WHO Director-General briefs UN on antimicrobial resistance
Dr Margaret Chan
Director-General of the World Health Organization
Ambassadors, representatives of UN Member States, ladies and gentlemen,
The rise of antimicrobial resistance is a global crisis, recognized as one of the greatest threats to health today.
The threat is easy to describe. Antimicrobial resistance is on the rise in every region of the world. We are losing our first-line antibiotics. This makes a broad range of common infections much more difficult to treat.
Second- and third-choice antibiotics are more costly, more toxic, need much longer durations of treatment, and may require administration in intensive care units.
Superbugs haunt hospitals and intensive care units all around the world. Gonorrhoea, which is a sexually transmitted disease, is now resistant to multiple classes of drugs. An epidemic of multidrug-resistant typhoid fever is rolling across parts of Asia and Africa.
Even with the best of care, only around 50% of all patients with multi-drug resistant tuberculosis can be cured.
With few replacement products in the R&D pipeline, the world is heading towards a post-antibiotic era in which common infections will once again kill. If current trends continue, sophisticated interventions, like organ transplantation, joint replacements, cancer chemotherapy, and care of pre-term infants, will become more difficult or even too dangerous to undertake.
This may even bring the end of modern medicine as we know it. We need to act now to make sure this does not happen.
This is a crisis, and it is global. Resistant pathogens travel very well internationally in people, animals, and food. They can also spread directly from one person to another.
Compelling evidence shows that resistance is driven by the total volume of antibiotics used, also in food production. In some countries, more antibiotics are used in food production than in medical care.
A global action plan to tackle antimicrobial resistance was endorsed by all WHO Member States at last year’s World Health Assembly. The action plan, developed in close collaboration with our colleagues in FAO and OIE, recognizes that a crisis of this magnitude requires an effective One Health approach involving coordination among many national sectors and actors, and also different sectors and actors internationally.
I would like to add one other sector: foreign affairs. We need ambassadors to advocate, to talk to people, including well-informed consumers. We are beginning to hear that consumers are demanding meat that is not laced with antibiotics. They are prepared to pay a premium for high-quality meat as a contribution to good health.
What we need right now is to use the power that comes from political leaders. We need political commitment at the highest level of government. We need national action plans that amplify the global action plan.
We need ways to target all behaviours that contribute to the misuse of these fragile medicines. We should not blame any single sector. We are all in this together. We need ways to monitor progress and make quick course corrections if we are moving in the wrong direction.
Antimicrobial resistance, as I say again and again, is a slow-motion tsunami. It is a global crisis that must be managed with the utmost urgency.
As the world enters the ambitious new era of sustainable development, we cannot lose the hard-earned gains that your governments and your people achieved so admirably during the MDG era.
Thank you for giving us this opportunity to hear your concerns, to gather your advice, and to get guidance on the way forward.