Drug-resistant superbugs a worldwide threat

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Superbugs resistant to drugs pose a serious worldwide threat and demand a response on the same scale as efforts to combat climate change, infectious disease according to specialists.

Warning that a world without effective antibiotics would be "deadly", with routine surgery, treatments for cancer and diabetes and organ transplants becoming impossible, the experts said the international response had been far too weak.

"We have needed to take action against the development of antimicrobial resistance for more than 20 years. Despite repeated warnings, the international response has been feeble," said Jeremy Farrar, director of the Wellcome Trust medical charity.

Resistant to all known drugs

The World Health Organization had missed opportunities to take the lead, and very little progress had been made, he said, resulting in the emergence of strains of infections, including tuberculosis, malaria, pneumonia and gonorrhoea, which resist all known drugs.

"We need a new independent body that will not only monitor the spread of antimicrobial resistance, but also drive and direct efforts to contain it," he told reporters at a briefing in London.

Such a body should be modelled on the Intergovernmental Panel on Climate Change (IPCC) and work with governments and agencies who would implement its recommendations, Farrar said in a joint commentary in the journal Nature with Mark Woolhouse of Edinburgh University's Centre for Immunity, Infection and Evolution.

"In many ways, antimicrobial resistance is similar to climate change. Both are processes operating on a global scale for which humans are largely responsible," Farrar and Woolhouse wrote.

Asked at the briefing if he saw the threats as of a similar magnitude, Woolhouse said "Yes".

Drug resistance is driven by the misuse and overuse of antibiotics, which encourages bacteria to develop new ways of overcoming them. It has been a feature of medicine since Alexander Fleming's discovery of the first antibiotic, penicillin, in 1928.

Race against time

Only a handful of new antibiotics have been developed and brought to market in the past few decades, and it is a race against time to find more as bacterial infections increasingly evolve into superbugs resistant to even the most powerful last-resort medicines reserved for extreme cases.

One of the best known superbugs, MRSA, is alone estimated to kill around 19 000 people every year in the United States - far more than HIV and Aids - and a similar number in Europe.

The WHO issued a report last month in which it said the spread of deadly superbugs was no longer a prediction but was happening right now across the world.

Woolhouse said the time had come "to stop re-stating the problems . . . and start taking action."

"We need independent, international leadership on this issue before the massive health gains that have been made since Alexander Fleming's discovery . . . are lost forever," he said.

The IPCC is a United Nations body set up in 1988 to provide a clear scientific view of the current state of climate change and its potential environmental and social impacts.

Woolhouse and Farrar said their vision of a similar body on antimicrobial resistance – which they dubbed the IPAMR or Intergovernmental Panel on Antimicrobial Resistance – would involve a broad range of experts, from specialists in clinical and veterinary medicine, to epidemiologists, microbiologists, pharmacologists, health economists and international lawyers.

"Creating an effective IPAMR will be a huge undertaking, but the successful global campaign to eradicate smallpox, led by the WHO, demonstrates that a co-ordinated international response to a public health threat can work," they wrote in the Nature commentary.

Read more:
Genome mapping may prevent superbugs
Drug-resistant 'superbugs' rife in Europe

Gene points to Achilles heel in MRSA superbug


Image: Superbug from Shutterstock

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