SEA/RC63/11 - Prevention and containment of antimicrobial resistance
AbstractDuring the past six decades antimicrobial agents have played a critical role in reducing the burden of communicable diseases all over the world. The emergence of resistance and its rapid spread is negating the impact of these drugs, obstructing progress towards achievement of the Millennium Development Goals for HIV, TB and malaria and hindering effective application of modern technologies in mitigating human misery. While appearance of resistance is a continuous phenomenon in microorganisms, its amplification and spread is through an array of practices conducted by human beings. Improper utilization of antimicrobial agents especially in high disease-burden settings and for non-therapeutic use as in the veterinary sector result in strong selection pressure that allows the resistant strain to grow and rapidly replace the susceptible isolates. Diseases due to resistant organisms take longer to heal, require expensive and at times toxic drugs for longer periods, often making the disease untreatable. The resistant organisms can also move across countries through travel and trade. In that sense, antimicrobial resistance is a global challenge requiring concerted efforts at national and international levels to preserve the available antimicrobial agents. This is possible through treatment policies such as combination therapy, rational prescription, patient adherence, strong regulatory mechanism and educational activities, along with an efficient surveillance system that monitors the emergence and spread of resistance, as well as the utilization of antimicrobial agents. To facilitate this activity at country level, WHO has developed a strategy that is simple, practical and easy to scale up. The regional strategy aims to give particular attention to interventions involving the introduction of legislation and policies governing the use of antimicrobial agents, establishing laboratory-based networks for surveillance of resistance and ensuring the rational use of these drugs at all levels of health-care settings. The effective implementation of this strategy by various national disease control programmes will lead to reduction in the morbidity and mortality due to antimicrobial-resistant infection, and preserve the effectiveness of antimicrobial agents in the treatment and prevention of microbial infections. The High-Level Preparatory (HLP) Meeting held at the Regional Office in New Delhi from 28 June to 1 July 2010 reviewed the working paper and made the following recommendations: Actions by Member States (1) Establish a nationally coordinated, multisectoral alliance against antimicrobial resistance (AMR) with a designated focal point in the Ministry of Health. (2) Strengthen national surveillance mechanisms for AMR. (3) Initiate and sustain awareness and educational activities for prescribers and users of antimicrobials for their rational use. Actions by WHO-SEARO (1) Provide technical support in development of national governance mechanisms and surveillance networks in accordance with the regional strategy on AMR. (2) Facilitate sharing of knowledge and information between and among countries of the SEA Region and with other regions. (3) Develop technical and educational material that can be adapted by Member States. The working paper and the HLP meeting recommendations based on it are submitted to the Sixty-third Session of the Regional Committee for its consideration. The Committee is also requested to consider the draft resolution on the subject.
World Health Organization, Regional Office for South-East Asia. (2010). SEA/RC63/11 - Prevention and containment of antimicrobial resistance. WHO Regional Office for South-East Asia. http://www.who.int/iris/handle/10665/128387