Sav­ior be­com­ing a threat, but that is pre­ventable

China Daily (Canada) - - LIFE -

Last month, all of China ap­plauded Tu Youyou as she was awarded the No­bel Prize in­Medicine for her work in de­vel­op­ing a drug that is now used glob­ally to treat malaria. In 1945, the same prize was awarded to three sci­en­tists for pro­duc­ing the world’s first an­tibi­otic, peni­cillin.

The dis­cov­ery of peni­cillin was one of the sin­gle most im­por­tant ad­vances in the history of med­i­cal science. An­tibi­otics have rev­o­lu­tion­ized mod­ern medicine by making pre­vi­ously in­cur­able ill­nesses like pneu­mo­nia, scar­let fever and tu­ber­cu­lo­sis and lifethreat­en­ing in­fec­tions treat­able. Count­less lives have been saved over the last 70 years as a re­sult.

To­day, an­tibi­otics have be­come a vic­tim of their own suc­cess. An­tibi­otics have been used so ex­ten­sively that many are be­com­ing pow­er­less against diseases they used to cure. Like other once bright, shiny, new­tools, an­tibi­otics have be­come worn out— and less ef­fec­tive and in­ci­sive over time sim­ply be­cause we haven’t used them right. Bac­te­ria are in­creas­ingly re­sis­tant to ex­ist­ing an­tibi­otics, and while new­drugs have been de­vel­oped, the pace of dis­cov­ery has not kept up with the pace of bac­te­rial re­sis­tance.

It is dif­fi­cult to imag­ine a world with­out ef­fec­tive an­tibi­otics, but that is where we are headed with­out firm ac­tion now to pre­serve the power of ex­ist­ing an­tibi­otics. In­fec­tious diseases which have mostly been rel­e­gated to the history sec­tion of the med­i­cal mu­se­ums could emerge to be­come com­mon killers again; the risk of un­treat­able in­fec­tions will make com­mon sur­gi­cal pro­ce­dures like cae­sar­ian sec­tions po­ten­tially lifethreat­en­ing. WorldHealth Or­ga­ni­za­tion di­rec­tor-gen­eral Mar­garet Chan has de­scribed an­tibi­otic re­sis­tance as “one of the great­est chal­lenges for global pub­lic health to­day”.

Be­yond the health sys­tem, the eco­nomic costs of an­tibi­otic re­sis­tance— for in­stance, in pre­ma­ture deaths and loss of work­place par­tic­i­pa­tion and pro­duc­tiv­ity— pose se­ri­ous threats to eco­nomic growth and de­vel­op­ment.

An­tibi­otic use has his­tor­i­cally been very high in China com­pared to other coun­tries. There are a num­ber of rea­sons for this, in­clud­ing the pres­sure doc­tors faced to make money from pre­scrib­ing drugs be­cause their salaries were low. Pub­lic aware­ness about the cor­rect use of an­tibi­otics is also low: for in­stance, nearly two-thirds of Chi­nese re­spon­dents in a sur­vey com­mis­sioned byWHOthought an­tibi­otics were ef­fec­tive against colds and flu (de­spite the fact that an­tibi­otics have no im­pact on viruses). Com­mon mis­con­cep­tions like this have led to in­cor­rect use of an­tibi­otics, and the emer­gence of an­tibi­otic re­sis­tance.

The prob­lem is com­plex. But the good news is that there are con­crete ac­tions we can all take to ad­dress it: gov­ern­ments, doc­tors and pa­tients.

Within the health sys­tem, ra­tio­nal and ap­pro­pri­ate use of an­tibi­otics is cru­cial— which the Chi­nese gov­ern­ment has been pro­mot­ing with a na­tion­wide cam­paign launched in 2011, with im­pres­sive re­sults. It is also es­sen­tial that health-fi­nanc­ing sys­tems do not cre­ate in­cen­tives for doc­tors to over-pre­scribe.

Doc­tors must only pre­scribe and dis­pense an­tibi­otics when they are truly needed, and give clear in­struc­tions to en­sure cor­rect use. All health work­ers can re­duce de­mand for an­tibi­otics by en­cour­ag­ing their pa­tients to get vac­ci­nated against in­fec­tious diseases, and by prac­tic­ing sim­ple hy­giene to re­duce in­fec­tions in the first place.

Pa­tients can help by not de­mand­ing that doc­tors pre­scribe a course of an­tibi­otics when they may not be nec­es­sary. And when an­tibi­otics are pre­scribed, pa­tients should al­ways care­fully fol­low the doc­tor’s in­struc­tions, take the full course, and never re­serve an­tibi­otics for use later or share with oth­ers.

If those doc­tors who first dis­cov­ered peni­cillin vis­ited a hos­pi­tal to­day, they would see that an­tibi­otics have be­come in­dis­pens­able to mod­ern medicine. If all of us play our part, we can help to en­sure that this re­mains the case now and in the fu­ture.

The au­thor is theWorldHealth Or­ga­ni­za­tion rep­re­sen­ta­tive in China.


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