Smith Richard D, Coast Joanna
Health Economics Group, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, England.
Bull World Health Organ. 2002;80(2):126-33.
Resistance to antimicrobial therapies reduces the effectiveness of these drugs, leading to increased morbidity, mortality, and health care expenditure. Because globalization increases the vulnerability of any country to diseases occurring in other countries, resistance presents a major threat to global public health, and no country acting on its own can adequately protect the health of its population against it. International collective action is therefore essential. Nevertheless, responsibility for health remains predominantly national. Consequently, there is a potentially significant disparity between the problems and solutions related to antimicrobial resistance and the institutions and mechanisms that are available to deal with them. This paper considers the capacity of national and international institutions and mechanisms to generate a collective response to antimicrobial resistance. Strategies for containing resistance are outlined, with particular reference to globally coordinated activities of countries. The adequacy of national and international responses to resistance is assessed, and the actions that international bodies could take to solve difficulties associated with present responses are highlighted. Approaches are suggested for securing international collective action for the containment of antimicrobial resistance.
对抗菌治疗产生耐药性会降低这些药物的疗效，导致发病率、死亡率上升以及医疗保健支出增加。由于全球化使任何国家都更容易受到其他国家出现的疾病的影响，耐药性对全球公共卫生构成了重大威胁，任何一个国家单独行动都无法充分保护其民众的健康免受其害。因此，国际集体行动至关重要。然而，卫生责任仍主要由各国承担。因此，与抗菌药物耐药性相关的问题和解决方案与可用于应对这些问题的机构和机制之间可能存在重大差距。本文探讨了国家和国际机构及机制对耐药性产生集体应对措施的能力。概述了控制耐药性的策略，特别提及各国全球协调的活动。评估了国家和国际对耐药性的应对措施是否充分，并强调了国际机构为解决当前应对措施相关困难可采取的行动。提出了确保国际集体行动以控制抗菌药物耐药性的方法。
