It’s time for Aotearoa to unite against infectious disease and antimicrobial resistance

In a new report released today, the Prime Minister’s Chief Science Advisor is calling for action to combat infectious disease and antimicrobial resistance in Aotearoa New Zealand.

Professor Dame Juliet Gerrard says that the science and solutions are clear. Combatting the rising tide of antimicrobial resistance and the threats posed by established, emerging, and re-emerging infectious diseases “is a matter of rolling up our collective sleeves and getting it done.”

Kotahitanga: Uniting Aotearoa against infectious disease and antimicrobial resistance is the Prime Minister’s Chief Science Advisor’s major report for 2021. The report was guided by a panel of ten researchers and practitioners with expertise in human, animal, and environmental health, with contributions from a reference group of more than 200 experts.

The report details the rise of harmful microbes that can resist drugs previously used against them. Antimicrobial resistance makes it increasingly difficult to treat infectious diseases in humans, animals, and plants, potentially turning a simple scratch or routine surgery into a life-threatening event. Overuse and inappropriate use of antimicrobials is a major driver of antimicrobial resistance, so promoting antimicrobial stewardship is one of the keys to combatting this threat.

The report situates the threat posed by antimicrobial resistance in the broader context of infectious disease in Aotearoa New Zealand, where gastrointestinal diseases and rheumatic fever place a uniquely high burden on the community and where economically, socially, and culturally important animals and plants are vulnerable to infectious diseases too.

The report applauds many aspects of Aotearoa New Zealand’s Covid-19 response but warns against losing focus on other infectious diseases and antimicrobial resistance and being “prepared for the last health crisis rather than the next one.” The report calls for lessons to be learned from the Covid-19 experience, including around promotion of equitable health outcomes that are consistent with te Tiriti o Waitangi.

The panel makes a series of recommendations covering antimicrobial stewardship, disease surveillance and outbreak response, infection prevention and control, workforce and research capability, health literacy, and primary healthcare. The recommendations emphasise the importance of monitoring infectious disease trends, antimicrobial resistance, and antimicrobial use so that Aotearoa New Zealand can build a clear picture of its risks, design targeted interventions, and evaluate the effectiveness of those interventions.

With Māori and Pacific peoples disproportionately burdened by infectious disease, the recommendations work to promote health equity, including by calling for barriers to healthcare access to be tackled.

Co-chair of the expert panel, Dr Matire Harwood say that “the greatest challenges are to focus on infection prevention rather than waiting for people to get sick and then being forced to focus on treatment and curbing inappropriate use of antimicrobials through more judicious use when infection inevitably occurs.”

Many of the recommendations are similar to those made in the 2017 New Zealand Antimicrobial Resistance Action Plan. The Kotahitanga report notes that implementation of the 2017 plan was lacking, observing that “leadership, unity, resolve, and resources” are needed to overcome the inaction of the past.

The report welcomes the government’s recent decision to invest $36 million in infectious disease research through the Strategic Science Investment Fund and a further $10 million in rheumatic fever research, including efforts to develop a vaccine.

The health sector reform programme is an opportunity to embed action against antimicrobial resistance and infectious disease in the national health system and leverage recent government investments in health sector digitisation.

The Kotahitanga report highlights examples of good research and practice across human, animal, plant, and environmental health in Aotearoa New Zealand, including academic research, antimicrobial stewardship initiatives, and industry efforts to reduce antimicrobial use in agriculture. In noting this work, the report highlights that Aotearoa New Zealand has a strong base to build from in pursuit of greater health and wellbeing for all New Zealanders.