Abstract
Antimicrobial drug resistance (AMR) is increasing rapidly worldwide, causing an estimated 700,000 deaths annually over the past decade, en route to becoming the leading global threat to public health by 2050 with an estimated 10 million deaths per year (more than heart disease, cancer, and stroke), while reducing global wealth by US$100 trillion. Yet AMR has not received the attention and action required to change this trajectory. Appropriate infection prevention and control (IPC) measures are needed to prevent transmission of infections to healthcare workers (HCWs), other patients, families, and the general public. In this review, we discuss a notable case study of AMR: highly drug-resistant tuberculosis (TB) has emerged repeatedly over the past 70 years as new drugs have been introduced, leading to new diagnostics, therapeutics, funding, public health strategies, and, in high-income countries, effective IPC measures that curtailed transmission. We review current efforts to control and prevent AMR using the example of drug-resistant tuberculosis to highlight important themes including laboratory systems, surveillance, control and prevention of healthcare-associated infections (especially among HCWs), better coordination across disciplines and diseases, and powerful advocacy/social change initiatives grounded in social and behavioral sciences. These strategies are the foundation of an effective response to the AMR threat to public health.
Highlights
The global advance of pathogenic microbes with resistance to all or most antimicrobial drugs is a major threat to public health
In 2016, the Political Declaration of the High-Level Meeting on Antimicrobial Resistance of the United Nations (UN) General Assembly represented a major milestone in confronting antimicrobial drug resistance (AMR) globally, leading to an Interagency Coordination Group on Antimicrobial Drug Resistance that focused on human medicine, animal husbandry, veterinary medicine, research and innovation, the pharmaceutical industry, and antimicrobial contamination of the environment – a One Health approach to AMR [5, 11, 34,35,36,37,38]
To address the threat of occupational risk among healthcare workers (HCWs) and of AMR more broadly, lowand middle-income countries (LMICs) could benefit from the experience gained with infection prevention and control (IPC) and antibiotic stewardship programs in countries that have already implemented cost-effective measures
Summary
The global advance of pathogenic microbes with resistance to all or most antimicrobial drugs is a major threat to public health. We review global efforts to prevent and control AMR using drug-resistant TB as a case study to highlight crucial themes, including laboratory systems and surveillance, control and prevention of HAIs (especially among healthcare workers, HCWs), better coordination across disciplines and diseases, and powerful advocacy/social change initiatives grounded in social and behavioral sciences.
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