This week, the World Health Assembly will adopt a global plan to address antibiotic resistance and other forms of antimicrobial resistance. But will it be implemented?
ACTION may be coming at last to deal with one of the most important threats facing humanity – the fast-increasing resistance of bacteria to antibiotics and other medicines.
For decades, this problem has been growing without any serious efforts across the world to stop it in its tracks.
Patients are the ones who suffer the most. Old medicines no longer work against many diseases, and newer and more potent medicines (often with stronger side effects) are also getting useless.
Pathogens are becoming increasingly resistant to drugs, affecting treatment for tuberculosis, malaria, influenza, HIV/AIDS, gonorrhoea and common infections such as pneumonia and urinary tract infections.
Patients who go to hospitals are increasingly acquiring infections unrelated to their original ailment, caused by highly resistant bacteria such as MRSA, which has caused thousands of deaths.
Despite the publicity on resistance, there has been little action in most countries, at least until the problem blows up to crisis proportions at the national and global levels.
World Health Organisation director-general Margaret Chan has called ours a post-antibiotic era, meaning that we are living in a world where antibiotics may not work anymore.
The consequences are horrifying to contemplate. In Thailand, antimicrobial resistance was found to kill 30,000 people a year and its economic impact amounted to 0.6% of the country’s Gross National Product, according to the Thai Minister of Public Health during a panel discussion at the World Health Assembly last week.
A similar study should be done in Malaysia. I wonder what it would reveal.
There is no time to lose for comprehensive action to be taken before the resistance crisis worsens.
Fortunately, a global action plan on antimicrobial resistance (AMR) will be adopted this week by health ministers at the World Health Assembly in Geneva.
The plan has five objectives – to use medicines properly in human and animal health, reduce infection by sanitation, hygiene and infection prevention measures, strengthen surveillance and research, educate the public as well as doctors, veterinarians and farmers on proper use of antibiotics and increase investment in developing new medicines, diagnostic tools and vaccines.
The plan calls for action by governments, the WHO Secretariat, international organisations, civil society groups and professional bodies.
Most importantly, all governments are expected to have in place a national action plan on antimicrobial resistance within two years.
These national plans are to be aligned with the global action plan and with international agencies’ standards and guidelines.
The national actions should include:
– Developing a national surveillance system for antimicrobial resistance to collect data on resistance by bacteria to various medicines, as well as surveillance in the animal health and agriculture sectors.
– Effective regulation and governance for the licensing, distribution, prescription, dispensing and use of medicines in human and animal health.
– Improve laboratory capacity to identify pathogens and their antimicrobial susceptibility in order to guide optimal use of antibiotics by doctors.
– Elimination of economic incentives in all sectors that encourage inappropriate use of antibiotics and introduction of incentives to optimise use.
– Introduce policies for proper use of antibiotics in animals, fishery and agriculture sectors, including phasing out the use of antibiotics for animal growth promotion.
– Actions to reduce infection through sanitation, hygiene and infection prevention measures.
– Increase national awareness of antimicrobial resistance through public education programmes, medical and school curricula, and establish coalitions, including civil society groups and scientific and industry bodies.
– Participate in research for developing new medicines, diagnostic tools and vaccines.
At the World Health Assembly session discussing the global plan, some developing countries’ health officials highlighted the special needs of developing countries in implementing the global and national action plans.
These include obtaining the necessary funding and technical equipment to implement a national action plan, as well as assurance that people in their countries will have access to the new medicines, vaccines and diagnostic tools that will be developed in future, and at affordable prices.
It would be terrible if, when present antibiotics don’t work anymore and new ones are developed, patients in developing countries cannot have access to them because they are patented and thus have high prices.
The global plan also calls on WHO to support countries to develop and implement their national plans, and to lead and coordinate support to countries to implement their investment needs and publish progress reports.
The adoption of the global action plan will be a landmark and gives hope that international and national actions will take off in a serious way to tackle antimicrobial resistance.
Now that the plans are drawn up and approved, the difficult part has to be done: implementation. Our lives depend on it.
> Martin Khor is executive director of the South Centre, a research centre of 51 developing countries, based in Geneva. You can e-mail him at firstname.lastname@example.org. The views expressed here are entirely his own.
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