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Resistance management

Antimicrobial resistance 

Bacteria, viruses and parasites are evolving to outsmart the drugs widely used to kill them. These include medicines used to treat some of the most common and potentially dangerous infectious diseases, such as antibiotics for pneumonia and tuberculosis, antiretroviral treatment for HIV/AIDS, and antimalarial drugs.

As resistance mechanisms emerge and spread, our ability to treat infections is compromised. The drugs take more time to work and as a result the patient may not recover completely and is infectious for longer. Poor recovery can lead to long term illness, disability and even death. It is unsurprising, therefore, that the World Health Organization (WHO) has deemed antimicrobial resistance (AMR) an ‘increasingly serious threat to global public health’.

Malaria drug resistance

Parasite resistance to malaria treatments is not a recent occurrence; it first appeared in the 1970s and 1980 when the antimalarial medicines of the time began to lose their effectiveness. Artemisinin based combination therapies remain the most effective drugs, but face similar challenges as resistance re-emerges in parts of Southeast Asia. Limiting the spread of antimalarial drug resistance in the region – and the development of resistance in other parts of Asia, Africa and beyond – is a global public health priority. 

We are supporting continuous monitoring of drug resistance in malaria-endemic countries along with research into the various contributing factors. This in turn, helps health authorities and practitioners control the spread of drug resistance more effectively. We are recognised as being among the foremost experts on the development of drug resistance response strategies in the Southeast Asia Greater Mekong Delta region, where resistance is particularly evident. 

Antibiotic resistance

We are focused on strengthening monitoring, evaluation and surveillance systems to support efforts to control emerging resistance to widely used antibiotic treatments – particularly among vulnerable and hard-to-reach populations.

  • Our community-based primary health care work in Uganda and Myanmar, which includes the training and supervision of community health workers on the correct use of antibiotics, is playing a role in setting standards in national polices
  • Improving community awareness – our community dialogues project in Bangladesh aims to develop, adapt, and pilot-test the community dialogues approach for preventing and controlling antibiotic resistance. This involves equipping community dialogue volunteers with the skills and tools to host regular community dialogues on the issue of resistance in their communities.
  • Encouraging the rational use of antibiotics through:
    • encouraging diagnostic testing confirmations prior to administering antibiotics – our ARIDA project is improving pneumonia diagnostics and is in turn, aiding the correct and appropriate use of antibiotics for pneumonia
    • strengthening enforcement of the prescription of antibiotics
  • Surveillance and laboratory testing – surveillance of antimicrobial resistance is key but lacking in many countries. We support the development of surveillance systems to allow doctors to prescribe the correct antibiotics and allow governments to make evidence-based decisions around AMR.
  • The One Health approach – the fight against AMR needs to be integrated in holistically within government public health strategies to address the misuse of antibiotics in both the animal and human health sectors. In Cambodia, we are studying the drivers of antibiotic resistance in humans, animals and the environment in cooperation with the Ministry of Health and Ministry of Agriculture.

For more information about AMR, please visit WHO’s fact sheet on this issue.

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