THE UNITED Nations General Assembly will hold its first high-level meeting Wednesday on the growing problem of antimicrobial resistance — the tendency of bacteria to fight back against antibiotics. This is a rare example of the world body devoting time to a public-health issue, and though concrete results may be a long way off, the event itself suggests a stirring awareness that it is a global threat.
Antibiotics were truly “wonder drugs” when created in the middle of the 20th century, and they became a pillar of modern medicine. But it has been known for decades that bacteria evolve to fight the drugs, and that overuse and abuse of antibiotics in human health and agriculture have stimulated resistance. Now the point has been reached where some antibiotics have lost their efficacy. Warnings of a looming post-antibiotic era, when a sore throat or a playground scratch could again lead to life-threatening infections, must be taken seriously. To make matters worse, the pipeline of new antibiotics has been running dry.
The United States and Britain have focused high-level attention on the growing threat in the past few years, but the rise of antimicrobial resistance transcends any one country. Superbugs — resistant to more than one antibiotic — are leapfrogging around the world. Last year, Chinese researchers reported finding a “major increase” in resistance to the antibiotic colistin. The resistance mechanism is mobile and can be transferred from one bacterium to another. Soon it started showing up in other countries, too.
The point is that what happens in China does not stay in China. While colistin has been used on farm animals in China, it has been a last-resort antibiotic for people in the United States and elsewhere. Losing it would leave another hole in the antibiotic armamentarium. China, the world’s largest consumer of antibiotics, has recently launched an action plan on resistance, and none too soon.
Antimicrobial resistance is about more than human health. It also involves difficult questions that affect agriculture and the environment. The U.N. General Assembly, with heads of state present, seems like the right place to debate a more concerted and broad response. The session ought to impress world leaders on the need for better stewardship of antibiotics in human health and for farm animals; improved diagnostics to help determine when people really need them and when they don’t; better surveillance of infectious diseases; and methods to stimulate the discovery and development of new antibiotics for all.
Later, it will be important to set targets for action and provide funding to track them. As in climate change, this is a real problem that affects everyone in the long run but is too easy to ignore today. If the United Nations meeting raises awareness about the risks of not taking action, it will be a worthwhile start.
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