The Pharmaceutical Journal
Vol 268 No 7187 p274-79
2 March 2002

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Global action on drug resistance needed, health economists warn

No country acting alone can adequately protect its population against rising antimicrobial resistance, researchers warn in the latest issue of the Bulletin of the World Health Organization.

Health economists Richard Smith and Joanna Coast, senior lecturers at the universities of East Anglia and Bristol, say that resistant organisms causing diseases such as tuberculosis, malaria and meningitis pose a major threat to global public health. "The greatest problems associated with antimicrobial resistance undoubtedly remain to be seen," the authors say. "It is necessary to persuade decision-makers at the national and international levels of the importance of resistance relative to other pressing health and non-health priorities. Only if adequate strategies of collective action are implemented soon is it likely that high future morbidity and mortality attributable to resistance can be averted in all countries."

The authors argue that increasing resistance is due in large part to the misuse of antimicrobial medicines. Uncontrolled over-the-counter availability, poor manufacture or counterfeiting, and the sale of these medicines from roadside stalls and by hawkers exacerbate the problem.

Containing the rise of resistance demands surveillance, together with systems for tracking antimicrobial consumption, encouraging research and development in new antimicrobials and alternative treatments, and fostering the appropriate use of existing antimicrobials. Extreme differences between countries with regard to economic conditions and health priorities make international co-ordination indispensable, in addition to measures designed to respond to the particular circumstances in each country. "The global nature of antimicrobial resistance calls for a global response," the authors say. They recommend that international bodies should make resistance a high priority, should collect global resistance data and should stimulate investment in research and development for new antimicrobials.

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