Dr Haileyesus Getahun
Director of Global Coordination and Partnership on AMR, World Health Organization
Framing the issue of antibiotics and bacterial infections within the broader antimicrobial resistance agenda will facilitate programmatic synergy, efficiency and catalyse country level action.
This week is World Antimicrobial Awareness Week, which we are marking at the height of the COVID-19 pandemic. This year, the focus of the campaign has widened, from antibiotics to antimicrobials, embracing also antivirals, antifungals and antiparasitic medication.
Antimicrobials are used to prevent and treat infections in humans, animals and plants. Antimicrobial resistance occurs when bacteria, fungi, parasites and viruses change over time and cease to respond to these medicines. It is driven by misuse and overuse in humans, animals and plants.
Reframing antibiotic resistance
Drug resistant infections are harder to treat and increase the risk of transmission and severity of illness, and death. The search for new antibiotics to treat drug resistant bacterial infections continues to be a priority.
We need to frame the response to antibiotics resistance within the broader health sector and antimicrobial resistance agenda. This will facilitate programmatic synergy, efficiency and catalyse country level action.
Antimicrobial resistance occurs when bacteria, fungi, parasites and viruses change over time and cease to respond to these medicines. It is driven by misuse and overuse in humans, animals and plants.
Drug resistance is a global challenge
Countries of all income levels are reporting alarming levels of antimicrobial resistance. High rates of drug resistant bloodstream bacterial infections have been reported in low and middle income countries.
Close to half a million people, mostly in low and middle income countries, developed drug resistant TB in 2019, of which only 38% received treatment. Resistance to antimalarials and insecticides as well as increasing resistance to HIV drugs threatens the progress made so far. Likewise, Candida auris, a multidrug resistant fungal infection which was first reported in 2009, has now spread to all continents with high mortality rates of up to 60%.
Uniting stakeholders for public health response
Expanding the campaign from antibiotics to antimicrobials will help to address this complex issue, by engaging key stakeholders and policy makers in a comprehensive public health response, and facilitates leveraging of resources, efficiencies and synergies.
For example, the Global Fund to Fight AIDS, TB and Malaria invests US$1 billion a year to build resilient and sustainable health systems with benefits beyond TB, HIV and malaria.
Its efforts to improve procurement and supply chains, laboratory and diagnostic capacities and strengthened data systems and use, could have significant impact and revolutionise antibiotic resistance efforts at the country level, with little additional investment.
Robust and representative data on drug resistant bacterial infections is urgently needed. It can be generated by modifying and funding existing and common laboratory diagnostic platforms, helping to inform coordinated national and global efforts to stem antimicrobial resistance.