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A Fair Fight Against Antimicrobial Resistance

Combating anti-microbial resistance will require not only major investments in the research and development of new drugs, but also a system in which new treatments are controlled and restricted. Only if we manage antibiotics in a fair and sustainable way will we be able to benefit from them at all.

BRIGHTON – Existing anti-microbial drugs are becoming ineffective. If current trends continue, we could end up reliving conditions before the discovery of antibiotics, when infectious diseases were major killers.

Meeting the challenge of drug-resistant microbes will be difficult. It will require not only major investments in research and development of new anti-microbial drugs, but also a system to control and restrict new treatments, in order to preserve their efficacy. As with the response to climate change, an effective strategy will require international coordination. In particular, the needs of pharmaceutical companies must be reconciled with those of government payers and the global poor.

Indeed, engaging the poor will be crucial to any effort. Low- and middle-income countries are an important source of drug-resistant organisms. Crowded housing, poor sanitation, and compromised immune systems, whether owing to malnutrition or chronic infections such as HIV, provide fertile ground for contagion. Antibiotics are often misused or low-quality, providing bacteria the opportunity to develop resistance. Large volumes of antibiotics are also used in animal husbandry. Meanwhile, greatly improved transportation infrastructure – between rural and urban areas and between countries – means that resistant genes quickly become part of a global pool.

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