BRUSSELS, December 5, 2018 (IPS) – Authorities from the European Union (EU) and international organizations urge aid to the poorest countries to address growing resistance to antibiotics, which threatens to become a "health tragedy" and at risk for sustainable development goals (ODS) in some parts of the world.
Antibiotic resistance has risen two-thirds in the last two decades, some studies indicate, and is responsible for the deaths of about 700,000 people a year worldwide.
But it is estimated that it will increase to 10 million people a year by 2050, which will cost about $ 100 trillion, unless governments redouble efforts to prevent it.
Antibiotics are used more and more often in both humans and animals, which means that bacteria generate resistance and antimicrobials stop fulfilling their function in some cases.
Doctors warn that the situation could make routine surgical operations more dangerous and that certain medical treatments, such as cancer, disappear completely.
Moreover, when a resistance appears in one place, it can spread rapidly to another, forcing the problem to be dealt with globally.
The member countries of the World Health Organization (WHO) have been integrated into a Global Plan of Action on Antimicrobial Resistance, multisectoral, in 2015, but progress has been uneven.
Some countries, especially in Europe, have progressed, but in other parts of the world, these are slow, if at all, which makes us fear that the problem will worsen in the poorest countries and the ODSs will not be attained.
EU Commissioner for Food Security and Health, Vytenis Andriukalitis, told IPS: "We need a global framework to tackle resistance in all regions, not just in Europe. will reach the ODS & # 39;
At the WorldOn the subject of antibiotics in November, the scale of this problem in developing countries was highlighted.
A study by the Organization for Economic Co-operation and Development (OECD) found that average resistance was 17 percent in OECD countries in 2015, rising to 42 percent in India, China and Russia and reaching 90 percent. for some combinations of antibiotics and bacteria.
Resistance could multiply between four and seven percent in some low- and middle-income countries, compared with OECD countries, and in countries with fragile health systems, could cause a "huge" number of deaths. deaths, especially among newborns, children under five and older adults.
Another study by ETH Zurich earlier this year, the University of Antwerp and Princeton University, indicates that the use of antibiotics in humans increased by 65% between 2000 and 2015, but in low- and middle-income countries it was 114%. .
The development of new antibiotics is complex since decades have passed since the last classes created, and the greatest effort in the fight against antimicrobial resistance is focused on prevention.
The Global Plan of Action is based on a multisectoral approach and requires governments to adopt national plans, which include measures of greaterunderstanding, monitoring, administration, prevention and control.
But in many developing countries, lack of funds in the health and animal industry, as well as weak laws and compliance with laws, are major barriers to the effective implementation of effective measures.
In India, for example, where an estimated 120,000 babies die each year from sepsis caused by resistant bacterial infections, doctors argue that the main factors responsible for resistance are the sale of antibiotics in the over-the-counter market and the lack control. infections in overcrowded health centers.
But proponents of the sale of antibiotics in pharmacies say it is essential to continue because of the serious shortage of doctors in many areas.
The government has tried to limit free trade, even if it is the so-called last resort antibiotics used when others fail, but the measure, which includes a red line in drug boxes to alert people, has not been effective. .
Regarding the use of antibiotics in the animal industry, the European Commission notes that in Europe, 70% of antimicrobials are destined for animal production. A similar number occurs in the United States, while it exceeds 50% in China.
Monitoring the use of antibiotics in the animal industry in poorer countries is often more difficult.
"It is extremely difficult to enforce the laws unless they are very good and there is a system of control," Nedret Emiroglu, director of the WHO program for Europe, told IPS.
The Indian government has approved a national plan of action for antimicrobial resistance for a year and a half, however, critics argue that laws and networks to control the use of antibiotics for the growth of animals and monitor the sale and use of the same in food production, in fact, does not exist or is not effective.
The WHO noted that many low- and middle-income countries may need long-term development assistance to implement their plans effectively and sustainably.
"We need economic support for low- and middle-income countries," Emiroglu confirmed. This is essential to ensure that progress in one region of the world is not hampered by lack of progress in another, he said.
"The measures have to be different for different countries, especially when we speak of poor states. You can not compare India to Liberia, "Andriukalitis said in a conversation with IPS.
"In some countries they have problems getting simple antibiotics, but in others there are problems because people self-medicate without proper control," he said.
"In some places, there is a lack of basic understanding of hygiene and sanitation issues. We need long-term local strategies for different countries, "he added.
Prolonged hospitalizations due to the slow recovery of patients and the increased risk of complications would mean a great weight for already demanded health systems, higher mortality and quality of life.
Economies will suffer the impact of failing to meet predictions that antimicrobial resistance would mean a 3.8% drop in global gross domestic product by 2050.
In addition, resistance makes disease care more expensive and, as universal health coverage is limited in many poor countries and people have to disburse for treatment, the higher cost as well as the loss of income due to morbidity and mortality could aggravate the poverty of many people and families.
For her part, the director of the European Center for Disease Control and Prevention, Andrea Ammon, told IPS: "In order to achieve (the third of) ODS, antimicrobial resistance is not the only issue to be addressed, but it is a problem. fundamental factor.
"The high degree of antimicrobial resistance indicates that several elements of a health system do not function satisfactorily due to several factors," he explained.
Responsible factors may be cultural values, patient and health provider behaviors, regulatory issues, such as the availability of over-the-counter drugs in pharmacies or infection control. These elements may also prevent other ODS third-party objectives from being achieved, "he warned.