What is Antimicrobial Resistance?
Antimicrobial resistance (AMR) is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others. AMR is an increasingly serious threat to global public health that requires action across all government sectors and society. Globally, 480 000 people develop multi-drug resistant TB each year, and drug resistance is starting to complicate the fight against HIV and malaria, as well.
Over the past years, the use and misuse of antimicrobials has increased the number and types of resistant organisms. Consequently many infectious diseases may one day become uncontrollable. With the growth of global trade and travel, resistant microorganisms can spread promptly to any part of the world.
How does Antimicrobial Resistance Develop ?
Drug resistance is a natural evolutionary phenomenon. When microorganisms are exposed to an antimicrobial, the more susceptible organisms succumb, leaving behind those resistant to the antimicrobial. They can then pass on their resistance to their offspring.
Inappropriate use of antimicrobials drives the development of drug resistance. Both overuse, underuse and misuse of medicines contribute to the problem. Ensuring that patients are informed about the need to take the right dosage of the right antimicrobial requires action from prescribers, pharmacists and dispensers, pharmaceutical industry, the public and patients, as well as the policy makers.
Most drug quality assurance systems are weak. This can lead to poor quality medicines, exposing patients to sub-optimal concentrations of antimicrobials, thus creating the conditions for drug resistance to develop. In some countries poor access to antimicrobials forces patients to take incomplete courses of treatment or to seek alternatives that could include substandard medicines.
Sub-therapeutic doses of antibiotics are used in animal-rearing for promoting growth or preventing diseases. This can result in resistant microorganisms, which can spread to humans.
An old man, sitting on his hospital bed, while nurses, hover around another patient’s bed, in India
Poor infection prevention and control can increase the spread of drug-resistant infections. Hospitalized patients are one of the main reservoirs of resistant microorganisms. Patients who are carriers of resistant microorganisms can act as a source of infection for others.
While surveillance for the emergence of drug resistant TB and HIV infection is improving, currently there are few well-established networks that regularly collect and report relevant data on drug resistance. Some countries lack laboratory facilities that can accurately identify resistant microorganisms. This impairs the ability to detect emergence of resistance and take prompt actions.
Existing antibiotics and anti-parasitic drugs, and, to a lesser extent, antiviral drugs, are losing their effect. At the same time there is insufficient investment in developing new antimicrobials. Similarly, there is insufficient new research into new diagnostics to detect resistant microorganisms; and new vaccines for preventing and controlling infections. If this trend continues, the arsenal of tools to combat resistant microorganism will soon be depleted.
Need for action against Antimicrobial Resistance
The threat from drug resistance is increasing. Antimicrobial resistance can compromise the achievement of the Sustainable Development Goals, affecting health security, poverty, economic growth and food security. Action is necessary across sectors and settings to mitigate, prevent and control antimicrobial resistance.
At the Sixty-eighth World Health Assembly in May 2015, Member States endorsed a global action plan to tackle antimicrobial resistance. The goal of the draft global action plan is to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.
Vaccines could be important to address antimicrobial resistance
Vaccinating humans and animals is a very effective way to stop them from getting infected and thereby preventing the need for antibiotics. Making better use of existing vaccines and developing new vaccines are important ways to tackle antibiotic resistance and reduce preventable illness and deaths.