Centre for Disease Dynamics, Economics & Policy, New Delhi, India; Princeton Environmental Institute, Princeton University, Princeton, NJ, USA.
Institute for Environmental Decisions, Swiss Federal Institute of Technology in Zurich, Zurich, Switzerland.
Lancet Infect Dis. 2020 Apr;20(4):e51-e60. doi: 10.1016/S1473-3099(20)30003-7. Epub 2020 Feb 11.
In 2013, a Lancet Infectious Diseases Commission described the state of antimicrobial resistance worldwide. Since then, greater awareness of the public health ramifications of antimicrobial resistance has led to national actions and global initiatives, including a resolution at the high-level meeting of the UN General Assembly in 2016. Progress in addressing this issue has ranged from a ban on irrational drug combinations in India to commitments to ban colistin as a growth promoter in animals, improve hospital infection control, and implement better antimicrobial stewardship. Funds have been mobilised, and regulatory barriers to new antibiotic development have been relaxed. These efforts have been episodic and uneven across countries, however. Sustained funding for antimicrobial resistance and globally harmonised targets to monitor progress are still urgently needed. Except for in a few leading countries, antimicrobial resistance has not captured the sustained focus of national leaders and country-level actors, including care providers.
2013 年,柳叶刀传染病委员会描述了全球抗微生物药物耐药性的状况。自那时以来,人们对抗微生物药物耐药性对公共卫生的影响的认识不断提高,促使各国采取行动并发起全球倡议,包括 2016 年联合国大会高级别会议通过的一项决议。在解决这一问题方面取得了一些进展,包括印度禁止不合理的药物联合使用,承诺禁止黏菌素在动物中作为生长促进剂,改善医院感染控制,以及实施更好的抗微生物药物管理。已经筹集了资金,并放宽了新抗生素开发的监管障碍。然而,这些努力在各国之间是间歇性的且不平衡的。仍然迫切需要为抗微生物药物耐药性提供持续的资金,并制定全球协调一致的目标来监测进展情况。除了少数几个领先国家外,包括医护人员在内的各国领导人及国家一级行为体并没有持续关注抗微生物药物耐药性问题。