3.2 International legal frameworks for action on AMR
Our response to AMR will be led by the laws and policies of our governments. These government mechanisms need to address the ethical issues related to managing AMR. Where government mechanisms currently exist, they tend to focus on interventions to reduce AMU or the types of AMU in certain populations.
International legal agreements specifically for action on AMR have been proposed but not yet fully enacted. Possible forums for developing such an agreement include WHO, the World Trade Organization (WTO) and the United Nations General Assembly. This section will present some examples of how these ideas are being considered and enacted.
International Health Regulations 2005
The International Health Regulations (IHR) are the overarching legal framework that define countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders. The IHR are legally binding, meaning countries are required to:
- report public health emergencies of international concern (PHEIC)
- communicate with the WHO
- establish and maintain surveillance and response capabilities
- protect the rights of people in relation to their personal data, informed consent and non-discrimination.
A PHEIC has been declared for Ebola, swine flu, Zika virus and, of course, Covid-19. While the IHR are designed to manage the spread of infectious diseases of immediate public health concern, they could be used or expanded to provide a legal global framework for the response to AMR.
An increasing focus of the AMR response at the national level is the engagement of public-private sector agreements to tackle AMR. The Global Health Security Agenda (GHSA) is one such initiative, which aims to build multi-sectoral collaborations across health, security, environmental and agriculture. The GHSA and other initiatives help countries mobilise to prevent, detect and respond to a range of health-related crises, including AMR; Case Study 1 includes an example.
Case Study 1: A public-private partnership for global health security
‘At the 72nd World Health Assembly (May 2019), the Private Sector Roundtable (PSRT) and the Government of Uganda signed a Memorandum of Understanding to advance the Global Health Security Agenda (GHSA). The partnership marks the first between the PSRT and a GHSA country and will serve to support Uganda in addressing specific health security needs as identified by its Joint External Evaluation (JEE). …
‘The partnership will include offerings from PSRT member companies, including workforce training in public health management and leadership, diagnostics in AMR, data literacy, among other areas …’
Codex: negotiations on AMR in the food chain
In 2017, the
The TFAMR is working on revisions to the Code of Practice to Minimise and Contain Foodborne Antimicrobial Resistance (CXC 61-2005) and developing new Guidelines on Integrated Monitoring and Surveillance of Foodborne Antimicrobial Resistance. The revised code of practice was presented at the 43rd Codex Commission in November 2020, where it was provisionally adopted. The TFAMR has been given another 12 months to be completed; you can find out more about Codex’s work on AMR and the changes to the existing guidelines on its website.
3.1 Public health law and ethics
