New plan seeks to ensure appropriate use of drugs, improve surveillance and monitoring, and expand research and development
Washington, D.C., 1 October, 2015 (PAHO/WHO) — Building on two decades of public health efforts to fight the growth of drug-resistant bacteria, health ministers from throughout the Americas agreed this week on new actions to address the ongoing threat and to ensure that drugs to fight infectious diseases remain effective.
The actions are spelled out in a new action plan approved by the 54th Directive Council of the Pan American Health Organization (PAHO), which is meeting this week in Washington, D.C. The plan aims to raise awareness and education on antimicrobial resistance, reduce the misuse of antimicrobial drugs, expand surveillance of drug resistance, improve infection prevention, and increase investment in new antibiotic drugs and diagnostics.
The agreement to step up action in this area follows the release earlier this year of a new report by the World Health Organization (WHO) that warns of a global public health catastrophe if resistance to antibiotics and other antimicrobials continues to grow. Antimicrobial agents have been used for the last 70 years to cure infectious diseases. But they have been used so widely and in many cases inappropriately that many of the infectious organisms they are designed to kill have adapted to them, making the drugs less effective.
"We have fought for decades to prevent a future in which common infections and injuries can once again become deadly, but we have not yet won this fight," said Marcos Espinal, director of PAHO/WHO's Communicable Diseases and Health Analysis Department. "We have had successes, but we need a sustained and coordinated approach to bring antimicrobial resistance under control."
Despite the efforts of public health authorities, antimicrobials in many countries in the Americas are dispensed without a doctor's prescription. Worldwide, more than 50% of such drugs are prescribed or sold inappropriately.
Patients sometimes take antibiotics inappropriately, to treat illnesses like the common cold, caused by viruses that do not respond to these drugs. Antimicrobials are also used widely in agriculture to prevent disease and stimulate growth in animals produced for human consumption. These antibiotics promote the spread of resistant bacteria through food.
The grow of drug-resistant tuberculosis has slowed in the region, thanks to the imposition of strict controls on prescriptions for some TB drugs and the rational use of second-line tuberculosis drugs acquired at accessible prices through the PAHO Strategic Fund.
Among HIV-infected patients in Latin America and the Caribbean, 44% have access to antiretroviral therapy, higher than anywhere else in world among low- and middle-income countries. But 7% of people with HIV starting antiretroviral therapy are infected with a drug-resistant virus.
The risk of anti-malarial drug resistance continues to threaten the remarkable 67% overall malaria case reduction reported in the Region between 2000 and 2014. Specific technical cooperation projects led by PAHO strongly positions the Region in proactively addressing issues that increase the risk of developing antimalarial drug resistance.
With no new major antibiotics developed in the last 30 years, the growing resistance to the drugs available for treating a wide range of diseases is bringing both economic and public health costs, especially in low-income countries.
Given these high stakes, the ministers agreed to:
- Institute a sustained and coordinated approach to regulating the quality, sales and use in of antimicrobials in clinical settings;
- Promote better hygiene in general, including access to clean water and sanitation, and control infections in health facilities to reduce health care associated infections;
- Strengthen surveillance, monitoring, reporting and analysis of the use of antimicrobial drugs and the emergence of drug resistance, in both humans and animals;
- Support research on antimicrobial resistance, including in academia and the private sector, to identify new ways to extend the shelf life of antimicrobials and to stimulate the development of new diagnostic tools and antimicrobial drugs;
- Establish platforms for information exchange and to promote participation in these actions by other sectors including other ministries, agriculture, the private sector and civil society.