WHO report finds systems to combat antibiotic resistance lacking in all regions of the world

A quarter of countries that responded to a World Health Organization (WHO) survey have national plans to preserve antimicrobial medicines like antibiotics, but many more countries must also step up.

A new report, Worldwide country situation analysis: Response to antimicrobial resistance, which outlines the survey findings, reveals that while much activity is underway and many governments are committed to addressing the problem, there are major gaps in actions needed across all six WHO regions to prevent the misuse of antibiotics and reduce spread of antimicrobial resistance.

Antibiotic resistance is single greatest challenge in infectious diseases today

“This is the single greatest challenge in infectious diseases today,” says Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security. “All types of microbes—including many viruses and parasites—are becoming resistant to medicines. Of particularly urgent concern is the development of bacteria that are progressively less treatable by available antibiotics. This is happening in all parts of the world, so all countries must do their part to tackle this global threat.”

Issued a year after WHO’s first report on the extent of antimicrobial resistance globally, which warned of a ‘post-antibiotic era’, this survey—which was completed by 133 countries in 2013 and 2014—is the first to capture governments’ own assessments of their response to resistance to antimicrobial medicines used to treat conditions such as bloodstream infections, pneumonia, tuberculosis (TB), malaria and HIV. It summarises current practices and structures aimed to address the issue, and shows there are significant areas for improvement.

“While there is a lot to be encouraged by, much more work needs to be done to combat one of the most serious global health threats of our time,” says Dr Fukuda. “Scientists, medical practitioners and other authorities including WHO have been sounding the warning of the potentially catastrophic impact of ignoring antibiotic resistance. Today, we welcome what has been achieved so far, but much more needs to be done to avoid losing the ability to practise medicine and treat both common and serious illnesses.”

Sales of antibiotics and other antimicrobial medicines without prescription remain widespread

Key findings of the report include:

• Few countries (34 out of 133 participating in the survey) have a comprehensive national plan to fight resistance to antibiotics and other antimicrobial medicines.
• Monitoring is key for controlling antibiotic resistance, but it is infrequent. In many countries, poor laboratory capacity, infrastructure and data management are preventing effective surveillance, which can reveal patterns of resistance and identify trends and outbreaks.
• Sales of antibiotics and other antimicrobial medicines without prescription remain widespread, with many countries lacking standard treatment guidelines, increasing the potential for overuse of antimicrobial medicines by the public and medical professionals.
• Public awareness of the issue is low in all regions, with many people still believing that antibiotics are effective against viral infections.
• Lack of programmes to prevent and control hospital-acquired infections remains a major problem.

WHO, countries and partners have developed a draft Global Action Plan to combat antimicrobial resistance, including antibiotic resistance, which has been submitted to the sixty-eighth World Health Assembly, taking place in May 2015. Governments will be asked to approve the plan and, in doing so, declare their commitment to address a problem that threatens global health as we know it. One essential step in implementing the Global Action Plan would be the development of comprehensive national plans in countries where they are now lacking and further develop and strengthen existing plans.