Esmita Charani looks at the global issues presented by antimicrobial resistance and considers the strategies and policies that need to be created and properly implemented to tackle the problem at a local level in communities around the world.
Image credit: Illustration by Candice Bonaconsa, PhD Candidate University of Cape Town ([email protected]) and Dr Oluchi Mbamalu, Postdoctoral researcher at University of Cape Town ([email protected]).
Antimicrobial resistance (AMR) has become an ever-increasing threat to health and wellbeing. Infections caused by drug-resistant bacteria are becoming more common and much more difficult to manage. Whilst the emergence of AMR is an evolutionary process, it is undisputed that the overuse and misuse of antibiotics in human and animal health, agriculture, aquaculture and their presence in the environment is one of the key drivers for AMR in human populations. To manage this threat collective efforts are needed globally and across the human, animal and environment sectors as part of One Health approach. Whilst it is acknowledged that the new antibiotic pipeline needs investment, this is only part of the solution. Unless sustainable strategies to optimise the use of new and existing agents are implemented, no matter how many new drugs are brought to market, AMR will continue to pose a threat.
As part of a research roadmap developed in collaboration with the Wellcome Trust, the inequities in the current funding mechanisms in human health in relation to AMR highlight that there is a disproportionate amount of funding dedicated to technology development and technology evaluation, with less funding being channelled for implementing effective policy and strategy, implementing better surveillance systems, and understanding the contextual and cultural drivers of AMR. These are important gaps which need to be addressed if we are to achieve sustainable change in AMR. The areas of policy, surveillance and behaviour are critical to measures needed to manage AMR.
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