Drug resistance 'is major threat to poor nations'

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Multidrug-resistant tuberculosis bacteria infect thousands of people a year CDC/Janice Haney Carr
Multidrug-resistant tuberculosis bacteria infect thousands of people a year
CDC/Janice Haney Carr

[MANILA] The increasing number of drug-resistant infections is of particular threat to public health in developing countries as they have limited resources to fight their spread, health experts have warned at a conference in Bangkok, Thailand, earlier this month (4–6 February).

The two-day forum Antimicrobial Resistance: Challenges of the 21st Century, gathered together global researchers and clinicians involved in infectious disease prevention and control. The aim is to create an integrated approach on research on resistant diseases and learn more about new drugs for emerging infections.

“There are increasing reports of bacterial, viral and parasite resistance to antimicrobials .. and very few new antibiotics in the pipeline and drug companies are investing less and less in antimicrobial drugs,” Laurent Rénia, a principal investigator at the Singapore Immunology Network, tells SciDev.Net: .

Emerging economies suffer most from the rising incidence of antimicrobial resistance as bacterial diseases are the major killers in low-income countries, he says.

“The increase in resistance will lead to more mortality and morbidity, and thus will be an extra burden on the health budget of these countries,” Rénia says.

For example, about 440,000 cases of multidrug-resistant tuberculosis emerge each year according to data from the WHO. And in most parts of Asia and Africa where malaria is endemic, resistance to earlier-generation antimalarial medicines such as chloroquine and sulfadoxine-pyrimethamine is widespread.

Factors that have led to antimicrobial resistance, include inappropriate antibiotic use and inadequate systems to ensure the quality and uninterrupted supply of medicines, according to the WHO.

Another problem is that poor patients often lack the money for vital medicines. This is illustrated by Cambodia, where the high poverty rate means that most of its citizens are unable to afford antibiotics.

In a report presented at the conference, Erika Vlieghe, a clinical infectologist at the Institute of Tropical Medicine (ITM), Belgium, noted the increasing rate of drug-resistant E. coli, Salmonella and melioidosis in Cambodia.

To help stop the spread of these infectious diseases the Cambodian government turned to aid agencies and international development organisations to supplement their cash-strapped health programmes, Vlieghe said.

The US Agency for International Development, the WHO and ITM, for instance, helped Cambodian health officials conduct national workshops on infectious diseases, draft guidelines on infection control and train nurses, microbiologists and midwives.

Rénia says there is now a need for multiple, concerted approaches to improve bacterial resistance amid limited resources in developing countries.

He suggests that more people should be educated on the proper use of antibiotics, new and affordable ways to diagnose drug-resistant parasites should be developed and a regulatory agency to control antimicrobial distribution and quality should be established. (Prime Sarmiento/SciDev)

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