THE UN SECRETARY GENERAL, BAN KI-MOON, SAID ANTIMICROBIAL RESISTANCE IS A “FUNDAMENTAL THREAT” TO GLOBAL HEALTH AND SAFETY AT THE FIRST GENERAL ASSEMBLY MEETING ON DRUG-RESISTANT BACTERIA.
A microbiologist works with tubes of bacteria samples in a US antimicrobial resistance and characterization lab. Photograph: David Goldman/AP
Amanda Holpuch in New York
The Guardian, US Edition
Wednesday 21 September 2016 00.01 EDTLast modified on Wednesday 21 September 2016 17.00 EDT
It is only the fourth time the general assembly has held a high-level meeting for a health issue.
“If we fail to address this problem quickly and comprehensively, antimicrobial resistance will make providing high-quality universal healthcare coverage more difficult if not impossible,” said Ban. “It will undermine sustainable food production. And it will put the sustainable development goals in jeopardy.”
Just before world leaders convened for the meeting, all 193 member states agreed in a declaration signed on Wednesday to combat the proliferation of antibiotic resistance.
The declaration routes the global response to superbugs along a similar path to the one used to combat climate change. In two years, groups including UN agencies will provide an update on the superbug fight to the UN secretary general.
It is estimated that more than 700,000 people die each year due to drug-resistant infections, though it could be much higher because there is no global system to monitor these deaths. And there has been trouble tracking those deaths in places where they are monitored, like in the US, where tens of thousands of deaths have not been attributed to superbugs, according to a Reuters investigation.
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Scientists have known for more than half a century that patients could develop resistance to the drugs used to treat them – one of the first people to sound the alarm was Alexander Fleming, who is credited with creating the first antibiotic, penicillin, in 1928. He cautioned of the impending crisis while accepting his Nobel prize in 1945: “There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”
But scientific innovation, and increased awareness, has shown the severity of the threat. The World Bank announced this week that without containment, the economic impact of the crisis makes it unlikely for the UN to reach its sustainable development goals for 2030.
“The scale and nature of this economic threat could wipe out hard-fought development gains and take us away from our goals of ending extreme poverty,” said the World Bank president, Jim Yong Kim. “We must urgently change course to avert this potential crisis.”
There has also been considerable advocacy by health officials, like Sally Davies, chief medical officer of the UK.
“Drug-resistant infections are firmly on the global agenda but now the real work begins,” Davies said in a statement. “We need governments, the pharmaceutical industry, health professionals and the agricultural sector to follow through on their commitments to save modern medicine.”
The World Health Organization director general, Margaret Chan, said on Wednesday that it was imperative for consumers and medical providers to rely less on antibiotics for disease treatment.
“On current trends, a common disease like gonorrhea may become untreatable,” Chan said. “Doctors facing patients will have to say, ‘I’m sorry – there’s nothing I can do for you.’”
Margaret Chan, director general for the World Health Organization, speaking at another UN event on refugees and migrants. Photograph: Julie Jacobson/AP
She also called for more innovation in antibiotic development, noting that only two new classes of antibiotics reached the market in the past half century. “The emergence of bacterial resistance is outpacing the world’s capacity for antibiotic discovery,” Chan said.
She warned specifically about gram-negative bacteria, which causes infections like pneumonia, wound or surgical site infections and meningitis in healthcare settings, and is proving increasingly resistant to antibiotics.
“With few replacement products in the pipeline, the world is heading to a post-antibiotic era in which common infections, especially those caused by gram-negative bacteria, will once again kill.”
Signatories to the UN declaration committed to encouraging innovation in antibiotic development, increasing public awareness of the threat and developing surveillance and regulatory systems on the use and sales of antimicrobial medicine for humans and animals.
Only three other health issues have been the subject of general assembly high-level meetings: HIV/Aids, non-communicable diseases and Ebola.
Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh, said he was encouraged that unlike with HIV/Aids and Ebola, the UN is addressing this health crisis before it has spun out of control.
“It’s very serious indeed – it’s killing people around the world at the rate of hundreds of thousands of year and we all expect it to get worse if something isn’t done now,” Woolhouse said. “But the UN is coming in at just the right time, in a sense.”