G7 leaders and antimicrobial resistance: it's time for global action

The world faces unprecedented global challenges that pose existential-level threats to the survival of humanity and the planet. Despite these challenges, world leaders have failed to rise to the occasion. Instead, we have observed increasingly nationalistic, siloed responses that undermine much-needed approaches centred around global solidarity. We write on behalf of the Global Alliance for Infections in Surgery, recognizing the urgency of the challenges we face and the limited time we have to address them.
G7 countries must take responsibility for current failures and commit to a more equitable governance structure where the priorities of all countries are considered equally in health crises. This recognition of responsibility is central to both current response strengthening and sustainable future pandemic preparedness efforts.
The Group of Seven (G7) is an informal forum that brings together Italy, Canada, France, Germany, Japan, the United Kingdom, and the United States of America. The European Union also participates in the Group and is represented at the summits by the President of the European Council and the President of the European Commission
The Group was established as a platform for economic and financial cooperation in response to the 1973 energy crisis.
Over the years G7 has progressively expanded its focus. From an ad-hoc gathering to discuss financial challenges, it has become a more formal, prominent venue to address major global issues. On January 1, 2024, Italy assumed, for the seventh time, the Presidency of the G7.
By this letter, we ask the G7 to consider antimicrobial resistance (AMR) as a global burden.
AMR is not a disease for which we should expect ultimately to develop a cure. Instead, it is a concept, a global concept, involving multiple disciplines – working locally, nationally, and globally – to attain optimal health for people, animals, and the environment. It is something that undermines the treatment of many diseases and therefore health systems. AMR is not something that you can identify easily, such as malaria or HIV. AMR is part of a larger phenomenon and is thus not amenable to easy technical interventions.
AMR is a natural phenomenon that occurs as microbes evolve. All prescribed antibiotics can contribute to the spread of AMR and antibiotics in human health or animal health in driving the spread of resistance in the eco-system must be properly understood and addressed. Moreover, a vast majority of bacteria are essential for life and the health of humans, animals, and the ecosystem and only a tiny percentage of them cause disease. This implies that the treatment of infectious diseases should be optimized in a way that does not make the cure worse than the disease.
Actions against AMR should focus firstly on local needs and national action plans because each country is different. However, resistance is everyone's problem and all countries have a role in solving the problem.
Some countries that have crafted inclusive national plans have been successful in controlling AMR. These approaches include: improving awareness and understanding of AMR through effective communication, education, and training; strengthening the knowledge through surveillance and research; reducing the incidence of infection through effective sanitation, hygiene, and infection prevention measures; and optimizing the use of antimicrobial agents in human and animal health. These strategies require patience and time to be organized. Furthermore, these require a comprehensive endorsement from the government authorities with ample funds.
However, AMR poses a global challenge. No single country, however effective it is at containing resistance within its boundaries, can protect itself from the importation of AMR through travel and trade. Working alone is not sufficient and international partner-ships to seek global solutions are mandatory to tackle AMR.
By collaborating, there are opportunities for disseminating the best approaches for infection prevention and management. The global nature of AMR calls for a global response, both in the geographic sense and across the whole range of sectors involved. Nobody is exempt from the problem.
Responding to outbreaks of drug-resistant infections involves the coordination of efforts across national boundaries, varied health systems, and involving international agencies.
AMR has often been wrongfully depicted as purely a medical problem, presumably because of the direct and devastating consequences that patients with multi-drug-resistant infections may experience. Such a narrow perspective prevents the issue from being recognized as a systems failure and from getting the global attention that it requires.
There is no single 'silver bullet' to address AMR.
What we need to tackle the AMR problem is an adaptive, multipronged approach involving many stakeholders – working locally, nationally, and globally – to attain optimal health for people, animals, and the environment.
What we need is a multidisciplinary approach, considering also the great diversity of social, economic, political, and cultural contexts in which AMR emerges or spreads.
What we need are strategies to increase awareness about AMR to implement more effective interventions.
Finally, what we need is a comprehensive and solidaristic model as the only solution for a problem that knows no borders.
To tackle AMR, antimicrobial effectiveness needs to be recognized as a fundamentally important global public good and governed accordingly.
AMR is a challenge to global development.
Antimicrobial effectiveness must be looked upon as a limited global public good on the verge of becoming scarce, and the world has a collective responsibility to preserve it to avoid countless future victims of drug-resistant infections.
The COVID-19 pandemic has shown that despite all of our medical advances, we remain incredibly vulnerable to infections for which we have no therapies. However, it has shown that if sufficiently motivated, we can make huge changes in short time frames.
The COVID-19 pandemic has high-lighted the need for resilient health sys-tems and has resulted in an unprece-dented rate of collaboration in scientific, medical, social, and political dimensions. The pandemic has also created a renewed awareness of the importance of infectious diseases and is a substantial entry point for reigniting the momentum toward containing the silent pandemic of AMR.