The growing threat of antimicrobial resistance (AMR) could reduce or even eliminate the effectiveness of many common medications, putting people’s health and lives at risk. In response, global health experts have banded together to urge the United Nations to set global targets for reduced antibiotic consumption.
According to their recommendations, countries should consume no more than the current median global level of antibiotics, which is 8.54 defined daily doses per capita per year. This amount would reduce global antibiotic use by more than 17.5%, they say. Each country would have to determine its own strategy for reaching that goal.
In lower-income and middle-income countries that lack public health infrastructure, improving public health and sanitation could reduce antibiotic use. But wealthier nations, which often exceed the 8.54 dose target, will require public educational campaigns directed at physicians and patients alike to discourage the inappropriate use of antibiotics.
The experts note that the general public often doesn’t know when antibiotics should be used. In a recent European Commission survey, 57% of respondents incorrectly answered if antibiotics can kill viruses. In a recent US survey, 40% said antibiotics were the best treatment for a runny nose or sore throat.
“We need to measure progress and have some idea of what progress will look like,” said Ramanan Laxminarayan, PhD, MPH, lead author and director of the Center for Disease Dynamics, Economics & Policy in Washington, DC. He also noted that targets are the only way public officials will be able to tell if their efforts are working.
The United Nations will discuss strategies for preserving global access to effective antimicrobials during its September 21 General Assembly meeting. Laxminarayan believes this meeting is important because AMR isn’t an imminent threat like Zika or Ebola, so people don’t have a sense of how it could affect them personally.
“Getting people to respond to a problem that is creeping up slowly,” he said, “is difficult.”
The researchers estimate that $5 billion would be needed annually to develop new vaccines that would reduce the need for antibiotics, diagnostic tools that can determine the nature of an infection more quickly, and novel alternatives to antibiotics. New antibiotics are needed but aren’t a long-term solution, they said, because resistance to them will develop quickly.
To supervise these efforts, the authors call for the creation of a high-level coordinating mechanism that would bring together the World Health Organization, the UN Food and Agricultural Organization, the World Organization for Animal Health, and other UN agencies and stakeholders to coordinate support for the development, implementation, and monitoring of national AMR plans.
“Having goals is one thing, but having the architecture is absolutely critical,” said Laxminarayan.
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