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With More and more drugs are losing their ability to fight dangerous infections and few new drugs are being prepared, the world is facing an imminent crisis that could lead to millions of deaths, increased poverty in the world and a gap even bigger between the rich and the poor the UN in a report released Monday.
Drug-resistant infections already claim 700,000 lives a year, including 230,000 deaths due to drug-resistant TB, the report said. The widespread overuse of antibiotics and antifungal drugs in humans, livestock, and agriculture is accelerating a crisis poorly understood by the public and largely ignored by world leaders. Without concerted action, a United Nations sign According to him, resistant infections could kill 10 million people a year by 2050 and cause an economic slowdown comparable to the global financial crisis of 2008.
The problem threatens people all over the world. According to UN experts, 2.4 million people in Europe, North America and Australia could die of drug-resistant infections, making routine hospital procedures such as knee replacements and riskier deliveries that they are not today.
"This is a silent tsunami," said Dr Haileyesus Getahun, director of the United Nations Interagency Coordination Group on Antimicrobial Resistance, who spent two years reviewing the report. "We do not see the political momentum we have seen in other public health emergencies, but if we do not act now, antimicrobial resistance will have a disastrous impact from here. a generation. "
The group, in collaboration with public health experts, ministers and industry representatives, called for the creation of an independent body with the status and funding of the United Nations Expert Group on Change. climate.
The report's predictions are intended to raise public awareness and to encourage political leaders to take action. He proposes a series of measures that, according to health officials, could help stop the progression of drug-resistant pathogens. The recommendations include a global ban on the use of medically important antibiotics to promote the growth of farm animals; financial incentives for pharmaceutical companies to develop new antimicrobial compounds; and tighter rules to limit the sale of antibiotics in countries where drugs can often be purchased at convenience stores without a prescription.
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The report also highlights underestimated factors in the spread of drug-resistant germs: lack of clean water and inadequate sewage systems that claim millions of lives in the developing world. Many of them are too poor to consult a doctor and instead buy cheap antibiotics from street vendors who are not very specialized in the medical field. Sometimes they unconsciously buy counterfeit medicines, a problem that causes millions of deaths, most of them in Africa.
According to the report, to reduce the epidemics of infectious diseases, the richest countries should help poor countries to finance the improvement of public hygiene and to ensure better access to properly manufactured vaccines and antibiotics.
Health officials find it difficult to understand the extent of the problem as many countries are ill equipped to monitor drug-resistant infections. As part of a study by the United Nations for the report, 39 out of 146 countries have not been able to provide data on the use of antimicrobials in animals, which, according to experts, is an important factor of resistance in humans. while resistant bacteria are transmitted to humans through contaminated food and water.
"We fly pretty blind and work hard to have a clear vision," said Sally Davies, chief medical officer in England and head of the UN group.
As a first step, the report calls on UN Member States to develop national management plans to reduce the unnecessary use of antimicrobials.
A key element of the report is a call for new incentives to encourage the development of antimicrobial drugs. According to the World Health Organization, six new antimicrobial drugs were approved between 2010 and 2014, most of them added to existing drug classes. In contrast, 19 new antimicrobial the drugs were approved between 1980 and 1984.
The shortage of new drugs is linked to the perverse economic aspects of antimicrobial resistance and the free market. The development of a new compound can cost half a billion dollars, but doctors are discouraged from using these drugs to reduce the risk of resistance of targeted pathogens. Even when doctors prescribe medications, most patients take them for a week or two, which limits the ability of a pharmaceutical company to recover its initial investment.
"Everyone agrees on the absolute need for new antibiotics but there is no sustainable market," said Thomas Cueni, director general of the International Federation of Pharmaceutical Manufacturers and Associations.
Incentives to develop new drugs could include generous government funding for research or regulatory changes that would increase the reimbursement of newly approved antibiotics considered medically important. According to the World Bank, such investments would quickly pay off; he notes that containing antimicrobial resistance costs $ 9 billion a year.
"I congratulate the US government for at least putting incentives on the map, but it takes more than just discussion," said Cueni, who also chairs the AMR Industry Alliance, a professional group tackling the problem of antimicrobial resistance. "What is needed is money."
Nevertheless, many public health advocates said the report was an important step in the resolution of a crisis that failed to attract attention to other global issues. such as climate change and AIDS.
Lance Price, director of the Antibiotic Resistance Action Center at George Washington University, worries that the report is not very successful with the Trump administration, which opposes multilateral cooperation.
Fear, he said, was the key to changing the status quo.
"Even if you do not care about the suffering of people who drink dirty water and get resistant infections, you still have to recognize that these bacteria do not recognize international borders," he said. "They will come here and they will kill us. We need to let people know that the problem is more serious than they think. "
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