Crisis can be an over-used word but in the case of antimicrobial resistance it is entirely apt.
According to health organisations the world over, the need to come up with new solutions to illnesses that are unaffected by drugs is an urgent global priority and companies are being urged to invest in the research.
The need for such work is illustrated in the case of what has so far been an easily treated sexually transmitted disease.
Data from 77 countries show that antibiotic resistance is making gonorrhoea much harder, and sometimes impossible, to treat.
The World Health Organisation (WHO) reports widespread resistance to older and cheaper antibiotics. Some countries are finding cases of the infection that are untreatable by all known antibiotics.
Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO, said: “The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.
“These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common.”
Each year, an estimated 78 million people are infected with gonorrhoea and complications disproportionally affect women, including pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV.
Decreasing condom use, increased urbanisation and travel, poor infection detection rates, and inadequate or failed treatment all contribute to the increase.
The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP), which monitors trends in drug-resistant gonorrhoea, analysed data from 2009 to 2014 and found widespread resistance to a number of well-known and widely used drugs.
Now, the Drugs for Neglected Diseases initiative (DNDi) and WHO have launched the Global Antibiotic Research and Development Partnership (GARDP), a not-for-profit research and development organisation to develop new antibiotic treatments.
Dr Manica Balasegaram, GARDP Director, said: “To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline.
“In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use. Any new treatment developed should be accessible to everyone who needs it, while ensuring it’s used appropriately, so that drug resistance is slowed as much as possible.”
Dr Marc Sprenger, Director of Antimicrobial Resistance at WHO, said. “To control gonorrhoea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures. specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhoea.”
