A survey by the World Health Organization (WHO) paints a fairly bleak picture of global efforts to address antimicrobial resistance, with national programs often missing, patchy monitoring of the problem, widespread sales of the drugs without prescription, and low public awareness.
Conducted in 2013 and 2014, the survey showed "that while much activity is underway and many governments are committed to addressing the problem, there are major gaps in actions needed across all 6 WHO regions to prevent the misuse of antibiotics and reduce spread of antimicrobial resistance," the WHO reported in a statement.
The agency said 133 of 194 countries responded to the survey, conducted by questionnaire or interview. It is billed as the first survey to detail governments' own assessments of their response to resistance to antimicrobials used to treat conditions such as bloodstream infections, pneumonia, tuberculosis (TB), malaria, and HIV.
Its release comes a year after the WHO issued its first report on the global extent of antimicrobial resistance, which warned of the threat of a "post-antibiotic era."
Antimicrobial resistance "is the single greatest challenge in infectious diseases today, " Keiji Fukuda, MD, the WHO's assistant director-general for health security, said in the statement. "All types of microbes—including many viruses and parasites—are becoming resistant to medicines."
The WHO listed these as key findings of the survey:
- Only 33 of 134 responding countries have a comprehensive national plan to fight antimicrobial resistance.
- Monitoring of resistance is "infrequent," as many countries have poor laboratory capacity, infrastructure, and data management.
- Sales of antibiotics and other antimicrobials remain widespread, increasing the potential for overuse.
- Public awareness of the issue is low in all regions, with many people still believing that antibiotics are effective against viral infections.
- Lack of programs to prevent and control hospital-acquired infections is a major problem.
Among main findings noted for the six global regions are these:
- Africa (8 of 47 countries responding): All eight countries said resistance to malaria and TB drugs are their greatest challenges, with poor-quality medicines exacerbating the problem.
- The Americas (26 of 35 countries responding): Antibiotics are available over the counter in 18 countries, and just 10 had standard treatment guidelines.
- Eastern Mediterranean (13 of 21 countries responding): No country reported having a national action plan, and nine allow sales of antimicrobials without a prescription.
- Europe (49 of 53 countries responding): Forty percent of countries report having comprehensive plans, and all European Union members are monitoring resistance through a network supported by the European Centre for Disease Prevention and Control. But about half the population believe that antibiotics work against viruses.
- Southeast Asia (all 11 countries responding): Five countries have national plans, monitoring of antimicrobial use is limited, and the drugs are available without prescription in more than half the countries.
- Western Pacific (26 of 27 countries responding): Close to 70% of countries said they are monitoring antibiotic resistance, but only four countries have a national plan, and regulation of the sales of antimicrobials is weak.
The WHO said a draft global plan to address antimicrobial resistance will be presented at the World Health Assembly, the agency's annual member-state meeting, in May. "One essential step in implementing the Global Action Plan would be the development of comprehensive national plans in countries where they are now lacking and further develop and strengthen existing plans," the agency said.
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