Toespraak Prinses Margriet bij de tweede ministeriële conferentie over antimicrobiële resistentie (AMR) in Noordwijk

Toespraak | 20-06-2019

Thank you Minister Bruins for your kind words of introduction
and thank you for inviting me to this Conference.

Good morning!

I’m very pleased to see so many nations and organizations represented here today that are committed to quell the threat AMR poses to human and veterinary medicine.
Today, I would like to share my thoughts with you on:
the risk AMR presents to our global health security, the importance of involving civil society, and raising awareness amongst our citizens.

Human Medicine

I am not an expert on today’s subject from the scholarly or policymaking field.
I am, however, well acquainted with AMR in the course of my life and I have witnessed the effects of AMR up close.

One of our sons was prescribed antibiotics several times in a time span of just a few months.
As a result he had next to no resistance to a simple infection.
The infection persisted to a dangerous level and only thanks to a special treatment he slowly recovered.
We noticed that doctors prescribe antibiotics more or less automatically without keeping track of the frequency of these prescriptions.
 
The fact that both individuals and our global society as a whole are so susceptible to AMR has prompted my interest in the challenges and dangers AMR present. I therefore feel compelled to raise awareness for this subject matter whenever I can.

As early as 1945, Sir Alexander Fleming, the discoverer of penicillin and founding father of modern day antibiotics, warned us about the danger of AMR. During the past decades, the overuse and misuse of antibiotics in human and veterinary medicine turned Fleming’s warning into reality as the emergence and expansion of resistant bacteria escalated.
I find it shocking that antibiotics, which have allowed us to treat previously deadly bacterial infections and save many lives, are becoming less and less effective.

Veterinary Medicine

As we know, resistant bacteria are found in people, animals, food and the environment. They can spread from person to person and between people and animals.
This underscores the necessity to strengthen the link between human and veterinary medicine, and the need for coordinated action in these sectors.
There is no point in combatting AMR amongst humans – unless – we tackle the problem in livestock as well. I am sure this statement is widely supported in the present company!

Consequences of AMR

Minister Bruins already mentioned some staggering figures concerning the increased resistance of anti-bacterium combinations, the number of unnecessary deaths and the effects on health care expenditures.

AMR is starting to complicate the fight against HIV and malaria as well.
It also endangers current medical interventions such as organ transplants; chemotherapy; and orthopedic and simple surgery. The same goes for the treatment of tuberculosis, which still is a high risk.

Tuberculosis

One third of all worldwide deaths resulting from drug resistance, are caused by multi-drug resistant Tuberculosis.

Data from the World Health Organization indicate that 490.000 people contracted resistant TB in 2016. TB is the deadliest infectious global disease –  with a yearly death toll of 1.6 million every year.

I mentioned my personal experience with antibiotic resistance and how this motivated me to voice my concerns in public: a feat that I share with my great grandmother Queen Emma.
She was also prompted by a personal experience to take public action when she lost her 15-year-old sister Sophie to Tuberculosis.

Queen Emma became the driving force behind TB control in the Netherlands, where at that time tuberculosis was the common disease.
As I am presently patroness of the KNCV Tuberculosis Foundation I am greatly concerned with the threat AMR poses to fight TB.
The KNCV is committed to the global fight against TB and has strong roots in Dutch Civil Society. Moreover the Fund is in the process of raising a multi-nation awareness campaign.

Involving Civil Society

This brings me to the necessity to engage civil society in the struggle against AMR.

AMR is a multi-sectoral, complex and challenging problem that affects us all. It is therefore of the utmost importance to involve the public. In spite of the invaluable initiatives developed by nations and international organizations in recent years, such as the Global Action Plan on AMR and the One Health approach, resistance levels are still increasing.  

It is obvious that our good intentions are not enough to stop the emergence and spread of resistant bacteria.
Community participation and informing the public about the risks of AMR is therefore vital. Ultimately, this will change people’s mindsets and reduce overuse and misuse of antibiotics.
Here, both individuals and doctors share a responsibility.
If an infection is an impediment to one’s daily life, one’s holyday, one’s important meeting or business trip, one reverts to antibiotics as life always must go on. In the developed part of the world,
people don’t accept being ill anymore. We all want ‘control’ our health at any time and any cost.
And doctors too often give in to the demands of their patients …

To change these mindsets we need a collective effort in the fight against AMR; this requires a great deal from you as political and community leaders.  

Yet you do not stand alone in this endeavor. Civil society and numerous international organizations are offering their knowledge and support as well.

I strongly believe that the key to combatting AMR is continuous and intensified international cooperation at all levels:
from the policy-making and academic level to civil society and ultimately individual citizens.

I hope this Conference will inspire novel ideas and initiatives and above all lead to new or renewed partnerships between governments and civil society stakeholders that will allow each of you
to fast-track the global struggle against AMR, TOGETHER.

In this spirit, I open this conference!