Message from the PAHO/WHO Representative in Guyana, Dr. Beverley Barnett
On the occasion of World Health Day, 7 April 2011
“Combat Antimicrobial Resistance – No Action Today, No Cure Tomorrow”
Antimicrobials, or substances that are used to fight the many microbes (“germs”) that can cause disease, are significant tools to prevent illness and maintain health. These substances include antibiotics, such as penicillin and tetracycline; antiretrovirals, such as didanosine and zidovudine, which have helped to turn HIV infection from certain death to a chronic disease; antimalarials, such as chloroquine; and many other drugs. They have saved millions of lives globally, and can save many more.
However, sometimes the microbes that these and other antimicrobials are meant to damage or kill develop resistance to the drugs, and these life-saving pharmaceuticals lose their effect. Antimicrobial resistance is therefore a major threat to the control of communicable or infectious diseases, including HIV, malaria, and tuberculosis. Resistance to common, cheaper antimicrobials makes it necessary to use more expensive and complex treatments. Some of the second- and third-line drugs are not so easy to get and keep in large supply, especially in settings where resources are limited. Worse, there are some microbes that are resistant to multiple drugs, making effective treatment of patients with those infections very challenging.
Antimicrobial resistance occurs more easily when there is inappropriate use of these drugs, and can happen if there is inappropriate prescribing, which includes unnecessary prescribing and self-prescribing, or failure to complete the prescribed course of treatment. Other factors include the use of low-quality medicines, wrong prescriptions, poor infection control in health facilities, and misuse of antibiotics in animal husbandry.
Preventing antimicrobial resistance is a major public health challenge. There are several requirements for countries to properly deal with these issues, and an important one is government commitment and action. The Pan American Health Organization/World Health Organization (PAHO/WHO) congratulates the Guyana Ministry of Health for its efforts to update the national drug formulary, improve systems for procurement of pharmaceuticals, test for drug quality, provide protocols and guidelines for managing diseases and prescribing, and work with partners to strengthen surveillance for antimicrobial resistance, especially in HIV, malaria, and tuberculosis. The Ministry’s draft national medicines policy focuses on, among other things, policy implementation and management, legislation and regulation, human resource development, selection and rational drug use, procurement and supply management, financing, and quality assurance. This is well aligned with the Caribbean Pharmaceutical Policy, which aims to guide Caribbean countries in ensuring equitable access, availability, and affordability of essential medicines; quality, safety and efficacy of all medicines; and therapeutically sound and cost-effective use of medicines by health professionals and consumers.
The Caribbean Pharmaceutical Policy is guided by the main principle of access to medicines as a human right and by public health values and principles, with emphasis on the renewal of primary health care. A draft of this regional policy will be presented to Ministers of Health and Chief Medical Officers at the meeting of the CARICOM Council for Human and Social Development (COSHOD) that will be held in Guyana during the week of 11 April.
World Health Day 2011 seeks to raise awareness of the factors that contribute to antimicrobial resistance; to build commitment to develop and implement common solutions across diseases; and to encourage the implementation or strengthening of policies and practices that can prevent and contain antimicrobial resistance. We all have a role to play in this important matter, to ensure that the pharmaceutical weapons available to fight infections continue to be sharp and lethal. Today, PAHO/WHO calls for renewed commitment by all – policy makers, managers, health workers, consumers, patients, and partners – to make sure that antimicrobial resistance is prevented or minimized, and commits to continue to its technical cooperation in the development and implementation of relevant strategies and interventions – “action today, so that there will still be a cure tomorrow”.
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