World Health Day: Combating antimicrobial resistance

Today is World Health Day, an event held on the 7th April every year since 1950 to mark the founding of the World Health Organisation and an opportunity to draw worldwide attention to a subject of major importance to global health.

This year the World Health Organisation has devoted World Health Day to antimicrobial resistance. This is a problem that is becoming more widespread as bacteria, viruses and parasites develop resistance to antibiotics. Antibiotics and antimicrobial drugs have changed human history since their introduction in the 1940s, reducing the burden of major diseases such as syphilis, tuberculosis (TB), and leprosy. But in a statement on the WHO website Margaret Chan raises the prospect of a “post-antibiotic era, in which many common infections will no longer have a cure and will, once again, kill unabated.” This statement underlines the urgency of the issue in malaria and TB in particular –  resistance to the latest generation of malaria drugs has been detected and although worldwide deaths from TB are declining, the WHO reports that nearly half a million people last year developed multidrug resistant TB. (This video highlights the effect of drug-resistant TB in Kazakstan, Lesotho and the Philippines).

A major factor contributing to the growth of antimicrobial resistance is the inappropriate use of medicines and this features in the six point policy package that the WHO proposes to encourage governments to take the right measures to tackle the problem. The package emphasizes the need to regulate medicine use and ensure that patients gain uninterrupted access to essential medicines, to enhance infection prevention and control, as well as developing comprehensive national financial plans, strengthening laboratory and surveillance capacity, and help foster innovation and research into new tools to deal with the problems.

The coverage of World Health Day in the media has emphasized the “race against time” to deal with drug resistant microbes. In a special report, Reuters highlights the emergence of the superbug MRSA in hospitals in the developed world – MRSA is estimated to have killed 19,000 in United States last year and a similar number in Europe – whilst the BBC and the Wall Street Journal focus on the NDM-1 gene resistant to antibiotics recently found in water supplies in Delhi that has worryingly spread to bacteria causing dysentery and cholera. The Parliament focuses on the European Union’s response to the issue, stressing that the “global community needs to recognise [that] existing market mechanisms do not work and that more incentives and ideas are needed to increase the pipeline of new antibiotics”.

But whilst government initiatives and a clear framework for action are needed, the WHO emphasizes that everyone can contribute to the fight against antimicrobial resistance – from collaboration between human health and animal health professions to reduce drug resistance generated in the food industry and transferred to humans, to action to reduce the spread of infection in health care facilities, to greater understanding between patients and doctors to reduce the demand for antibiotics and “well-known” medicines when they are not necessary.

Papers on antimicrobial resistance recently published in PLoS Medicine:

-          Geographic distribution of Staphylococcus aureus causing invasive infections in Europe: a molecular-epidemiological analysis.

-          Antibiotic selection pressure and macrolide resistance in nasopharyngeal Streptococcus pneumoniae: a cluster-randomized clinical trial.

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