Towards an International Treaty on Antimicrobial Resistance

Abstract

Antimicrobial resistance (AMR) is a transnational and multi-sectoral issue that requires global collective action, since individual states cannot fully address the threat that migrating “superbugs” pose to their citizens. Understanding the underlying global market and governance failures that prevent collective action makes it clear that an international legal response is needed to tackle this challenge. An international AMR treaty could promote access, conservation and innovation for antimicrobials by designating universally appropriate use standards, mobilizing financial resources, coordinating national responses, and setting surveillance expectations. This article expands upon previous proposals for development of an AMR treaty as a mechanism for coordinating states to safeguard sustainable access to effective antimicrobials. Specifically, this article identifies the functions needed to address AMR globally which individual countries cannot achieve on their own; the policies that would most benefit from international legalization as opposed to other approaches; as well as a roadmap to transform these functions and their implementation mechanisms into components of a treaty. We argue that an international treaty is the most suitable platform for achieving global collective action on AMR, with standards for responsible use and surveillance requiring enforced legalization (core policies); funding for access, infrastructure, and infection control measures benefitting from legalization (supportive policies); incentives for innovation being included to contribute to a grand bargain (incentivizing policies); and implementation mechanisms to ensure the treaty’s text has real-world effects.