Exclusive Interviews with the candidates for the post of Director General of the WHO Regarding Anti-Microbial Resistance

By Garance Fannie Upham writing for AMR Times

We sent three set of questions with multi choices to each of the three candidates in the upcoming May elections for the post of Director-General of the World Health Organization:

AMR-Times: As WHO DG, how would you first go about implementation on the GAPAMR, the Global Plan adopted in last year’s World Health Assembly. In what order would you place priorities below and why?

1- Stewardship — better management of antibiotics in health care

2- Infection prevention and control, making sure health system don’t propagate AMR

3- Surveillance in human and/or animal health

Dr Tedros A. Ghebreyesus: The overall goal of the global action plan is to ensure continuity of successful treatment and prevention of infectious diseases with effective, quality and safe medicines that are accessible to all who need them and used in a responsible way. All three of these priorities are important to addressing AMR — and they need to be addressed in parallel because they are interconnected. We need surveillance to better understand the challenge we face and to know when a resistant pathogen is spreading or when a new one has emerged. Infection prevention and control can stop a pathogen’s spread. And meanwhile, better management of antibiotics is necessary to stall the development of antimicrobial resistance in the first place. We should also need to strengthen the efforts in terms of developing and abiding to the stewardship framework for better management of antibiotics on humans, animal and agricultural products, and promotion of one health approach

AMR-Times: How would you view AMR priorities in relation to Climate Change & Health and why?

Climate change means more extreme events notably flooding, which is more important:

1- Resilient health care systems?

2- Better water and sanitation infrastructure?

Dr Tedros A. Ghebreyesus: AMR and the health impacts of climate change are both in my leadership priorities as a Director General candidate. Neither is constrained by country, regional or continental boundaries. Both are truly global challenges. The commitment on sustainable development goals (SDGs) offers a unique opportunity to address our health challenges in a comprehensive and integrated manner. Ensuring universal health care should be the center of gravity for the implementation of not only the health objectives of the SDGs but also to all goals. This will help to strengthen resilient health system, with strong primary health care, effective public health emergency preparedness and response as well as addressing essentials of a healthy life including water and sanitation infrastructure. Because these issues supersede national and regional boundaries, the WHO can be a strong voice in combatting them. Over the past few years, there has been great progress on both issues, including the Paris Agreement on Climate Change and the GPAMR, and the WHO has done a great job keeping these issues on the agenda. WHO has to intensify its efforts and build inter-agency and inter-sectoral partnerships to better understand and address the health impacts of climate change and enhance access climate financing instruments. The WHO is not the technical expert on all these issues, but I believe it can lead the way in breaking the silos among our development objectives and in forging new models to engage and collaborate across different stakeholder groups.

AMR-Times: How do you envision working with not for profit civil society and will it be a priority for you?

1- to implement Universal Health Coverage, so as to strengthen means to face AMR?

2- to achieve TB & HIV control as ARV and TB drugs resistance is on the increase?

3- to manage NCDs, considering that cancer treatment is threatened by antibiotic resistance?

Dr Tedros A. Ghebreyesus: Civil society is a critical stakeholder and partner in global health — it helps to hold us all accountable, brings new ideas, gives voice to the voiceless and marginalized, and acts as our greatest advocates when we do good work. If you look at many other, newer global health entities such as the Global Fund, GAVI and UNITAID, they include civil society as full partners. That is the new order for which WHO should also be aligned. WHO is somewhat different, as a member-state organization. But I believe that partnerships and collaboration, including those with civil society, will be critical for the WHO to achieve its mandate. The recently agreed Framework for Engagement of Non-State Actors should provide a systematic way to enhance and facilitate the civil society in the work of WHO without compromise to its role in standard and norm setting as well as protection from conflict of interest.

On the specific issues, in my view, all roads should lead to universal health coverage.

Accordingly, I have made universal health coverage my highest priority. It is an ambitious goal, but it is one that can and must be achieved to create a healthier and more equitable world. Greater commitment to universal health care will help to develop and deliver affordable, effective, safe and quality drugs for diseases that disproportionately affect developing countries and vulnerable populations and remain poorly addressed owing to market failures.

Continuing to scale up treatment for HIV and TB — and addressing the growing rates of resistance –should be high on the agenda of our efforts in combating AMR. We have made tremendous gains on these diseases in the past few decades, and I’m gravely concerned that resistance will start to unwind that progress. In 2015, for example, the WHO estimated that there were more than half a million new cases of drug-resistant TB cases that require treatment but only 20% of them were treated. Even those treated they have about 50% treatment success rate. We cannot underestimate this crisis and we must do better to identify, track and manage these drug-resistant TB cases as part of our AMR efforts.

Combating NCDs like cancer, heart disease, chronic respiratory diseases and diabetes is also one of my priorities for the WHO. We need to do this by scaling up evidence-based approaches to prevention, diagnosis, and treatment, encouraging healthy lifestyles and well-informed decisions, strengthening prevention and treatment of substance abuse and accelerating the implementation of the WHO Framework Convention on Tobacco Control. Here we can take what we’ve learned from treating communicable diseases for decades.

  • This Q&A, which featured all three of the WHO Director General Candidates who are running, originally appeared in the April 2017 of AMR Times, HERE: http://bit.ly/2pFRQS1

You can read more about Dr. Tedros and his vision for a healthy world as #NextDG at #WHA70 on his website: http://www.drtedros.com/ — and follow along with his campaign on social media at Facebook.com/DrTedros.Official and on Twitter at @DrTedros. Sign up for the campaign’s newsletter `From the Desk of Dr. Tedros’ at http://bit.ly/2nGWtLm.