Global need for antibiotics, and antibiotic resistance

Along with clean water, sanitation, and vaccines, antibiotics were responsible for the vast improvements in health and longevity in high-income countries over the past century. The critical question is how we can responsibly scale up access to antibiotics in low- and middle-income countries (LMICs) while minimizing the threat of resistance and prolonging their effectiveness.

1 Laxminarayan R.

et al. Antibiotic resistance – the need for global solutions. 2 Van Boeckel T.P.

et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Antibiotic resistance has often been compared to climate change in its scope and scale []. Actions undertaken by any single country have the potential to adversely (or positively) affect other countries. For example, improved water, sanitation, vaccination, and pharmaceutical regulation in India can have global benefits if this results in reducing selection pressure for resistant strains of bacteria to evolve and spread elsewhere, such as with the notorious New Delhi metallo-beta-lactamase (NDM)-1. Unlike the uniform global increase in carbon dioxide levels caused by fossil fuel burning, however, the effects of antibiotic use on resistance levels are as much local as they are global, and effective conservation measures benefit the local population directly as well as contributing to the global good. Use of antibiotics is growing in LMICs, particularly in the BRICS (Brazil, Russia, India, China, and South Africa) countries []. LMICs are likely to be the hardest hit by declining effectiveness of antibiotics because of their greater burden of infectious disease in both human and animal populations, the lack of access to affordable second- and third-line antibiotics, and because of suboptimal infection-prevention measures in hospitals and communities.