IMPERATIVE: International response to this threat has been feeble. Photo: CH. Vijaya Bhaskar
Growing resistance among pathogens to antibiotics and other drugs demands a coordinated global response on the same scale as efforts to address climate change, experts say.
Without an international commitment to tackle the issue, the world faces a future in which simple infections that have been treatable for decades become deadly diseases, they warn while recommending establishing a powerful global organisation similar to the Intergovernmental Panel on Climate Change to lead an international response. Resistance to antibiotics (to tackle bacterial infections) and antimicrobial drugs (to treat parasites, viruses and fungi) is spreading at an alarming rate.
Treatment for many infectious diseases is now reliant on just one or two drugs.
Dr Farrar, Director of the Wellcome Trust and Professor Mark Woolhouse, of the University of Edinburgh, outlined their concerns at an event hosted recent by the Royal Society in London and subsequently in a comment piece published in Nature.
The authors argue that the growing threat of antimicrobial resistance is similar to that posed by climate change because it is a natural process exacerbated by human activity and because the actions of one country can have global ramifications.
Yet, the international response to this threat — caused by the overuse and misuse of antimicrobial drugs — has been feeble, they say. Calling for the creation of an independent body to oversee surveillance efforts and set strict evidence-based targets, to stem the loss of drug potency and speed the development of new therapies, the authors suggest such an organisation should work closely with national governments and international agencies to be tasked with implementing its recommendations.
An intergovernmental panel on antimicrobial resistance (IPAMR) must have the same firm foundation on the best available science and potentially an even stronger mandate for action.
It must move rapidly to an agenda that includes identifying key knowledge gaps and how to fill them; assessing viable short- and long-term solutions; evaluating barriers to implementation; and setting out road maps for sustainable control of disease-causing microbes. It could, for example, support studies to investigate dosing regimes that stall resistance, coordinate incentives for developing new types of antimicrobial and set targets for prescriptions and animal use.
In a world without antibiotics, routine surgical procedures would become deadly. Treatment for cancer and diabetes, as well as organ transplants, would be impossible in their current form. Industrial agriculture would also suffer, owing to the increased use of antibiotics in animals as growth promoters.
According to Dr. Jeremy Farrar, we have been seeking to take action against the development of antimicrobial resistance for more than 20 years. Despite repeated warnings, the international response has been feeble, the WHO has missed opportunities to provide leadership, and very little progress has been made.
The result has been the emergence of strains of infections, including tuberculosis and malaria, pneumonia and gonorrhoea resistant to all known classes of drugs.
“We need a new independent body that will not only monitor the spread of antimicrobial resistance, but also drive and direct efforts to contain it.” Prof. Mark Woolhouse, of the University of Edinburgh’s Centre for Immunity, Infection and Evolution, said: “The time has come to stop re-stating the problems of antimicrobial resistance and start taking action.”
