May 27, 2024, GENEVA, Switzerland – The International Vaccine Institute (IVI), in collaboration with the Governments of Bhutan, El Salvador, Ethiopia, the Republic of Korea, Sweden, and the United Kingdom, hosted a special event on the sidelines of the 77th World Health Assembly, titled: The role of existing and new vaccines in curbing the emergence and spread of drug resistance in low- and middle-income countries (LMICs). The event focused on the crucial intersection of national vaccine strategies and efforts to combat AMR in the countries that are affected most.

The speakers highlighted the essential role of vaccines in preventing infectious diseases, reducing the misuse of antibiotics, and controlling the spread of AMR. The key strategies to tackle AMR discussed during the event included supporting LMICs in their vaccination efforts and achieving vaccination goals. In addition to vaccination, efforts must be made to provide sustainable access to effective antibiotics for those who need them most and strengthen surveillance and monitoring programs in LMICs.

Dr. Anh Wartel, Deputy Director of IVI, welcomed the guests and the speakers to the event.

‘Together, we stand at a crucial juncture where decisive action is required to safeguard and supplement existing antimicrobial medicines. By leveraging the power of vaccines and nurturing synergies between stakeholders of the Global North and the Global South, we can forge a path towards a future where the threat of AMR is contained, – Dr. Wartel said.

Dr. Youngmee Jee, Commissioner of the Korea Disease Control and Prevention Agency, highlighted that AMR is a global threat that causes two to five million deaths annually. She noted that effective vaccine use could prevent over half a million AMR cases. Dr. Jee emphasized Korea’s support for IVI’s immunization programs in LMICs and the role these programs have in addressing AMR. She underscored the critical role of vaccines in reducing the burden of AMR and called for continuous global support to expand these efforts.

Dr. Malin Grape, Sweden’s AMR Ambassador, addressed Sweden’s extensive experience in AMR prevention, noting a steady decline in antibiotic use over the past 30 years. Despite this, antibiotic resistance has not decreased proportionally, underscoring the urgent need for improved preventive measures.

Speaking about Sweden’s contribution to AMR research and prevention, Dr. Grape regarded IVI as a critical partner in this work:

‘Sweden has a long-standing cooperation with IVI. I was proud to attend the inauguration of the new office in Stockholm. And I am happy to hear that IVI is establishing new offices in Rwanda and Kenya. It is such an essential step towards not securing global health.  Through this partnership, we can contribute to preventing infections and ensuring access to effective treatments now and in the future, – concluded Dr. Grape.

Karin Tegmark Wisell, Director General of the Public Health Agency of Sweden, shared concrete examples of the Swedish story of counteracting and preventing AMR over the last three decades. She highlighted the importance of a joint approach and reaching all groups of society with the AMR messages. She presented the “Antibiotics-smart Sweden” initiative and the ‘Healthier Preschools’ project.’ Karin Tegmark Wisell stressed that building public trust in health institutions is crucial for successful immunization programs and reducing antibiotic reliance.

‘Public health work is essential to build trust in populations, maximize the adherence to immunization programs, and minimize the need for antibiotics. Good public health will promote healthy lifestyles and prevent chronic diseases, which we know are drivers to the use of antibiotics, –  Dr. Tegmark Wisell emphasized.

Her Excellency Dr. Mekdes Daba, Minister of Health of Ethiopia, acknowledged the severe impact of AMR on health in LMICs. She addressed Ethiopia’s initiatives to strengthen surveillance systems and expand vaccination programs. H.E. Dr. Daba emphasized Ethiopia’s commitment to establishing GMP-compliant vaccine production facilities by 2027-2028, aiming to have two vaccines fully developed and available on the local market by 2029. H.E. Dr. Daba underscored the critical need for the One Health approach and for expanded global cooperation to increase vaccine coverage and to generate scientific evidence on the impact of vaccines in reducing AMR.

‘I want to take this opportunity to say that we should not neglect anyone, especially poor and hard-to-reach populations. We should not forget that the Sustainable Development Goals Agenda 2030 – is health for all and all for health,”  – H.E. Dr. Daba highlighted.

Dr. Amaury Morales Landrove, the National Coordinator of the Office of Infectious Diseases from El Salvador, shared insights into the country’s comprehensive five-year AMR strategy. This strategy includes enhancing national surveillance and monitoring systems, implementing antimicrobial stewardship programs, and integrating activities for infection prevention. Dr. Morales Landrove emphasized the importance of regulation in antibiotic use and the need for a national infection prevention program to tackle AMR effectively.

Dr. Ugyen Tashi, Chief Program Officer from the Ministry of Health of Bhutan, highlighted AMR’s economic and health burden, particularly in LMICs. Dr. Tashi discussed Bhutan’s national efforts in infection prevention and said that the rational use of antibiotics is critical to reducing AMR. Dr. Tashi outlined Bhutan’s robust vaccination programs to prevent neonatal diseases and align vaccine strategies with AMR efforts. He emphasized the importance of international cooperation.

In her speech, Prof. Dame Sally Davies emphasized the UK’s commitment to global collaboration in combating AMR. She mentioned the UK’s recently published national action plan, which focuses on developing vaccines for both domestic use and global health. She reiterated the significance of including animals and the food chain in AMR strategies and highlighted the UK’s investment in 50 individual vaccine development projects. Prof. Dame Sally Davies spoke about the need to strengthen public confidence in vaccines and support regulatory innovations for their development and approval.

‘We must ensure all countries provide us with the best available scientific evidence and advice on AMR. And that’s why the UK is asking to establish a genuinely independent global scientific panel at the UN high-level meeting this September. My government has committed up to ten million pounds over the next five years to make this panel a reality. The UK also calls for existing international financial instruments to be available to support AMR interventions. – Prof. Dame Sally Davies said.

Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance, started her speech by observing that AMR has long been underrepresented and perhaps even ignored in academia and clinical practice. She highlighted that only 14 of 108 national AMR action plans included immunization  as a strategy. Dr. Nishtar identified a lack of awareness of AMR among regular citizens and even among clinicians, combined with the inappropriate use of antibiotics, as exacerbating factors of the AMR trend worldwide.

“When a woman walks into a primary healthcare setting with a child on her arm or a child on her back, she is not interested in Gavi, Global Fund, WHO, and the rest of us globally. She is only interested in helping her child get better. And she will go to one kiosk and the other. And we need to make things work for that woman. And the better we synergize, the better we coordinate, the better we reduce duplications, the better it will all go for that woman who carries a child on her back, – said Dr. Nishtar.

Finalizing her insightful speech, Dr. Nishtar announced that Gavi will incorporate AMR considerations into its new vaccine investment strategy as a key criterion for prioritizing vaccines.

Dr. Ramanan Laxminarayan, Founder and President of the One Health Trust, presented the Lancet series and the goals for reducing AMR-associated deaths and inappropriate antibiotic use. He highlighted that improving access to effective antibiotics and vaccines is vital for achieving global health goals, especially in child survival and healthy aging. Dr. Laxminarayan pointed out that universal coverage of high-priority pediatric vaccines could significantly reduce AMR-associated deaths. While addressing the global ambitions for sustainable access to effective antibiotics, he focused on specific targets such as reducing deaths from AMR by 10%, inappropriate antibiotic use in humans by 20% and reducing antibiotic use in animals by 30%.

Dr. Raphaël Zellweger, Senior Research Scientist at IVI, discussed a study examining the impact of typhoid vaccine introduction on AMR in Fiji. He stressed the need for more evidence to guide policy and prioritize interventions, suggesting that every vaccine trial is an opportunity to measure the impact of vaccination on AMR. He provided examples of how environmental sampling and DNA isolation can help detect AMR genes and monitor resistance patterns, offering valuable data for public health interventions.

After the high-level remarks and presentations, a panel discussion took place, moderated by Dr. Suman Rijal, Director of Communicable Diseases at WHO Southeast Asia Region. The panelists, including Dr. Mateusz Hasso-Agopsowicz, Technical Officer at WHO, Dr. Yoo-kyoung Lee, Director of Vaccine Development at the Korean Disease Control and Prevention Agency, Prof. Afework Kassu, the Director General of the Armauer Hansen Research Institute, and Dr. Suvanand Sahu, Deputy Executive Director at the STOP TB Partnership, discussed challenges and opportunities in supporting AMR considerations in vaccine development.

In conclusion, Dr. Anh Wartel emphasized the vital role of collaboration, innovation and solidarity in tackling AMR. She highlighted that new models are needed to improve understanding of AMR-associated vaccine-preventable deaths and pointed to novel measures taken by Ethiopia and Korea. She mentioned the significance of the recently updated WHO’s 2024 bacterial priority pathogens list and announced that IVI is developing vaccines for four priority pathogens: Salmonella Typhi, Shigella, Non-typhoidal Salmonella, and Group A Streptococcus. She expressed IVI’s commitment to expanding its portfolio of AMR-targeted vaccines and welcomed collaboration with global partners to advance vaccine development.

About the International Vaccine Institute (IVI)

The International Vaccine Institute (IVI) is a non-profit international organization established in 1997 at the initiative of the United Nations Development Program with a mission to discover, develop, and deliver safe, effective, and affordable vaccines for global health.

IVI’s current portfolio includes vaccines at all stages of pre-clinical and clinical development for infectious diseases that disproportionately affect low- and middle-income countries, such as cholera, typhoid, chikungunya, shigella, salmonella, schistosomiasis, hepatitis E, HPV, COVID-19, and more. IVI developed the world’s first low-cost oral cholera vaccine, pre-qualified by the World Health Organization (WHO), and developed a new-generation typhoid conjugate vaccine that also achieved WHO prequalification in early 2024.

IVI is headquartered in Seoul, Republic of Korea, with a Europe Regional Office in Sweden, an Africa Regional Office in Rwanda, a Country Office in Austria, and a Country and Project Office in Kenya. IVI additionally co-founded the Hong Kong Jockey Club Global Health Institute in Hong Kong and hosts Collaborating Centers in Ghana, Ethiopia, and Madagascar. Forty countries and the WHO are members of IVI, and the governments of the Republic of Korea, Sweden, India, Finland, and Thailand provide state funding. For more information, please visit https://www.ivi.int.