WHO: Too Few Countries Fighting Antimicrobial Resistance; Global Action Plan Advocates Equitable Access

The World Health Organization released a report today on countries’ response to the global declining effect of antibiotics on bacteria and microbes, heightened by overuse or misuse of those products. Next month the World Health Assembly will consider a draft global action plan to fight the problem, which includes suggestions for sustainable investment in the area such as de-linking research from price and sales, as well as equitable access to new products.

Charles Penn, coordinator, antimicrobial resistance at the WHO, said at a press briefing today that bacteria and other microbes naturally adapt to the use of antibiotics and other antimicrobials. This natural occurrence is unduly accelerated by factors such as overuse or misuse of antibiotics, he said.

If nothing is done to address the problem, he said, minor infections will kill again and the benefits of advanced medical treatments such as major surgery or chemotherapy for cancer may be lost.

The report captures governments’ own assessments of their effort in tackling the issue, he said. Out of the 194 WHO members, 133 responded to the survey upon which the report is based. Only 34 countries participating in the survey have a comprehensive national plan to fight resistance to antibiotics, the report said, which Penn said is too few.

The sale of antibiotics without prescription or products obtained over the internet bypassing national regulations are among the issues to be tackled, Penn said. This issue remains widespread, so the potential overuse or misuse of those products is high in many countries.

Public awareness is also lagging, with many people still believing that antibiotics can treat viral infections, he said.

According to the report, in the WHO European region, 40 percent of countries have reported having comprehensive plans and strategies to address antimicrobial resistance, while in the Americas region, only three countries do.

WHO South-East Asia region, in which all 11 member states participated in the survey, shows that 5 countries have national plans in place.

The survey focused on “the building blocks that are considered prerequisites to combat antimicrobial resistance: a comprehensive national plan, laboratory capacity to undertake surveillance for resistant microorganisms, access to safe, effective antimicrobial medicines, control of the misuse of these medicines, awareness and understanding among the general public and effective prevention and control programmes,” according to the report.

The report also mentions counterfeit medicines as an issue in many regions, encouraged by weak regulatory systems and inability to enforce laws. Penn answering a question about what counterfeit product refers to said it referred to poor quality medicines.

Draft Global Action Plan

Penn said the upcoming World Health Assembly (WHA) is expected to examine the draft global action plan on antimicrobial resistance. The report will provide the WHA with information on what is being done and what still needs to be done. One of the recommendations of the global action plan is that all countries have in place national action plans within two years, he said.

The draft global action plan includes five strategic objectives: “(1) to improve awareness and understanding of antimicrobial resistance; (2) to strengthen knowledge through surveillance and research; (3) to reduce the incidence of infection; (4) to optimize the use of antimicrobial agents; and (5) to ensure sustainable investment in countering antimicrobial resistance.”

It also states that “Reducing antimicrobial resistance will require the political will to adopt new policies, including controlling the use of antimicrobial medicines in human health and animal and food production.”

“No major new class of antibiotics has been discovered since 1987 and too few antibacterial agents are in development to meet the challenge of multidrug resistance,” the draft action plans underlines.

Most major pharmaceutical companies have stopped research in the area of antibiotics, it says, and new processes are needed to facilitate renewed investment in research and development. The use of antibiotics should then be regulated by a public health framework so that the effectiveness and longevity of the products are maintained. Fears that resistance will develop rapidly, limiting returns on investment, has been a factor in the industry’s neglect in this area, it said.

De-linkage, Antibiotics as Public Good

The global action plan suggests that the cost of investment in research and development (R&D) be de-linked from price and the volume of sales to “facilitate equitable and affordable access to new medicines.”

The global action plan also stresses the importance of public-private partnerships “to help ensure equitable access to quality-assured products and other related health technologies, through fair pricing and donations for poorest populations.”

Also noted by the global action plan is the fact that “More widespread recognition of antimicrobial medicines as a public good is needed in order to strengthen regulation of their distribution, quality and use, and encourage investment in research and development.”

“In some cases,” it said, “industry’s spending on promoting products is greater than governmental investment in promoting rational use of antimicrobial medicines or providing objective information.”

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