2024 is a crucial year for antimicrobial resistance, with the United Nations General Assembly High-Level Meeting on AMR taking place in New York in September, and the 4th High-Level Ministerial Meeting on AMR following in Jeddah, Saudi Arabia, in November. 

The One Health approach  

One Health is built on the recognition that human, animal, plant and environmental health are inextricably linked. Disease transmission across species, environmental factors driving disease outbreaks, and the overuse of antibiotics in both human and animal populations all illustrate the interconnectedness of health systems.  

The Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH) have taken a leading role in promoting One Health at global level. Known as the Quadripartite, this partnership leverages the strengths of each agency to address challenges that no single organization or sector can solve alone. By working together, the Quadripartite helps countries strengthen their capacities to prevent, detect and respond to health threats in the human, agrifood and environmental sectors. By pooling their expertise, resources, and networks, the Quadripartite partners jointly deliver a more effective and comprehensive response. 

The fight against zoonotic diseases 

Zoonotic diseases, such as Ebola, Middle East Respiratory Syndrome (MERS), and the avian influenza, have made it clear that health threats can arise from any corner of the globe. These diseases, which originate in animals and can be transmitted to humans, require a coordinated global response that spans multiple sectors. 

FAO has been instrumental in controlling zoonotic diseases that threaten both animal and human health. Through regional and national animal health and the One Health team, FAO helps Member countries manage outbreaks of diseases such as avian influenza, African swine fever, and Rift Valley fever.  

The Global Early Warning System for Health Threats and Emerging Risks at the Human-Animal-Ecosystem Interface (GLEWS+) aims to improve the early detection and risk assessment of health threats that emerge from the human-animal-environment interface. By sharing data and expertise amongst the Quadripartite partners, GLEWS+ enables rapid and coordinated responses to emerging threats, such as zoonotic disease outbreaks.  

In addition, partners FAO, WHO and WOAH have collected experience from countries and worked with over 100 international experts to develop the 2019 Tripartite Zoonoses Guide (TZG). This guide provides standard practices and technical chapters to help countries address zoonotic diseases using a multisectoral, One Health approach, aligning with international standards and frameworks. To further assist countries in applying the TZG’s principles, several operational tools (OTs) have been developed, including the Joint Risk Assessment (JRA OT), the Multisectoral One Health Coordination Mechanism (MCM OT), and the Surveillance and Information Sharing (SIS OT), with new tools such as the Workforce Development (WFD OT) and Monitoring and Evaluation (M&E OT) Operational Tools set to be published soon. Each tool has been piloted and is already in use, addressing different needs in different countries. The JRA OT, for example, is already used by 40 countries, and is a prime example of how collaboration can lead to better preparedness and response. For instance, in 2021, FAO, WHO and WOAH conducted a country-level JRA for SARS-CoV-2 in fur-farmed animals. This assessment identified the risks of virus transmission from animals to humans and provided guidance to countries on how to manage these risks.    

Tackling antimicrobial resistance 

The Quadripartite has also joined efforts to address AMR through a One Health approach, promoting the need to reduce the use of antimicrobials and ensure their responsible and prudent use in agriculture, human health and the environment. Together, these agencies support countries in implementing their national action plans on AMR; improve surveillance; enhance global governance on AMR; promote increased public awareness, the role of research, development, knowledge and innovation; improve the legal and environmental aspects of AMR; and evaluate the economic costs of action on AMR. 

The AMR Multi-Partner Trust Fund (MPTF), established by the Quadripartite in 2019, aims to address the threat of AMR by supporting developing countries in the implementation of their national action plans across sectors applying a One Health approach. The MPTF is a unique financial mechanism that is country-driven, country-led, and based on countries’ strategic priorities and areas of interest, contributing to the development and strengthening of national multi-sectoral coordination mechanisms. To date, the MPTF has provided support to over 14 developing countries, including via its four global components that focus on monitoring and evaluation, integrated surveillance, and the legal and environmental aspects of AMR, with financial contributions from the UK, Sweden, Germany, the Netherlands and the European Commission. 

“The MPTF is the only financing mechanism dedicated to helping countries achieve their own ambition on AMR. Only with countries in the lead, can we succeed,” said Nicole Watt from the German Development Cooperation (GIZ) in a recent co-branded side-event to the G20 Health Working Group in Natal, Brazil.  

A Representative of the Fleming Fund stressed: “We have chosen to provide substantial ongoing investment to the AMR-MPTF, not only because the MPTF is well placed to provide essential support to strengthen AMR governance in countries, but because the Fund offers the opportunity to coordinate resource partners and AMR activity at the country, regional and global level.” 

Among its success stories is Cambodia, where the MPTF support has played a catalytic role in helping implement the country’s Multi-sector National Action Plan to address AMR. Funding also helped to implement activities such as developing treatment guidelines and training manuals for animal producers to minimize the risks associated with the use of antimicrobials, which was disseminated nationwide. The Fund played a catalytic role leading the KfW Development Bank to invest USD 34M to address AMR through a multi-sector collaboration among the Ministries of Health, Agriculture and Environment.  

Tapfumanei Mashe, AMR Project Coordinator, highlighted in the G20 co-branded event on the MPTF that his country, Zimbabwe, “has made remarkable progress in the fight against AMR, bolstered by the support of the MPTF.”  Among the key initiatives are the production and distribution of the Theileriosis vaccine, educational programmes for poultry farmers on responsible antibiotic use through Farmer Field Schools, assessments of the typhoid conjugate vaccine (TCV) and its effect on typhoid incidence, and the launch of a robust surveillance program for healthcare-associated infections (HAI) aimed at improving patient safety.  

Other success stories can be found in the AMR MPTF Annual Report 2023.