By Timo Minssen
One of my previous blogs discussed the growing threat of antimicrobial resistance (AMR). I concluded that antimicrobial resistance is a growing and complex threat involving multifaceted legal, socio-economic and scientific aspects. This requires sustained and coordinated action on both global and local levels.
A recent medical review on drug resistant tuberculosis supports these findings and provides further fodder to the debate. In their study, which was published in April 2014 in The Lancet – Respiratory Medicine, the authors analyzed the epidemiology, pathogenesis, diagnosis, management, implications for health-care workers, and ethical and medico-legal aspects of extensively drug-resistant tuberculosis and other resistant strains. In particular, the authors discussed the increasing threat of functionally untreatable tuberculosis, and the problems that it creates for public health and clinical practice. The paper concludes that the growth of highly resistant strains of tuberculosis make the development of new drugs and rapid diagnostics for tuberculosis—and increased funding to strengthen global control efforts, research, and advocacy—even more pressing.
This was also recognized in the recent WHO’s Global Surveillance Report on AMR, which was published this April. It is the first WHO report that studied the problem of AMR on a global level. Noting that resistance is occurring across many different infectious agents, the report concentrates on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea. The results demonstrate a wide-spread growth of resistance to antibiotics, especially “last resort” antibiotics. In particular the report reveals that this serious threat is no longer a mere forecast for the future. AMR is a contemporary problem in every region of the world and has the potential to affect anyone, of any age, in any country. Consequently the WHO report concludes that antibiotic resistance is now a major threat to public health that needs to be tackled on a global level.
That something is indeed being done to tackle these problems on an international level is documented by the Progress report of the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR), which was published in May 2014. This report summarizes the progress and the outcomes with regard to 17 recommendations that were identified in an earlier TATFAR report to strengthen EU and US communication and cooperation in the area of AMR. These recommendations fall into three key areas: (1) appropriate use of antimicrobial drugs in medicine; (2) prevention of drug resistant infections; and (3) strategies to improve the pipeline of new antimicrobial drugs for use in human medicine. The report concluded that while significant progress has been made in these three key areas AMR continues to escalate. Therefore, the EU and US partners decided that the work of the TATFAR will continue for a period of at least two years. Major outcomes, such as consensus papers, meeting reports, and periodic progress reports, will be posted on the TATFAR website.
The extension of the TATFAR mandate is an important and necessary step that can only be welcomed. By re-affirming their commitment, the US and the EU can continue to work collaboratively through the TATFAR to effectively address the scientific and regulatory challenges related to this priority public health issue. But it is evident that any sustainable solution must also include other regions of the world and in particular the specific challenges in developing countries.