The way forward
The report stresses that antibiotic stewardship (reducing the inappropriate and unnecessary use of antibiotics) is key to controlling antibiotic resistance. It lays out 6 strategies that should be incorporated in national antibiotic policies to halt its spread: (i) Reduce antibiotic need through improved water, sanitation and immunization; (ii) Improve hospital infection control; (iii) Dis-incentivize antibiotic overuse/misuse and incentivize antibiotic stewardship; (iv) Reduce and phase out subtherapeutic antibiotic use in agriculture; (v) Educate health professionals, policy makers and the public on sustainable antibiotic use; and (vi) Ensure political commitment to meet the threat of antibiotic resistance.
The report advises that limiting overuse and misuse of antibiotics are the only sustainable solutions. "A rampant rise in antibiotic use poses a major threat to public health. We need to focus 80% of our global resources on stewardship and no more than 20% on drug development. No matter how many new drugs come out, if we continue to misuse them they might as well have never been discovered," said Ramanan Laxminarayan, Director, CDDEP and co-author of the report.
One major drawback to focusing on drug development as a solution is that new antibiotics are significantly more expensive than those currently available--and hence unaffordable for most people in low and middle-income countries. "When it comes to antibiotic-resistant infections, the rich pay with their wallets and the poor pay with their lives," said Laxminarayan.
There is still hope to conserve antibiotic effectiveness for future generations. In May 2015, the World Health Assembly has endorsed the Global Action Plan on Antimicrobial Resistance, which calls on all countries to adopt national strategies within two years. The new CDDEP report could help countries take coordinated and research-backed action to alleviate the problem.
Instead of being the default treatment for mild ailments--like coughs, colds, and uncomplicated diarrhea-- antibiotics must be treated as precious life-saving medicines, to be used rationally under medical supervision when needed.
Shobha Shukla, Citizen News Service -- CNS
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