Welcome to our new interview series: Interviews with the Experts.
In this series we ask some of the leading experts in the field of AMR and One Health for their take on progress, leadership and challenges.
Our sixth interviewee is Zoltán Massay-Kosubek, Policy Manager for Health Policy Coherence (responsibilities include following AMR related developments) at the European Public Health Alliance (EPHA)
Hi Zoltan, what have you been doing on AMR in the last few years?
At EPHA we have been following AMR-related developments from a One Health perspective. EPHA has focused on supporting the implementation of the Antimicrobial Resistance (AMR) Action Plan. Our 2019 in-depth study of the content and scope of National AMR Action Plans revealed important implementation gaps and big differences between the actions being taken by EU and EEA countries.
Apart from reacting to animal health related developments, we have been vocal on the need to have a greater commitment on AMR in the EU pharmaceutical strategy, and to have AMR as a factor considered in environmental policies. EPHA updated its general position on AMR in December 2020 to reflect this.
In 2017 EPHA established the AMR Stakeholder Network within the EU Health Policy Platform and since then it has coordinated its activities. EPHA led the adoption of the Roadmap for action on antimicrobial resistance in November 2019, which outlines the political priorities for the current EU policy cycle to tackle AMR effectively.
Alongside Healthcare Without Harm Europe, EPHA is also providing the Secretariat for the MEP Interest Group on AMR, launched in February 2020, to make sure that AMR remains high on the EU political agenda.
How has the global AMR community responded to the Covid-19 pandemic?
We witnessed a global disruption in taking the AMR challenge seriously as the pandemic dominated not only the front pages of news but also the attention of the AMR community. As regards research and innovation, the race for the COVID-19 vaccine immediately began and became both a priority and a business case as well. The AMR Action Fund is at least a good step in the right direction but it is late, lacking in ambition as a commitment and needs urgent acceleration.
During the pandemic, national governments have focused on the immediate impacts of the virus and despite AMR affecting Covid-19 patients because of virus-related infections, there has not been enough of a push to get an increased commitment to action on AMR.
In the EU we witnessed AMR being dropped from the political agenda. The European Centre for Disease Prevention was responsible for addressing COVID-19 as well as AMR and that conflict was not beneficial for AMR-related actions.
Will the pandemic affect the global response to AMR over the next few years?
The pandemic is not over, but getting control of the virus is at least in the foreseeable future, which will allow the global response to AMR to regain momentum.
As the world recovers from the pandemic we also have a window of opportunity to talk about AMR in the context of greater public awareness of the spread of infectious disease. This can be seen as an opportunity.
Also, and as with many other zoonotic disease, the emergence of COVID-19 has been linked to biodiversity loss, the climate emergency and thus requires multi-stakeholder action to tackle it. The AMR response can benefit from this interdisciplinary approach that will forge the way for the One Health approach and make multisectoral action plans more palatable to policy makers than they have been in the past. But this will not happen by itself, so it is vital for the global AMR community to keep up the pressure and repeat constantly the need for action.
Do you think the public’s perception of the AMR risk has changed because of the pandemic?
Yes, the One Health approach became the new norm and has been more widely accepted than before. Nowadays it is easier to put forward One Health complex solutions in the post-pandemic situation, and it will make implementation easier too.
As increased public attention goes to COVID-19 hospitals and many reports are available about the conditions under which medical professionals work, this could also be a valuable reminder of the risk of AMR-linked infections in hospitals and care settings. Hygiene practices, which are also relevant to fight AMR, have already started to prevail in hospitals. Finally, the simple fact that COVID-19 is a virus could also accelerate the public understanding and acceptance of unnecessary prescription of antibiotics.
What lessons have you learned from this pandemic?
Systemic, global public health challenges such as the climate emergency, air pollution or AMR cannot be kept under the carpet anymore. If we do not act, AMR could be the next pandemic. Therefore the post-pandemic healthy recovery must include a strong counter reaction to AMR.
What do you think the most important thing is for the next year in fighting AMR?
Adopting One Health minded National Action Plans is the alfa and the omega to fighting AMR. With appropriate prioritisation, the healthy recovery period can start the momentum to have countries acting on AMR and – if it happens - other stakeholders and the industry will follow. This is why EPHA is very keen to identify existing good practices so those proven solutions could be promoted and, if accepted, used by countries.
If you had $1bn to fight AMR, how would you spend it?
I would use it to strengthen the capacity / AMR unit of national agencies, motivating them to facilitate the adoption of One Health action plans and use that amount to finance good practices which could then actually decrease AMR.
What advice would you give to world leaders about their response to AMR?
AMR is the next COVID-19 and unless it receives the required political attention we will sleepwalk into the next, much more difficult, AMR world health crisis.
Thank you for your time Zoltan, and for giving us an insight into your work.