Today, if you get a bacterial infection – even a serious one that lands you in a hospital bed – you probably feel confident an antibiotic will cure you.
My parents lived in a different world. When I was three years old, I became seriously ill with tuberculosis. I can only imagine their anguish. I had to be hospitalised for a full year, and I would probably have died were it not for the availability of a new form of treatment that combined three antibiotics. I was one of the first people in Europe to receive it.
The advent of antibiotics introduced a new era in medicine. But now, I fear we are moving backwards – to the world in which my parents lived, when bacterial infections were often lethal because there were no specific treatments available.
Many such infections are rapidly becoming resistant to life-saving drugs. This development can be attributed, to some extent, to biology. It is inevitable that each drug will lose its ability to kill disease-causing bacteria over time. That is because bacteria, through natural selection and genetic adaptation, become resistant to antibiotics.
However, we are speeding up the process dramatically by using antibiotics too much and often in the wrong contexts. We need to slow down the development and spread of resistance so that the antibiotics we have continue to work for as long as possible. We also urgently need to devote more resources to the research and development of new antibiotics.
Prescription for action from WHO:
Doctors, nurses, veterinarians and other health workers
Don’t prescribe or dispense antibiotics unless they are truly necessary and you have made all efforts to test and confirm which antibiotic your human patient or the animal you are treating should have. Today, it is estimated that in half of all cases, antibiotics are prescribed for conditions caused by viruses, where they do no good. You can also do more to prevent infections in the first place by ensuring your hands, instruments and environment are clean, and employing vaccines where appropriate.
"We are speeding up the process dramatically by using antibiotics too much and often in the wrong contexts."
Marc Sprenger, Director of the WHO’s secretariat for antimicrobial resistance
People using healthcare
Take antibiotics only when prescribed by a certified health professional, but also don’t be timid about asking if you feel you really need them. If you take an antibiotic, always complete the full prescription, even if you feel better, because stopping treatment early promotes the growth of drug-resistant bacteria.
Farmers and others in the agriculture sector
Ensure that antibiotics given to animals are used only to control or treat infectious diseases and under veterinary supervision. Misuse of antibiotics in livestock, aquaculture and crops is a key factor contributing to antibiotic resistance and its spread into the environment, food chain and humans. Clean and uncrowded conditions and vaccination of animals can reduce the need to use antibiotics.
Governments
We need robust national action plans to tackle antibiotic resistance. Critical steps are improved surveillance of antibiotic-resistant infections, regulation of the appropriate use of quality medicines, and education about the dangers of overuse.
Development organisations
Compared with populations in industrialised nations, people in low-income countries are not getting fair access to antibiotics. Countries seeking donor help to strengthen their health systems need guidance to ensure essential antibiotics are affordable, reach the people who really need them, and are used responsibly.
Industry
Industry needs to move faster and more aggressively to research and develop new antibiotics, but we also have to implement new ways of stimulating research and development. Many talk of an antibiotic “discovery void” since the late 1980s. We are currently in a race between drug development and bacterial evolution.
Incentives for developing new antibiotics can help. There are some encouraging trends.
For example, the EU, the UK, the US and Canada have moved forward on projects to fill this knowledge gap by directly funding basic and clinical research by scientists; working with pharmaceutical companies; and offering monetary prizes for new diagnostics needed to use antibiotics more responsibly.
But it is clear that a new, more global approach is needed. The WHO global action plan on antimicrobial resistance calls for the creation of new partnerships to foster the development of antibiotics. The WHO and the drugs for neglected diseases initiative are working on the creation of a global antibiotic research and development facility that will collaborate closely with the pharmaceutical industry, universities, civil society and health authorities worldwide. The partnership will also ensure that new drugs are affordable for all and embed the need for conservation of new antibiotics in the development process.
Without a novel system for using antibiotics, we will repeat failed historic efforts to capitalise on one of the greatest scientific discoveries the world has ever seen.
Time is running out.
COMMENTARY by Marc Sprenger, Director of the WHO’s secretariat for antimicrobial resistance
reference link- http://www.who.int/mediacentre/commentaries/stop-antibiotic-resistance/en/