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人人都能参与抗击抗生素耐药性行动

几十年来, 抗生素一直是一种神奇的药物。它从曾经致命的感染中拯救了数百万人的生命,使复杂的手术不再困难。但由于在医疗卫生领域和动物卫生领域的过度使用或误用, 这些不可或缺的抗生素正迅速失去效力。这种现象被称为抗生素耐药性。抗生素耐药性威胁着每个人的健康与生命以及环境,威胁粮食与农业生产系统的可持续性。

为什么会发生这样的事情?在医疗卫生领域,对抗生素的滥用是指人们在不需要时服用抗生素;或没有按疗程服用;或不讲究卫生以防止细菌感染。所有这些行为都会滋生细菌,使其产生耐药性,并将耐药性传给其它细菌。正是这些细菌具有最大的耐药性和最难被治疗。

因此,如果抗生素或其他抗菌药物已经不能用于防止细菌感染,剖腹产等常见的外科手术或普通的肺炎都可威胁病人的生命。

抗生素不仅在医疗卫生领域被滥用,在农业领域也为了预防和治疗动物感染而滥用、误用抗生素。许多农民用抗生素来保护他们的动物免受感染性疾病的危害,促进动物生长,以满足全球对高蛋白食物日益增长的需求。


发达国家和发展中国家有越来越多的人感染了现有方法无法治疗的“超级细菌”。每年,全球约70万人死于耐药菌感染,大部分在发展中国家。最近的估计数字表明,到2050年,这个数字可能会上升到1000万,多于目前癌症死亡人数。

抗生素滥用不仅严重影响人类健康,也会导致经济损失。最近世界银行和联合国粮农组织的报告指出,如果2050年仍未解决抗生素耐药性问题,全球年度GDP将下降约1.1%-3.8%,等同于2008年金融危机的影响。为了我们家人和后代的未来,我们不能置之不理。


值得庆幸的是,今年我们在解决这一日益逼近的全球危机方面取得了巨大进步。今年八月,中国政府发布了《遏制细菌耐药国家行动计划》。今年九月,中国在杭州举办的G20会议上呼吁成员国解决抗生素耐药“严重威胁公共健康、经济增长和全球经济稳定”的问题。今年九月,中国参加联合国大会抗生素耐药性高级会议,体现出各国领导人已意识到抗生素耐药性带来的灾难性后果。

现在的挑战是如何加快行动,遏制抗生素耐药的增长。如同当今的很多问题一样,这没有万能灵药。

我们必须提升对抗生素耐药性的认识和了解,不仅是开抗生素的医生,患者也应知道如何正确使用抗生素。另一个可减少感染的方法是教育人们尤其是在医院里如何有效地洗手;还有要加强养殖场的防病措施以及提高生物安全水平。

本周是“世界提高抗生素认识周”。今年“世界提高抗生素认识周”的全球目标是呼吁负责任的开处方和使用抗生素。我们通过提高群众认识,呼吁每个人,包括患者、医生、兽医和农民采取积极行动,联手支持国家卫生和计划生育委员会实行国家行动计划。通过我们的活动,我们希望建立专业人员在医疗卫生和动物疾病的合理处方和抗生素使用方面的信心与知识,并鼓励他们改变自己的行为。我们也希望我们的活动可以让公众意识到良好的卫生对于减少感染的重要性,呼吁人们在适当的情况下负责任地使用抗生素。

不管身处何方,每个人都可以,也必须为抗击抗生素耐药性作出微小但是重要的贡献。我们正处于转折点,未来几代人会认为我们作出了正确的决定和行动。


原文

World Antibiotic Awareness Week: Everyone can fight antimicrobial resistance

Joint opinion piece by

Dr Bernhard Schwartlnder,

WHO Representative in China and

Mr Vincent Martin,

FAO Representative in China and DPR Korea

Antibiotics have been our miracle drugs for decades. They have allowed us to save millions of lives from infections that were once deadly, and have played a key role in making complex surgeries possible. But these go-to medicines are fast losing their power because of widespread overuse and misuse in the human and animal health sectors. This phenomenon-known as antimicrobial resistance or AMR – threatens the health and lives of everyone, the environment, as well as the sustainability of our food and agriculture production systems.


How is this happening? Well, in human health, misuse is driven by people taking antibiotics when they do not need them; failing to take a full course of antibiotics when they are prescribed; or not following good hygiene to prevent bacterial infections. All of these actions allow bacteria to survive, to develop resistance to the drugs used to treat them, and to be passed on to others. It is these bacteria that will be the ones with the greatest resistance to antibiotics and be the most difficult to treat.

As a result, common surgical procedures such as a caesarean section, or a simple bout of pneumonia, could suddenly become life threatening because we can't fight infections with antibiotics or other antimicrobial drugs.

And, the misuse of antibiotics does not just start and end with humans. Antibiotics are also misused and overused in agriculture while treating and preventing infections in animals, to prompt animal growth, and to meet growing global demand for protein-rich food.

There are already increasing numbers of people in both developed and developing countries acquiring "superbugs" that do not respond to available treatments. Every year, drug-resistant infections kill an estimated 700,000 people worldwide—most of these in developing countries. And some estimates suggest that by 2050, the number could rise to 10 million—more than the number of people who currently die from cancer.

Beyond the tragic human cost that we pay for the misuse of antibiotics, there is also an enormous financial cost. A recent World Bank Group report put a price tag on failing to tackle AMR by 2050 at an approximately 1.1 to 3.8 per cent fall in annual global GDP. This is on par with the impact of the 2008 global financial crisis.

Clearly we cannot afford to sit idle if we care about the future of our families and those of coming generations.

Thankfully we have seen some huge steps taken this year to address this looming global crisis. In August, China issued its National Action Plan to Contain Antimicrobial Resistance. In September China hosted the G20 meeting in Hangzhou, which committed member countries to address the "threat to public health, growth and global economic stability" posed by AMR.And in September China attended the United Nations General Assembly High-Level meeting on AMR, which provided a further signal that global leaders recognize the catastrophic consequences of failing to tackle AMR.

The challenge now is to accelerate aggressive actions to control the growth of AMR. But as with many of today's problems, there is no silver bullet.


One of the things we must do is improve awareness and understanding of AMR, both among those who prescribe and dispense antibiotics, as well as among patients — for instance, raising awareness about taking antibiotics correctly. Another is to reduce the incidence of infection — by getting people serious about washing their hands effectively, especially in hospitals and by reinforcing disease control preventative measures and biosecurity levels in farms.

This week is World Antibiotic Awareness Week, and the global objective this year is to encourage the responsible prescription and use of antibiotics. We are joining forces to support the National Health and Family Planning in implementing China's National Action Plan by helping to raise awareness of the problem, and to spread greater understanding of the role that everyone – patients, doctors, veterinarians and farmers – can play. Through our activities we hope to build the confidence and knowledge of professionals across human and animal health on the rational prescription and use of antibiotics, and encourage them to be the drivers of behavioral change. We also hope our activities can instill upon the general public the importance of hygiene in reducing infection and encouraging responsible demand and use of antibiotics under the right circumstances.

Everyone everywhere can, and must, do their own bit by taking some simple but very important steps to fight AMR. We are now standing at a turning point, to which future generations will look and say we made the right choice and acted.

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