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Antibiotic resistance warning! - WHO warns of major threat to worldwide public health

Published:Wednesday | May 6, 2015 | 12:00 AM

The World Health Organization (WHO) is warning that antibiotic resistance poses a very serious threat to worldwide public health.

In its first global look at antimicrobial resistance, including antibiotic resistance, the new report reveals that this serious threat is no longer a prediction for the future, it is happening right now, in every region of the world, and has the potential to affect anybody, of any age, in any country.

In the most comprehensive picture of antibiotic resistance to date, WHO has concluded that antibiotic resistance - when bacteria change so antibiotics no longer work in people who need them to treat infections - is now a major threat to public health.

Antibiotic resistance causes people to be sick longer and increases the risk of death.

"This is the single greatest challenge in infectious diseases today. Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill,"said Dr Keiji Fukuda, WHO's assistant director general for health security.

"Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more-and-more of these global public-health goods, and the implications will be devastating."

Using data from a survey completed by 133 countries (including Jamaica) in 2013 and 2014, the report is the first to capture governments' assessments of their response to resistance to antimicrobial medicines used to treat conditions such as bloodstream infections, pneumonia, tuberculosis (TB), malaria and HIV. It summarises current practices and structures aimed to address the issue, and shows there are significant areas for improvement.




The report, 'Antimicrobial resistance: Global report on surveillance', notes resistance is occurring across many different infectious agents, but it focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary-tract infections and gonorrhoea.

The results are cause for high concern, documenting resistance to antibiotics, especially last-resort antibiotics, in all regions of the world.

Among key findings the report noted are:

- Few countries (34 out of 133 participating in the survey) have a comprehensive national plan to fight resistance to antibiotics and other antimicrobial medicines.

- Monitoring is key for controlling antibiotic resistance, but it is infrequent. In many countries, poor laboratory capacity, infrastructure and data management are preventing effective surveillance, which can reveal patterns of resistance and identify trends and outbreaks.

- Sales of antibiotics and other antimicrobial medicines without prescription remain widespread, with many countries lacking standard treatment guidelines, increasing the potential for overuse of antimicrobial medicines by the public and medical professionals.

- Public awareness of the issue is low in all regions, with many people still believing that antibiotics are effective against viral infections.

- Lack of programmes to prevent and control hospital-acquired infections remains a major problem.

- Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, klebsiella pneumonia - carbapenem antibiotics - has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns, and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.

- Resistance to one of the most widely used antibacterial medicines for the treatment of urinary-tract infections caused by E. Coli - fluoroquinolones - is very widespread.

In the 1980s, when these drugs were first introduced, resistance was virtually zero. Today, there are countries in many parts of the world where this treatment is now ineffective in more than half of patients.

- Treatment failure to the last resort of treatment for gonorrhoea - third-generation cephalosporins - has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom. An estimated 106 million people are infected with gonorrhoea every year (2008 estimates).

- Antibiotic resistance causes people to be sick for longer and increases the risk of death. For example, people with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64 per cent more likely to die than people with a non-resistant form of the infection. Resistance also increases the cost of health care, lengthier stays in hospital and more intensive care required.




The report reveals that key tools to tackle antibiotic resistance - such as basic systems to track and monitor the problem - show gaps or do not exist in many countries. While some countries have taken important steps in addressing the problem, every country and individual needs to do more.

Other important actions include preventing infections from happening in the first place through better hygiene, access to clean water, infection control in health-care facilities, and vaccination to reduce the need for antibiotics.

WHO is also calling attention to the need to develop new diagnostics, antibiotics and other tools to allow healthcare professionals to stay ahead of emerging resistance.

This report is kick-starting a global effort, led by WHO, to address drug resistance. This will involve the development of tools and standards, and improved collaboration around the world, to track drug resistance, measure its health and economic impacts, and design targeted solutions.




People can help tackle resistance by:

- Using antibiotics only when prescribed by a doctor.

- Completing the full prescription, even if they feel better.

- Never sharing antibiotics with others, or using leftover prescriptions.

Health workers and pharmacists can help tackle resistance by:

- Enhancing infection prevention and control.

- Only prescribing and dispensing antibiotics when they are truly needed.

- Prescribing and dispensing the right antibiotic(s) to treat the illness.

Policymakers can help tackle resistance by:

- Strengthening resistance tracking and laboratory capacity.

- Regulating and promoting appropriate use of medicines.

Policymakers and industry can help tackle resistance by:

- Fostering innovation and research and development of new tools.

- Promoting cooperation and information sharing among all stakeholders.

The report also includes information on resistance to medicines for treating other infections such as HIV, malaria, tuberculosis and influenza.

WHO, countries and partners have developed a draft Global Action Plan to combat antimicrobial resistance, including antibiotic resistance, which has been submitted to the 68th World Health Assembly, taking place in Geneva, Switzerland, May 18-23.

Governments will be asked to approve the plan and, in doing so, declare their commitment to address a problem that threatens global health, as we know it. One essential step in implementing the Global Action Plan would be the development of comprehensive national plans, in countries where they are now lacking, and further develop and strengthen existing plans.

Jamaica is expected to form part of those discussions.