Three draft resolutions, but still the same aims in the WHO

Now that the merging process is over in the World Health Organization, all countries find themselves arguing about the strengths and weaknesses of the three draft resolution they have. Even though each country seeks its personal interest, all of them are standing against the same issue, Antimicrobial Resistance. For instance, countries such as Ukraine admitted being in favor of the 1st draft resolution as its “clauses benefit and can help much better the country”. Nevertheless, the delegate affirms that that resolution emphasizes on aspects such as the awareness campaigns and education, which he believes are crucial. Indeed, he claims that “there are few laws regarding the use of antibiotics, and people remain unaware of the situation”. In Ukraine, prescription are not needed to buy those drugs. Although this is illegal, there is still a lot of over-the-counter selling.

Besides, according to the UK, one of the authors of that first draft resolution, the plan that they have set called DAIS, Development of Awareness, Innovation and Surveillance, focuses on a much efficient awareness, which is “key to developing countries as they need to be properly educated on the matter”. Although the UK supports the first draft resolution, the country is still open-minded to combining with the other drafts. “Everyone wants the same things, he says, but it all comes down to the preciseness and effectiveness of each clause”.

Obviously, the same sentiments were expressed by Germany, who invites other delegates to debate and amend the third draft resolution. As an author of that draft, the country thinks one of its advantages are that it includes the developping countries, through the creation of GARAR, Global Association Responding to Antimicrobial Resistance. In fact, that body works on both regional and global level, “providing immediate funds and care, having the objective to build up long term infrastructure”, as told by the German delegate.

To cut a long story short, all countries hope to reach an agreement by the end of the conference, and are convinced that the amendment process could lead to the resolution that suits all countries’ policies.

 

The Times of India.

WHO Knows What’ll Happen Next?

Who knows anything about anti-microbial resistance? Antibiotics? Bacteria? Most don’t bother learning more than what you’d find in an average biology textbook. The word antibiotics brings to mind the medicine you have when you get the flu, penicillin, and if you have a really good memory, Alexander Fleming, the man who discovered the drugs. But I’ll tell you who does know a lot about them, who has to know it because it’s part of the job description – WHO knows.

The WHO is the World Health Organization, a specialized agency of the United Nations organization. The WHO knows that antibiotics are chemicals produced by certain special microorganisms. They have the ability to kill or inhibit the growth of other microorganisms. Anti-microbial resistance is the acquired resistance of a microorganism to an anti-microbial medicine which was previously used to treat it. This resistance is a threat to the treatment and prevention of a range of bacterial, parasitical, and viral infections that grows wider each year. Because of this, healthcare and research costs are increasing, surgeries like C-sections are becoming increasingly harder to perform, and more people are suffering, as microbes get sensitized, from diseases that used to be easier to cure. That’s why the WHO believes there is a need for immediate action, and all countries need to contribute.

That’s also why the WHO is currently discussing draft resolutions. The committee was, this evening, engaged in a question-answer session with the writers of Draft Resolution 1.3, with a panel of the six most important contributors answering questions about their paper. The purpose of this is the ironing out of kinks in the resolution. The delegates of Mozambique, Germany, Nicaragua, Senegal, the Ivory Coast, and Bahrain were in the process of explaining how and why their resolution would be effective, if passed.

However, the entire committee wasn’t completely sure that this was the best option. The questions that arose brought to light many of the concerns delegates had with regard to certain clauses of the question paper. The delegate of the USA had doubts about funding, and said that investment in anti-microbial research was at an all-time low. Where did they plan to produce investors from? The delegate of France wanted more specifics about the global fund the resolution proposed for all nations. It was supposed to be accessible to all nations in times of crisis, but France wasn’t so sure that it would be that simple. How did the six author countries know exactly what the needs of the other countries were, and what would prevent a country from siphoning money from the fund for its own purposes, even when there was no emergency?

Despite the concerns the committee had, the writers managed to answer. According to them, innovation funds would be set up all over the world by the Global Innovation Fund. This would focus on funding and recognizing scientists in antibiotic research who are normally simply published in scientific journals. They would also work with organizations to help scientists in developing countries. In response to questions about the creation of a global health fund, they proposed the establishment of global platforms for constant communication and discussion between the countries of the world. Hospitals, doctors, and science and health experts would also submit reports on the condition of the country in question before it could receive any funds, so that the country’s crisis could be confirmed as a real one.

But this was the discussion surrounding a draft resolution and not a true solution to the problem. All countries need to reach a consensus so that something can be done about anti-microbial resistance, which will, if carried out effectively, help what could grow to be millions of people all over the world.

 

Everybody’s a “politician”(WHO follow up)

The consensus once reached in the World Health Organization has broken down, leaving many third world countries feeling unaccounted for. “The different blocs are pitted against each other like politicians” said Afghanistan, commenting on the throat cut debate that is adding to the frustrations in the room. One of the most prominent draft resolutions, Resolution 1.1, seeks to control antimicrobial resistance through a multi-step plan that includes educating the public through workshops to create awareness, improving healthcare facilities and laboratories, regulating the agricultural sector to control spread of the microbes, a tax-reduction incentive program to compel companies to research antimicrobial resistance, and finally funding.

Many third world countries feel as though Resolution 1.1 simply fails to step into the shoes of developing nations and take a look at antimicrobial resistance through their eyes. “Some people are calling for a complete ban of antibiotic use on food, but for smaller nations, that just isn’t possible” said Madagascar, who believes that while limiting antibiotic use on agriculture may help eradicate the problem, as one of the most impoverished countries in the world,  Madagascar believes that “food security comes first and foremost.” Ghana echoed similar sentiments saying that she “feels like people aren’t listening…antimicrobial resistance is a major problem in developing nations not developed nations.” Ghana also feels that there isn’t enough focus on developing nations in resolutions, stressing the importance of this in her logic that “if we can’t eradicate microbial resistance in developing nations they can never become developed nations.” Afghanistan agreed with this assertion, citing the fact that the current agricultural industry cannot support the 7 billion (and rapidly growing) world population.

Moreover, Resolution 1.1 cites usage of the Global Innovation Fund to provide financial compensation for research and infrastructure. The only caveat is that developing nations wouldn’t be able to choose where the funding given to their nation would go. Instead developing nations are expected to apply to the program and then can participate only after they are chosen. This plan doesn’t give developing nations much freedom or power in the fight against antimicrobial resistance, making developing nations less autonomous then they already are.

Ghana cites a major merge between resolution papers as a reason for the “understanding gap” between developed and developing nations. As tension grows so does the debate between third world and first world countries, we can only hope that amendments will be made to pacify the discourse.

WHO will win the battle against Anti- Microbial Resistant Bacteria. (?)

I stepped foot into the World Health Organization, only to be greeted by a soporific roll call for 163 delegates. Hoping that committee would make up for that torture, I took the brave decision of taking a seat somewhere in the back of the committee room.

A crisis was announced, as if to answer my prayers, and the enthusiastic buzz that filled the air made me smile. I knew I would find something important to report on. The crisis at hand was a dangerous outbreak of drug resistant bacteria in Mozambique. Things started to speed up, and so did my pulse. Six moderated caucuses were raised. The first four, after numerous bouts of counting and double-checking, were rejected. My hope started dwindling, but then thankfully the fifth moderated caucus was passed. Its topic was “Short term solutions to the crisis at hand.”

Hungary spoke forcefully about implementing ways to regulate and stop gene expression of the Anti-Microbial Resistant bacteria. Bahrain emphasized on education of the farmers and people in the agricultural sector all over the world, so that there is no misuse or overuse of antibiotics for treatment of crops. El Salvador stressed on the involvement of Non-Governmental Organizations in government programs to help raise awareness. Germany promoted the triple ‘S’ slogan- Smart Sanitation System. Lastly, the Republic of Korea encouraged people to eat healthy, to keep healthy, so that antibiotics were not overused and hence bacteria would not be able to take the better of us.

Things started to slow down once again and I finally left the Independence Ballroom, to my own independence.

WHO cries “who?”

As I wandered the room that housed The World Health Organization committee, I couldn’t help but notice the amount of resounding “yes'” and head nods that filled up the room that housed the large committee. The WHO appears to be in resounding agreement on their views on antimicrobial resistance. Most nations agree that the developing nations must be educated on the dangers of overusing antibiotics. Madagascar stresses the importance of antimicrobial education starting at a young age, and supports getting a social media team to aid in the education process. Furthermore, most nations agree that research targeting the development of molecules that can combat antimicrobial resistancce is imperative, along with the idea of working together with other nations to solve the problem together rather than individually. Many delegates appeared to be frustrated with the lack of discourse, particularly Kazakstan who claimed that “the amount of consensus is pretty obnoxious, [and] the intelligent discourse is zero”.

However, logistically, the most important part of a research initiative is finding funding,  leaving many nations questioning “who will fund our research?”  Turkministan claims that they “lack the resources and technology to investigate antimicrobial resistence”, and Nambia, who  echos the same sentiments.

When asked about funding, Afghanistan was quick with a detailed response. Afghanistan belives that an incentive program between developing and developed nations could be a potential solution to the problem. The incentive program requires developing nations to donate their natural resources to developed countries with depleted resources in exchange for funding and development of infrastructure (in the form of research facilities and hospitals).

After a ten minute unmoderated causes, WHO transitioned into a ten minute moterated caucus, and is well on their way to resolution.

WHO is On Top in the World Health Organization?

Earlier I spoke with a group of delegations in the World Health Organization representing developing countries, and they told of the struggle within WHO between More Developed Countries (MDCs) and Less Developed Countries (LDCs) as well as their differing perspectives. I managed to speak with a delegate from a semi-developed country in order to understand their perspectives upon the situation. There have been new issues raised as well as new solutions in this committee, and Saudi Arabia has brought some interesting points to the table, already having worked with a bloc to submit a Working Paper.

This bloc is discussing the ways in which MDCs may work to create a system of funding in order to provide proper financial support to LDCs that are currently struggling to sufficient access to appropriate medications. Some funding could also be directed toward constructing better systems of education in LDCs in order to ensure that there are properly qualified medical professionals among future generations. The bloc then presented the possibility of creating a data base for the purpose of pursuing and providing correctly certified medical professionals as well as administering correctly prescribed medication.

Saudi Arabia’s bloc also discussed the implications of the usage of supplements and antibiotics on livestock. According to Saudi Arabia, “The use of antimicrobials in agriculture has led to detriments across multiple nations.” They deliberated prospective solutions in which growth stimulants and other such antibiotics could be replaced or even eliminated from the diets of livestock, so as to combat animal cruelty as well as health implications upon human consumers.

Overall the division between MDCs and LDCs remains apparent, as well as some countries caught between; each group is currently working on developing coherent Working Papers within their blocs. Let’s see how this carries out; will one come out on top, or will there arise one single collaborative Resolution?

The Resistance to Antimicrobial Resistance

Many microorganisms, such as bacteria, fungi, viruses, and parasites, pose a threat to public health. Pharmacies create antibacterials to kill and disrupt the growth and reproduction of these microorganism, but, over time, these microorganisms evolve and change their genetic make up through Darwin’s natural selection. Organisms with slight genetic mutations are able to survive and reproduce, passing this genetic information on to the next generation, and thus creating a slight variation in the genetic make up of the system of organisms. When used in context with microorganisms, this process is known as “antimicrobial resistance,” or AMR for short.

This cycle can have detrimental consequences all across the globe, as the World Health Organization (WHO)  predicts that by 2050, 10 million people will die annually from the effects of antimicrobial resistance. The WHO gathered this weekend to discuss creating a plan on how to either stop or slow down this mechanism for growth.

The main topic of discussion was providing global awareness, education, and surveillance. Delegations such as Belarus and Turkey were in the process of drafting two separate working papers, but each with many equal points. “We see awareness and education specifically as a long term goal, and finding alternate techniques for discovering AMRs, such as quorum sensing, a short term goal,” said the delegation of Turkey. “Quorum sensing is a technique that is therapeutic and detects and records genes that cause harmful bacteria to spread and evolve.” This information that is gather by the quorum sensing can be used to create medications to stay one step ahead of AMR. Te delegation of Belarus agreed with these points, as well as adding that “surveillance is imperative to the success of antibacterial medications.” He did not say specifically what these plans for surveillance were.

Funding was another hot topic for debate. The delegation of Thailand, for example, was drafting a working paper with the delegations of Romania, Botswana, and San Marino that would provide “organic” and “in-house” growth for developing countries such as their own. When asked about his specific working paper, he responded saying “We want to specifically ally with countries at the same level as us to create a more withstandable future to prevent AMR and save the lives of those all around the globe.”