A Public Health Emergency of International Concern? Response to a Proposal to Apply the International Health Regulations to Antimicrobial Resistance

There is little question that the international spread of antimicrobial resistance (AMR) is an alarming development that the global public health community must confront as a matter of some priority. Reducing the incidence of new cases will take the concerted effort and participation of all community sectors, and will require strong political leadership. The World Health Organization (WHO) is best placed to lead the international community’s efforts to tackle this phenomenon, and as evidenced by the release of a new fact sheet on 21 February 2011 [1], the WHO Secretariat is acutely aware of the dangers microbial resistance presents. In the paper ‘‘A Call for Action: The Application of the International Health Regulations to the Global Threat of Antimicrobial Resistance’’ published this week in PLoS Medicine [2], Stephen Harbarth and colleagues make the case to utilize the revised International Health Regulations (2005) (IHR 2005) to encourage Member States to report all cases of AMR as they fulfil ‘‘at least two’’ of the criteria for a public health emergency of international concern (PHEIC). While I commend the authors for seeking to further the field of understanding relating to the interpretation, application, and implementation of the IHR, I disagree with their proposal. For reasons of brevity, I will outline just three reasons here.