On April 7th, each year, is observed the World Health Day. Today, the World Health Organization main issue is fighting against the spread of antimicrobial resistance.
Why do microorganisms acquire resistance to the drugs?
Bacteria, viruses or parasites are microorganisms which can acquire resistance to standards treatment (such as antibiotics, antivirals, and antimalarials) when they mutate or acquire a resistance gene . As a consequence, infections can spread overwhelmingly.
In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated. Dr. Margaret Chan, WHO Director General
Originally, antimicrobial medicine treat diseases such as leprosy, tuberculosis, gonorrhea and syphilis. But this is a natural biological phenomenon over time which microorganisms acquire resistance to the drugs meant to kill them. Moreover, the exchange of resistance gene between different bacterial populations linked with the strong mobility of populations in the world amplify the phenomenon. The resistance to antiretroviral medicines for AIDS treatment is an emerging concern for researchers because HIV is evolving very quickly. Owing to FHDH, in France, 80 per cent of HIV treatment failure are viruses resistant to antiretroviral.
Underuse, overuse or misuse of infection-fighting drugs (antibiotics for a cold, sharing one prescription, etc.) is a factor of antimicrobial resistance development.
Also, the use of disinfectants with antibacterial agents raises a cross-resistance to antimicrobial human drugs.
What about Arab World?
Some cases of extensively drug-resistant tuberculosis (also called XDR-TB) were reported, especially in Iran.
Prevalence of multi resistant tuberculosis among the new tuberculosis cases from 1994 to 2002, and countries with at least one case of ultra resistant tuberculosis (January 2007)
Source : Maladies infectieuses en pratique ambulatoire, Cristina Bellini, Laurence Senn, Giorgio Zanetti
MDR-TB : multi resistant tuberculosis ; XDR-TB : ultra resistant tuberculosis.
On February, ArabNews bear us in mind the very progress made in the research for a better vaccination against tuberculosis in the Middle-East. A partnership with UE Parliament has embolden vaccination campaigns. A recent study lead in the UAE shown some cases of resistance. Because the prevalence is growing among local population -and not only among exogenous unskilled labor from South Asia, public policy must be strengthened. As said AME agency, migration flows of immigrant labor is a priority of public health policy and epidemiological monitoring.
This World Health Day must help people to become aware of the serious nature of the misuse of antimicrobial drugs. WHO identifies 6 points to pay attention:
- develop and implement a comprehensive, financed national plan
- strengthen surveillance and laboratory capacity
- ensure uninterrupted access to essential medicines of assured quality
- regulate and promote rational use of medicines
- enhance infection prevention and control
- foster innovation and research and development for new tools.
Nevertheless, when we discovered in 2008 in Atlit-Yam in Israël the skeleton of a woman, who lived 9.000 years ago and who died of tuberculosis, we understand that tuberculosis is a very old plague. But will drugs have the last word?
