Academic journal article Bulletin of the World Health Organization

United Nations Meeting on Antimicrobial Resistance: World Leaders Gather at the United Nations General Assembly in New York This Month to Mount a Response to the Growing Threat of Antimicrobial Resistance

Academic journal article Bulletin of the World Health Organization

United Nations Meeting on Antimicrobial Resistance: World Leaders Gather at the United Nations General Assembly in New York This Month to Mount a Response to the Growing Threat of Antimicrobial Resistance

Article excerpt

Dr Abdul Ghafur, a consultant in infectious diseases in Chennai, had become alarmed by the number of multidrug-resistant infections in patients at major hospitals across India.

In desperation, he and his colleagues issued the Chennai Declaration in 2012, calling on policy-makers to take action to address the growing problem in India.

Four years later little has changed and now they fear that patients in India may be acquiring infections that are resistant to an antibiotic of last resort, colistin.

Due to its high toxicity, colistin has been used primarily as a growth promoter for livestock. However, as more bacteria become resistant to other classes of antibiotics, colistin is increasingly being used in humans.

The widespread use of colistin in animal farming has resulted in resistant infections that are spreading fast and weakening its power as a drug of last resort.

"Colistin is the only treatment option with a reliable effect against multidrug-resistant bacteria in many regions," says Professor Otto Cars of Uppsala University, Sweden, the founding director of ReAct, an independent network campaigning for global action on antibiotic resistance. "Losing it would put many lives at risk."

Ever since antibiotics were developed in the 1940s, scientists have warned that using them improperly leads to bacterial resistance and that overuse of antibiotics only increases that risk because microbes naturally adapt to their environment.

Today's threat of widespread antimicrobial resistance (AMR)--in bacteria, parasites and viruses that cause infections and disease--raises the prospect of a world without effective antimicrobials, where a patient can die from previously treatable infections.

This month global leaders gather at the United Nations General Assembly in New York to discuss the AMR problem and agree on a response.

For Dr Marc Sprenger, director of the World Health Organization's AMR Secretariat, the United Nations gathering on 21 September represents a significant ramping up of the global response.

"There has been discussion of AMR in WHO since the 1960s, and plans since 2000, but it is now shifting from being a technical problem to a much higher level political issue," Sprenger says, adding that this shift and the broad consensus on what needs to be done are reasons for optimism.

The gathering in New York is the result of efforts led by WHO, the Food and Agriculture Organization (FAO), the World Organisation for Animal Health and several governments. It comes in the wake of national, regional and international initiatives, including the Chennai Declaration, regional declarations, World Health Assembly resolutions and gatherings of high-ranking decision-makers across the world.

Recent high-profile reports warn of the dangers of not taking action. A bleak report by economist Jim O'Neill, commissioned by the British government and released in May, estimates that 700 000 deaths globally could be attributed to AMR this year and that the annual toll would climb to 10 million deaths in the next 35 years. The report projects US$ 100 trillion in losses by 2050 if nothing is done to reverse the trend.

WHO's Global action plan on antimicrobial resistance, adopted at the World Health Assembly last year by Member States, proposes a way forward.

The plan has five objectives: to improve awareness and understanding of antimicrobial resistance in policymakers and professionals; to strengthen surveillance and research; to reduce infection; to encourage the rational use of medicines in human and animal health care; and to increase investment in developing new medicines, diagnostics and vaccines.

Key to making the plan work is the "one-health" approach that reflects the links between human health, animal health and the environment, and requires many different sectors to come together to address the problem. …

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