Antimicrobial resistance: a priority for global health action

Editorials 439 From the earliest days of antibiotics, scientists have warned that without careful management of the way these powerful drugs are used, pathogens could quickly develop defences against them. Today, an-timicrobial resistance is spreading faster than ever, threatening the effectiveness of many of our most important weapons against infections. 1 Convened by the Foreign Policy and Global Health Initiative group of nations, 2 experts met in Oslo, Norway in Novem-ber 2014 to consider ways to reverse the dangerous spread of resistance to antibiotics and other antimicrobial medicines. As ministers charged with safeguarding the health of the public, we view this as a top priority. In an increasingly interconnected world, the challenge of combating anti-microbial resistance cannot be addressed by individual countries acting alone. We have therefore actively supported efforts by the World Health Organization (WHO) to develop a global action plan to combat antimicrobial resistance. 3 While antimicrobial medicines also play an important role in agriculture, 4 their essential function is to protect human health. Our focus is on ways to improve the stewardship of these critical medicines so they will maintain their usefulness. We recognize the burden faced by those living in poverty in low-and middle-income countries, who have limited access to these medicines, often at prices they cannot afford, forcing them to skimp on treatment courses. This puts them at particular risk from infections. Accordingly, we must simultaneously address issues of access along with improved stewardship and strengthened policies for the rational use of antimicrobial medicines. The Oslo meeting recommended that: everyone should have access to appropriate, effective and affordable antimicrobial medicines in a timely manner ; the use of antimicrobials needs to be well regulated and based on medical need and appropriate diagnosis; inappropriate, unnecessary and dangerous use of these medicines must be actively discouraged; manufacturers and marketers of these medicines should become active partners in furthering appropriate use and stopping excessive and inappropriate use; the direct marketing to consumers of antimicrobial medicines by manufacturers , importers and distributors should be forbidden or tightly controlled. 5 We are committed to combating the scourge of low-quality antimicro-bial products, which risks poor health outcomes for their users as well as the spread of antimicrobial resistance. WHO has a role as the platform for discussions on this problem in the interest of public health, in particular through the SSFFC (substandard/spurious/falsely-labelled/ falsified/counterfeit medical products) Member State mechanism. We will work …