The theme of World Health Day in 2011 is "Antimicrobial resistance: no action today, no cure tomorrow" That action must include the conservation of biodversity and improved environmental performance by the health care sector.
The number and diversity of drug resistant pathogens is increasing. Research has shown that drug-resistant infections account for a large number of emerging infectious diseases in the past 30 years, and that mutli-drug resistance (when an infection shows resistance to a range of drugs normally used to treat it) is a serious and growing concern.
The World Health Organisation warns that drug resistance is caused by the inappropriate use and over-use of antimicrobials, including the non-therapeutic use of antibiotics as growth promoters in agriculture.
The risk of resistance is also increased by the routine disposal of drugs and drug residues. The release of antimicrobial drugs into the environment from human use and manufacturing, veterinary applications, disposal at landfill, or use in aquaculture, increases exposure of microbes to those drugs, and therefore increases the potential for the development of drug resistance. Research has shown that pollution is an important risk factor, and that drug resistant microbes are found in nature and can be carried by wildlife, particularly by animals associated with agriculture or human settlements.
The WHO also warns us that the number of new antimicrobial drugs currently in development is too limited and that new drugs are not coming on stream fast enough to counter the growing need for new antimicrobial products.
Biodiversity - the variety of living organisms, their genetic make-up and the living systems which they create - has provided the foundations of medicine and a priceless store of medicinal compounds for centuries. The continuing loss of biodiversity (particularly the extinction of species and loss of genetic variety) threatens the development of future drugs, including antimicrobial products. Only a tiny proportion of the world's biodiversity has been investigated for medicinal potential, or even identified.
It is widely held that the decline in output from the pharmaceutical sector since the mid-1980s may be related to a move away from natural product exploration ("bioprospecting") in favor of synthetic chemistry. As more species are discovered and new drug-resistant diseases emerge, the value of biodiversity to the fight against drug resistance is increasingly clear. Conservation and sustainable use of our living natural resources is recognised as increasingly important for development of new antimicrobial products.
We need to conserve nature's living library of natural compounds in order to help to combat the rise in drug resistance and to insure society against the future emergence of new microbial pathogens.
If the threat of antimicrobial resistance is to be effectively managed and reduced, the health sector must also reduce its own impact on ecosystems. This means the development of better and more effective drugs that do not enter or do not persist in the environment. Hospitals and other health care facilities must also ensure that the use and disposal of drugs is environmentally sustainable. This means that the concept of Health Care Without Harm must become the standard for health systems around the world.
For further information on how the COHAB Initiative works to support wildlife conservation and sustainable health care systems in its programmes of work, please contact the secretariat.
Photo: A purple tunicate Clavelina spp. in the Indian ocean. Marine ecosystems are of particular interest to biomedicine for the enormous range of bioactive compunds, including antimicrobials, which Clavelina and other species hold. © 2007
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