Third Global High-Level Ministerial Conference on Antimicrobial Resistance concluded

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The Third Global High-Level Ministerial Conference on Antimicrobial Resistance, hosted in Muscat, Oman, concluded today, where targets to address the global antimicrobial resistance (AMR) challenge were discussed for the first time. The conference and its numerical targets for antimicrobial use in the human and animal sectors will pave the way for bold political commitments at the forthcoming UN General Assembly High-Level Meeting on AMR in 2024. 

The conference agreed the Muscat Ministerial Manifesto, which sets out the three global targets: 

1. Reduce the total amount of antimicrobials used in agrifood systems by at least 30-50% by 2030, galvanizing national and global efforts;  

2. Preserve critically important antimicrobials for human medicine, ending the use of medically important antimicrobials for growth promotion in animals;  

3. Ensure ‘Access’ group antibiotics (a category of antibiotics that are affordable, safe and have a low AMR risk) represent at least 60% of overall antibiotic consumption in humans by 2030. 

Countries also made commitments to implement National Action Plans for AMR and strengthen surveillance through improved data reporting and management, private sector engagement and implementation of evidence-based practices. 

The Food and Agriculture Organization of the United Nations (FAO), the UN Environment Programme (UNEP), the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH, founded as OIE), known as the Quadripartite, welcome the outcomes of the Conference for accelerating action on AMR.  

The 2019 WHO AWaRe Classification Database was developed on the recommendation of the WHO Expert Committee on Selection and Use of Essential Medicines. It includes details of 180 antibiotics classified as Access, Watch or Reserve, their pharmacological classes, Anatomical Therapeutic Chemical (ATC) codes and WHO Essential Medicines List status. 

WHO AWaRe Classification:

Improving use of antibiotics through antibiotic stewardship is one of the key interventions necessary to curb the further emergence and spread of antimicrobial resistance (AMR). It is also important for ensuring appropriate treatment.

For that reason, WHO in 2017 introduced the Access, Watch, Reserve (“AWaRe”) classification of antibiotics in its Essential Medicines List. The classification is a tool for antibiotic stewardship at local, national and global levels with the aim of reducing antimicrobial resistance.

AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal uses and potential for antimicrobial resistance.

ACCESS GROUP ANTIBIOTICS

This group includes antibiotics that have activity against a wide range of commonly encountered susceptible pathogens while also showing lower resistance potential than antibiotics in the other groups. The Access group includes 48 antibiotics, 19 of which are included individually on the WHO Model List of Essential Medicines as first- or second -choice empiric treatment options for specified infectious syndromes.

WATCH GROUP ANTIBIOTICS

This group includes antibiotics that have higher resistance potential and includes most of the highest priority agents among the Critically Important Antimicrobials for Human Medicine and/or antibiotics that are at relatively high risk of selection of bacterial resistance. Antibiotics in Watch group should be prioritized as key targets of stewardship programs and monitoring. The Watch group includes 110 antibiotics, 11 of which are included individually on the WHO Model List of Essential Medicines as first- or second -choice empiric treatment options for specified infectious syndromes.

RESERVE GROUP ANTIBIOTICS

This group includes antibiotics and antibiotic classes that should be reserved for treatment of confirmed or suspected infections due to multi-drug-resistant organisms. Antibiotics in Reserve group should be treated as “last resort” options, which should be accessible, but their use should be tailored to highly specific patients and settings, when all alternatives have failed or are not suitable. These medicines could be protected and prioritized as key targets of national and international stewardship programs involving monitoring and utilization reporting, to preserve their effectiveness. 22 antibiotics have been classified as Reserve group. Seven Reserve group antibiotics are listed individually on the WHO Model List of Essential Medicines.

https://www.unep.org/news-and-stories/press-release/quadripartite-welcomes-new-political-commitments-fight-against

https://www.who.int/news/item/01-10-2019-who-releases-the-2019-aware-classification-antibiotics

https://amrconference2022.om/About.html

>>>>> The Antimicrobial Resistance Multi-Stakeholder Partnership Platform Launched

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