Since their introduction into medicine in 1941, antibiotics and other antimicrobials transformed modern medicine and have saved countless lives. As a result, bacterial and other infections have become easily treatable and
the horizons for managing many chronic diseases, surgeries, transplants, cancers and more complicated life- saving procedures have expanded. However, increasing antimicrobial resistance is leading to greater morbidity, unnecessary deaths and higher treatment costs. We are depleting the effectiveness of existing antimicrobials at the same time the poorest segments of society in many countries still lack reliable access to them when they are needed.

The U.N. General Assembly High-Level Meeting on Antimicrobial Resistance opens a new era of global involvement in the crusade to ensure sustainable access to effective antimicrobials. We, the organizations joining to form the Conscience of Antimicrobial Resistance Accountability (CARA), will work to hold the United Nations and other international bodies, national governments, the private sector, and civil society to the commitments they have made to ensure sustainable access to effective antimicrobials.

As organizations from a range of disciplines and sectors concerned with human and animal health, we recognize our collective responsibility to 1) ensure that the world protects the effectiveness of all antimicrobials—those we have today, and those yet to be developed and 2) continues to extend access to effective antimicrobials to everyone across the globe.

We are joining forces as CARA, an alliance of organizations dedicated to:
• monitoring progress toward the agreed upon goals of access to effective antimicrobials for everyone

across the globe
• identifying obstacles to progress and bringing them to light, • working to offer solutions to problems in all sectors, and
• identifying, publicizing, and celebrating successes

An inclusive governance structure will be developed in the early phases of organization to create a stable base for operating. A plan for the first five years will be developed collaboratively, with members committing to undertake specific and appropriate activities for their own organizations and countries, consistent with specific, quantitative consensus goals set by the alliance.

Goals will be set to achieve the following:


• Support accurate and methodologically consistent data collection, analysis and reporting of antibiotic resistance and consumption in humans and animals.

• Support research that deepens our understanding of the current status of and trends in antimicrobial resistance and use.

Preserve effectiveness

• Seek greater coordination among all stakeholders in antimicrobials effectiveness, including human and animal interests, to promote knowledge sharing and a mutual commitment to antimicrobial stewardship.

• Use information about the underlying drivers of antimicrobial use so as to contribute to the evolving definition of “appropriate antimicrobial use,” and use this definition to guide stewardship efforts, including the education of the general public and healthcare personnel at all levels.

• Ensure that the disciplines that promote antimicrobial effectiveness in all sectors are supported and valued.

• Reinforce the judicious use of antimicrobials in agriculture by:
           o limiting use of medically important human antimicrobials in food animals,
           o phasing out antimicrobial use for growth promotion and routine disease prevention,
           o supporting use of such antimicrobials in animals only when necessary to ensure animal health,  
           o requiring veterinary oversight for antimicrobial use in animals

Universal access

• Promote access to and appropriate use of antimicrobials for those currently lacking such access.


• Encourage development of pharmaceutical products to sustain and advance effective prevention and treatment of infections, including

           o new antimicrobials and novel alternative therapies,
           o compounds to boost antimicrobial effectiveness,
           o diagnostics to better diagnose infections and their resistance characteristics, and o vaccines to prevent infections from      occurring, in both humans and animals.


• Urge creation of Office/Secretariat under the auspices of the U.N. Secretary General to coordinate AMR resistance policy across agencies (WHO, UNICEF, FAO, OIE, etc.) with financial support and mechanisms for monitoring and reporting on measurable goals

The following organizations are the first partners, with an intention to expand to include partners from all sectors and all parts of the world:

  • Alliance for the Prudent Use of Antibiotics (APUA)
  • American Society for Micobiology
  • Antibiotic Resistance Action Center (ARAC)
  • Australasian Society for Infectious Diseases (ASID)
  • Australian Society for Antimicrobials (ASA)
  • British Society for Antimicrobial Chemotherapy (BSAC)
  • CARB-X
  • Cempra Inc
  • Center for Disease Dynamics, Economics & Policy (CDDEP)
  • Center for Global Development (CGD)
  • Center for Infectious Disease Research and Policy (CIDRAP)
  • Central University of Punjab
  • CO-ADD (Community for Open Antimicrobial Drug Discovery)
  • Commonwealth Medical Trust (Commat)
  • Cranimal
  • GARP-Kenya
  • German Center for Infectious Disease Resarch (DZIF)
  • Miercurea Ciuc Emergency County Hospital
  • No More Epidemics
  • Norwegian Institute of Public Health (NIPH)
  • Pew Charitable Trusts
  • Saint Constantin Hospital
  • Small World Initiative
  • Spectrum Mobile Health Inc.
  • United States Pharmacopeial Convention (USP)
  • World Alliance Against Antibiotic Resistance (WAAAR)

We invite all organizations, including civil society and industry, to become CARA partners. If you would like your organization to join or would like more information, please contact:

Hellen Gelband   |   202.328.5104   |

Molly Miller-Petrie   |   202.803.6865   |