WHO alerts to global rise in ‘untreatable’ infectious diseases

THeworld Health Organisation’s (WHO’S) first release of surveillance data on antibiotic resistance reveals high levels of resistance to a number of serious bacterial infections in both high- and low-income countries.

WHO’S new Global Antimicrobial Surveillance System (GLASS) reveals widespread occurrence of antibiotic resistance among 500 000 people with suspected bacterial infections across 22 countries.

The most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, followed by Salmonella spp. The system does not include data on resistance of Mycobacterium tuberculosis, which causes tuberculosis

(TB), as WHO has been tracking it since 1994 and providing annual updates in the Global tuberculosis report.

Among patients with suspected bloodstream infection, the proportion that had bacteria resistant to at least one of the most commonly used antibiotics ranged tremendously between different countries – from zero to 82 per cent. Resistance to penicillin – the medicine used for decades worldwide to treat pneumonia – ranged from zero to 51 per cent among reporting countries. And between eight per cent to 65 per cent of E. coli associated with urinary tract infections presented resistance to ciprofloxacin, an antibiotic commonly used to treat this condition.

“The report confirms the serious situation of antibiotic resistance worldwide,” says Dr. Marc Sprenger, director of WHO’S Antimicrobial Resistance Secretariat.

“Some of the world’s most common – and potentially most dangerous – infections are proving drug-resistant,” adds Sprenger. “And most worrying of all, pathogens don’t respect national borders. That’s why WHO is encouraging all countries to set up good surveillance systems for detecting drug resistance that can provide data to this global system.”

To date, 52 countries (25 high-income, 20 middle-income and seven low-income countries) are enrolled in WHO’S Global Antimicrobial Surveillance System. For the first report, 40 countries provided information about their national surveillance systems and 22 countries also provided data on levels of antibiotic resistance.

“The report is a vital first step towards improving our understanding of the extent of antimicrobial resistance. Surveillance is in its infancy, but it is vital to develop it if we are to anticipate and tackle one of the biggest threats to global public health,” says Dr. Carmem Pessoa-silva, who coordinates the new surveillance system at WHO.

Data presented in this first GLASS report vary widely in quality and completeness. Some countries face major challenges in building their national surveillance systems, including a lack of personnel, funds and infrastructure.

However, WHO is supporting more countries to set up national antimicrobial resistance surveillance systems that can produce reliable, meaningful data. GLASS is helping to standardize the way that countries collect data and enable a more complete picture about antimicrobial resistance patterns and trends.

Solid drug resistance surveillance programmes in TB, HIV and malaria have been functioning for many years and have helped estimate disease burden, plan diagnostic and treatment services, monitor the effectiveness of control interventions, and design effective treatment regimens to address and prevent future resistance. GLASS is expected to perform a similar function for common bacterial pathogens.

The rollout of GLASS is already making a difference in many countries. For example, Kenya has enhanced the development of its national antimicrobial resistance system; Tunisia started to aggregate data on antimicrobial resistance at national level; the Republic of Korea completely revised its national surveillance system to align with the GLASS methodology, providing data of very high quality and completeness; and countries such as Afghanistan or Cambodia that face major structural challenges have enrolled in the system and are using the GLASS framework as an opportunity for strengthening their AMR surveillance capacities. In general, national participation in GLASS is seen as a sign of growing political commitment to support global efforts to control antimicrobial resistance.

Meanwhile, the need for a global surveillance system was highlighted by WHO in 2014 in the Antimicrobial resistance global report on surveillance.

WORRIED by the high rate of deaths caused by sickle cell disease (SCD) in Nigeria, expert has advocated for increased awareness and support on Bone marrow Transplant (BMT), to increase survival rate.

Bone marrow transplant, also known as stem cell transplant, has been perceived as the only curative measure for the SCD and other genetic issues, in which damaged or destroyed bone marrow are replaced with healthy bone marrow stem cells.

According to report, more that 280 million people have disease with genetic causes globally, as over 40 million Nigerians are carriers of the sickle cell gene. Further reports, revealed that over 150 children bone with the disease die

Speaking to the press during his visit in Lagos, the Senior Consultant and Head, Pediatric Hematology, Oncology Immunology and Bone marrow Transplant, Artemis Hospital, India, Dr Gaurav Kharya, said BMT, remains the only procedure to curing SCD, as many who have undergone the process are living healthy and doing their daily activities, just like those with normal genotype.

He said SCD is not a death sentence, but forms a huge burden of disease across the globe. Kharya noted that, no child should be allowed to die of the disease owing to the challenges hindering the BMT in Nigeria, which he said include, cost of treatment, lack of clear cut indications, awareness, donor availability, lack of trained personnel, infrastructure among others. According to the Hematology Oncologist, having a BMT done in Nigeria needs a strong commitment from the political system, for it to be effective.

He added that despite the rate of awareness on prevention of the disease, there is still need for the BMT, as the disease is inevitable, owing to ignorance among couples and other reasons.

Speaking on the misconception on environmental factor affecting patients who have undergone the transplant, Kharya said, it could be due to other factors and not environment, adding that Nigeria’s environment is safe for patients.

He, however, urged the government to take proactive steps in helping people with SCD undergo the bone marrow here in Nigeria, as cost remains the major barrier in accessing the treatment.

President Pharmaceutical Society of Nigeria (PSN), Ahmed Ibrahim Yakasai (right); Executive Director (ED), Operations, Fidson Healthcare, Biola Adebayo; and National Secreatry, PSN, Emeka Duru, during a facility visit of PSN Executive members to Fidson’s Factory at Ota, Ogun State