The World Health Organization (WHO) is today taking action to ensure that vital drugs can continue to be used effectively by this generation and in the future. Without concerted, global action many of the dramatic breakthroughs made in medical science over the past fifty years could be lost to the growing threat of drug resistance.
“Antibiotics were one of the most significant discoveries of the 20th century. Killer diseases such as tuberculosis, meningitis, scarlet fever and pneumonia could suddenly be treated and cured,” said Dr Gro Harlem Brundtland, WHO Director-General. “Unless we act to protect these medical miracles, we could be heading for a post-antibiotic age in which many medical and surgical advances could be undermined by the risk of incurable infection.”
Over the past five years, more than US$ 17 billion has been spent by the pharmaceutical industry on research and development of medicines used to treat infectious diseases (according to industry data). Unless drug resistance is tackled quickly, much of that investment could be lost.
Today, WHO is launching a comprehensive strategy to contain the spread of drug resistance. This carefully structured framework can be used by anyone involved in the use or management of medical treatments - from patients to doctors, hospital managers to health ministers. It is the result of three years of work by experts at WHO and other national and international partners.
“This strategy is designed to promote the wiser use of drugs so that resistance is minimized and effective treatments can continue to be used for generations to come,” said Dr David Heymann, WHO Executive Director for Communicable Diseases.
Better-informed patients can avoid putting pressure on doctors to give them antibiotics. Better-informed doctors will be able to prescribe only the drugs that are required to treat a patient, rather than automatically giving either the newest or best known medicines.
Hospital managers can put in place detailed procedures to monitor the effectiveness of drugs that are being used. Health ministers can make sure that the most badly needed drugs are available for people to use and that inappropriate drugs are not used.
Use of antibiotics in food production also contributes to increased drug resistance. Currently, 50% of all antibiotic production is used in agriculture - not only to treat sick animals, but also to promote livestock and poultry growth. Drug resistant microbes in animals can be transferred to humans.
To prevent this, the Global Strategy recommends a series of actions, including obligatory prescriptions for all antibiotic use for disease control in animals and the phasing out of antibiotics as growth promoters.
Drug resistance is a natural biological occurrence, but one that can kill. Today we live in a world where drug resistance is spreading fast and growing numbers of front-line drugs are becoming ineffective. There is indisputable evidence of resistance to medicines used to treat meningitis, sexually transmitted infections such as gonorrhoea, infections acquired in hospitals and even to the new classes of antiretroviral (ARV) drugs used to treat HIV.
For example, in several countries tuberculosis strains have become resistant to at least two of the most effective drugs used against the disease. Elsewhere, commonly used antimalarial drugs have become virtually useless because the malaria parasite has acquired resistance to them.
“This is a problem faced in both rich and poor communities, in industrialized as well as developing countries,” said Dr Heymann. “It has different roots in different societies - overuse of drugs in many developed countries, underuse in poorer nations - but the net result and the imminent danger are the same.”
It is a global problem. No country can afford to ignore it, no country can afford not to respond. At the same time, action taken in any one country will have clear and positive results around the world.