Act now to tame the su­per­bugs that are killing 700,000 a year

The Observer - - NEWS / HEALTH - Ed Whit­ing Well­come Trust

The UN gen­eral assem­bly recog­nised drug-re­sis­tant in­fec­tions last year as one of the great­est threats fac­ing hu­man­ity. And in May, G20 lead­ers called for na­tional ac­tion plans by the end of 2018 – plans set in train by the World Health Or­gan­i­sa­tion in 2015. But we have al­ready lost mo­men­tum. Com­mit­ments are the first step, but noth­ing will be achieved if we don’t trans­late them into ac­tion.

Anal­y­sis by Well­come and the UN Foun­da­tion shows, en­cour­ag­ingly, that 151 of 195 coun­tries are de­vel­op­ing a plan. How­ever, only half ad­dress the threat across hu­man and an­i­mal health and the en­vi­ron­ment, and only one in five com­mit to re­duc­ing an­tibi­otic use, im­prov­ing hy­giene and pre­serv­ing an­tibi­otics of last re­sort. Most tellingly, only 5% are ad­e­quately funded and mon­i­tored by the gov­ern­ments re­spon­si­ble for them.

And we still suf­fer from too few new an­tibi­otics in de­vel­op­ment. CARB-X is a new part­ner­ship sup­port­ing 18 new po­ten­tial treat­ments, but progress is still slow. If we want our grand­chil­dren to ben­e­fit from an­tibi­otics, as we have, we need more in­vest­ment.

Mean­while, the su­per­bugs are pro­gress­ing rapidly. Since the UN dec­la­ra­tion, they have killed about 700,000 peo­ple world­wide. In Ne­vada in 2016, a 70-year-old woman died af­ter break­ing her leg, which later be­came in­fected with a su­per­bug re­sis­tant to 26 an­tibi­otics. In South Africa, mul­tidru­gre­sis­tant TB is spread­ing. In the UK, un­treat­able strains of gon­or­rhoea are on the rise.

Politi­cians and sci­en­tists have an ur­gent role to play but they can­not solve the prob­lem alone. Tack­ling drug-re­sis­tant in­fec­tion is ev­ery­one’s busi­ness. The threat tran­scends that of HIV, TB and can­cer. To achieve real progress, those al­ready suf­fer­ing from un­treat­able in­fec­tions need a voice. So far they have been too quiet.

That is why Well­come, with the UN Foun­da­tion, UK, Thai and Ghana­ian gov­ern­ments, is host­ing a global call to ac­tion in Ber­lin this week. We have to make our re­sponse to this global threat move faster and with more fo­cus.

As we do so, we must also put our en­ergy into the other great chal­lenge with re­gard to an­tibi­otics: access. Around 385,000 ba­bies will be born to­day across the globe. Trag­i­cally, al­most half of them will die be­fore they reach 28 days of age. Those first weeks of life are in­cred­i­bly frag­ile, and in­fants born into the world’s poor­est com­mu­ni­ties are at great­est risk – al­though ad­vances in global health have led, in the 25 years to 2015, to death rates in neonates drop­ping from 5.1 mil­lion to 2.7 mil­lion a year.

An­tibi­otics could save so many more. Glob­ally, one in 10 new­borns dies from pneu­mo­nia or sep­sis, deaths pre­ventable with bet­ter access to ex­ist­ing an­tibi­otics and bet­ter con­trol of the spread of drug-re­sis­tant in­fec­tions.

In re­cent years, warn­ings of an­tibi­otic re­sis­tance, im­proper and overuse of an­tibi­otics and the dire need for new treat­ments have be­come fa­mil­iar. But what has of­ten been missing from this rhetoric is a fo­cus on im­prov­ing access to an­tibi­otics to all who need them. This com­plex mix­ture of bet­ter pre­scrib­ing twinned with bet­ter access is com­pli­cated and re­quires na­tions to act in a way which fits their needs.

To stop su­per­bugs un­der­min­ing mod­ern medicine, to pre­vent lives be­ing lost through lack of access to ef­fec­tive medicines, we must work to­gether. We can­not af­ford to de­lay.

Ed Whit­ing is di­rec­tor of pol­icy and chief of staff at the Well­come Trust

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