Drug Misuse Hastening Rise Of Resistant Diseases: WHO

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Drug misuse hastening rise of resistant diseases: WHO

By Pongphon Sarnsamak

The Nation

The problem of disease becoming more and more resistant to medicine is a serious threat to public health after more than 440,000 new cases of multi-drug-resistant tuberculosis were reported in 69 countries, according to the World Health Organisation.

"Though drug resistance is a natural phenomenon, the inappropriate use of medicines through over-prescription and misuse has accelerated the development of drug resistance to the point that we may lose our most effective medicines," said Dr Maureen Birmingham, WHO representative to Thailand.

She spoke yesterday at the Public Health Ministry to mark World Health Day 2011, which emphasises key policies and moves to fight drug resistance.

Dr Birmingham said last year about 440,000 new cases of multi-drug-resistant tuberculosis (TB) were detected, and it had now been found in 69 countries.

The malaria parasite was also acquiring resistance to the latest generation of medicines, as was HIV, the virus that causes Aids.

Some infections contracted in hospitals can become life-threatening when they are resistant to medicines.

"In our mobile society, drug-resistant micro-organisms can spread very far, very rapidly," she said.

WHO director-general Dr Margaret Chan said early this month that the emergence and spread of drug-resistant pathogens had accelerated. "More and more essential medicines are failing. The therapeutic arsenal is shrinking. The speed with which these drugs are being lost far outpaces the development of replacement drugs. In fact, the research-and-development pipeline for new anti-microbials has practically run dry.

"The implications are equally clear," Chan said. "In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, will kill unabated.

"The implications go beyond a resurgence of deadly infections to threaten many other life-saving and life-prolonging interventions, such as cancer treatments, sophisticated surgical operations, and organ transplants. With hospitals now the hotbeds for highly resistant pathogens, such procedures can themselves be life-threatening."

In Thailand, the Public Health Ministry's permanent secretary Dr Paijit Warachit said the Medical Science Department had conducted a nationwide surveillance of drug-resistant cases over 10 years and found a high level of resistance to antibiotics.

The level of resistance to penicillin by Streptococcus pneumoniae had increased from 47 per cent in 1998 to 64 per cent last year. Erythromycin resistance was also increased, from 27 per cent in 1998 to 54 per cent in 2010.

The bacterium Acinetobacter baumannii, which can cause infections in hospitals, has been found to be resistant to carbapenems. The level of resistance to this drug has increased from 2.1 per cent in 2000 to 63 per cent in 2010. Acinetobacter baumannii has also been found to resist cefoperazone, the latest weapon against the bacterium.

The WHO has introduced five key mechanisms to fight drug resistance: developing and implementing a comprehensive, well-financed national plan, strengthening surveillance and laboratory capacity, ensuring uninterrupted access to essential medicines of assured quality, regulating and promote rational use of medicines, and enhancing infection prevention and control.

"Much of this work is underway in Thailand, but much more remains to be done," Birmingham said.

She said pharmacists and doctors should only prescribe and dispense drugs that are required for treatment, and patients should not demand they be given the newest or best-known antibiotics.

"Patients can also ensure that they take the right dose of the right medicine for the right duration."

-- The Nation 2011-04-26