A Low-Key Summit with High-Key Potential

This is a joint post with Emma Back, consultant to the CGD Drug Resistance Working Group.

Last week’s 2009 US-EU Summit was hosted in Washington by President Obama and, while it didn’t exactly hog newspaper headlines, it did yield a few surprises. Alongside the expected commitments to co-operation on issues such as climate change and global security, the two parties also agreed “to establish a transatlantic task force on urgent antimicrobial resistance issues.”

Wow! Where did that come from?

This stated priority derives from Sweden’s current Presidency of the EU, and we applaud Sweden and the advocates there at ReACT for bringing this issue to the US-EU Summit. There’s no doubt that drug resistance presents an urgent threat to people’s health across the world. Can the US-EU task force provide the global leadership we so desperately need to address it?

It certainly has promise. The EU has recognized resistance as a serious matter. Some of the Nordic countries have stellar track records in controlling resistance, and the European CDC has conducted thorough resistance surveillance in all its member countries and provided good resistance prevention advice to EU governments. The task force will have a broad remit, covering the “appropriate therapeutic use of antimicrobial drugs in the medical and veterinary communities, prevention of both healthcare- and community-associated drug-resistant infections, and strategies for improving the pipeline of new antimicrobial drugs.” This comprehensive approach – embracing both prevention and treatment, in animal and human health – is necessary and welcome.

But many questions remain. We don’t yet know how the task force will be constituted, or for how long, or what outputs it should generate. We don’t know how much money either the US or the EU are prepared to invest in operating the task force or in responding to its recommendations. Crucially, it’s not clear whether this work will take a global health perspective, or focus on the resistant bugs most troubling the US and EU right now – such as Methicillin resistant Staphylococcus aureus and C. difficile.

If it’s the latter, then the US and EU will have missed the point. In a globalized world, drug resistant infections spread quickly from one country or region to another. Efforts taken in one part of the world can be rapidly undermined by a lack of effort elsewhere.

This new task force may be transatlantic in origin. But its research, deliberations and actions must be global. It should improve the use of medicines in Africa and Asia, as well as Europe and the Americas. It must consider the challenges of effectively preventing and treating disease in poorer communities with weak health systems infrastructure and human resource capacity. And the US and EU must be prepared to address those weaknesses and help out if the urgent threat of global drug resistance is to be contained.