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The Ethics of Fighting Drug Resistance

The fight against antimicrobial resistance is based on an ethical imperative to protect human, animal, and environmental health, not just today, but for future generations. And yet tackling AMR poses its own ethical challenges and dilemmas, which policymakers need to address sensibly, transparently, and urgently.

GOTHENBURG – In 2014, the World Health Organization reported that drug resistance – especially resistance to antibiotics – is a growing threat to human health, food security, and “the achievements of modern medicine.” Far from being an “apocalyptic fantasy,” the WHO said, a post-antibiotic era “is instead a very real possibility for the twenty-first century.”

Drug resistance threatens the effective treatment of a growing list of communicable diseases – from bacterial infections to viral to and fungal diseases. When people recklessly use antibiotics to fight a common cold, when farmers use antibiotics to boost livestock productivity, or when pharmacological factories emit antibiotics into the environment to cut production costs, the bacteria that the drugs are designed to kill become immune. The more antibiotics consumed and emitted, the faster resistance develops, leading to “superbugs” that jeopardize human health, both by raising the risk of massive deadly epidemics and by compromising medical services, such as surgery and cancer treatment, that rely on effective antibiotics.

This scary reality continues to frustrate health-care professionals. To be sure, there are solutions to the drug resistance crisis: restricted consumption, better diagnostics and disease surveillance, and expanded clinical development of new drugs are three. And some initial coordinated action has been taken in the WHO global action plan. But every fix has an ethical component, and four years after the WHO’s assessment, the ethical roadmap for addressing this medical emergency remains dangerously ill-defined.

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