have a particularly pernicious effect on health in LMICs (the spread of disease is exacerbated by weaker civil and health infrastructures, and affordable treatments are often unavailable) and could seriously impinge on the decrease of mortality rates from communicable diseases.

AMR, then, could have a serious impact on efforts to achieve SDG3. Moreover, as a result of its impact on agriculture, economic growth, and poverty, it will also likely inhibit progress towards other SDGs (for example, 1, 2, 6, 8, 12, and 17).[5] As such, the rise of AMR presents a number of threatening questions for any organisation committed to improving public health globally or ensuring sustainable development.

Although there is much global attention to AMR and the SDGs, there remains a need for specific policy recommendations that address these topics in a comprehensive way that reflects the interrelation between the two. Throughout this project we hope to find some specific and impactful ways in which this problem can be tackled by global governments.

References:

1. World Health Organization, Health in 2015: from MDGs, Millennium Development Goals to SDGs, Sustainable Development Goals. 2015, World Health Organization: Geneva, Switzerland.

2. Every Women Every Child, Un Commission On Life-Saving Commodities For Women And Children. 2012.

3. World Health Organization, Fight antimicrobial resistance: protect mothers and newborns 2016, World Health Organization.

4. Jasovský, D., et al., Antimicrobial Resistance - A Threat to the World's Sustainable Development, in Development Dialogue. 2016, ReAct Europe: Sweden

5. Jasovsky, D., et al., Antimicrobial resistance—a threat to the world’s sustainable development. Upsala Journal of Medical Sciences, 2016. 121(3).