Savior becoming a threat, but that is preventable
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.