The Scientific Consortium for Health Without Borders wishes all its readers a very very Happy New Year 2012.
May each day of the coming year be vibrant and new, bringing along many reasons for celebrations.

Water Crisis: Impact on Human Health

The world is expected to experience its worst water crisis in this century. Experts have predicted that even there may be wars may be over water. In India, the situation will be alarming. The International Food Policy Research Institute has projected that India’s water need will go up by 50% over the next few year; from just over 600 billion cubic meters in 1995 to over 900 billion cubic meters by 2020. In the northern Gujarat, farmers have to lower their pumps by 3 meters every two years to reach the falling groundwater levels. Over the last decade, some parts of Haryana and Punjab have seen the level sink by over 4 meters. The water levels in Tamil Nadu have fallen between 25 and 30 meters due to over pumping. The National Environmental Engineering Institute reports that in many states, groundwater is being drawn faster than its rate of recharge.

The failure to provide safe drinking water and adequate sanitation services to all people is perhaps the greatest development failure of the 20th century. The most glaring consequence of this failure is the high rate of mortality among young children from preventable water-related diseases. According to the WHO estimates, 1.1 billion people around the world lack access to “improved water supply” and more than 2.4 billion lack access to “improved sanitation.” Water-related diseases are typically placed in four classes.

• Waterborne diseases: caused by the ingestion of water contaminated with human or animal faeces or urine containing pathogenic bacteria or viruses, e.g. cholera, typhoid, amoebic and bacillary dysentery and other diarrhoeal diseases.
• Water-washed diseases: caused by poor personal hygiene and skin or eye contact with contaminated water, e.g. scabies, trachoma and flea, lice and tick-borne diseases.
• Water-based diseases: caused by parasites found in intermediate organisms living in contaminated water, e.g. dracunculiasis, schistosomiasis and other helminthic infections.
• Water-related diseases: caused by insect vectors, especially mosquitoes that breed in water, e.g. dengue, filariasis, malaria, onchocerciasis, trypanosomiasis and yellow fever.

The first three most clearly associate with lack of improved domestic water supply.

 

Dr. D. N. Garg

Former Dean

College of Veterinary Sciences, Hisar-125 004

Sharing health and disease with animals

There are about 300 zoonotic diseases (transmissible from animals to humans and vice versa) prevalent in the world. Active surveillance of such diseases among animals helps in preventing threats to human health, though surveillance programme for all of them is neither possible nor in place in any country. Further, out of 1461 diseases now recognized in humans, about 62% are caused by multiple-host pathogens characterized by their movement across species lines. Given the rate of population growth, changes in climatic conditions and rapid urban development, the new era of emerging infections will continue in future and even may accelerate. The WHO identified the ecologic impact of human activities as the most important risk factor in the rise of emerging diseases. These include international travel, global warming, trade in exotic and wild animals, growing population of humans and domestic animals, encroachment into wildlife habitat, and concentrated agriculture operations in close proximity to human populations. Travel around the world is faster than the incubation period of these diseases, helping their rapid spread giving rise to pandemics.

Dr. D. N. Garg

Former Dean, College of Veterinary Sciences,

Lala Lajpat Rai University of Veterinary & Animal Sciences,

Hisar (Haryana) India

Modernizing Needs of Veterinary Education

Prof. (Dr.) M. P. Yadav
President, National Academy of Veterinary Sciences (India)
(Extracts from the NAVS Newsletter, October 2011 issue)

Veterinary education in India is at crossroads due to internal constraints and contradictions as well as new challenges. There is a need for its revamping. The role of veterinary and animal scientists and field functionaries in reducing global hunger, controlling disease in animals and man, monitoring food quality, and promoting animal welfare is now well recognized. Shortage of veterinarians in various fields, such as food animal veterinarian, could have a devastating impact on food safety.

Veterinary education orientation has variations in India and developed countries. The developed countries mostly follow “crop agriculture” and “animal agriculture” models. In developing countries, there is no concept of animal agriculture, though the animals contribute enormously. Further, the developed countries have now geared up and started looking for changing the course curricula in such a way that both veterinary and medical education is empowered to produce graduates which can fill the vacuum in view of the requirement of specialist professionals for helping the “One Health” agenda.

Redefining “veterinary science” and “animal science” in Indian context is necessary as we cannot adopt the system of veterinary education in overseas countries, as our needs are different. Thus, the course curricula revision should consider the role of animal husbandry in economic and social context of farmers and also the country. The course curriculum in veterinary education, regulated by Veterinary Council of India, is common for all the colleges and universities. The veterinary and animal science graduates have a very wide exposure, making them “generalist veterinarians”. However, the changing requirements of livestock and poultry sector and consequently the enhanced role of veterinarians warrant their training in one or more specialized areas.

Fight against noncommunicable diseases

Thirty-six million people die each year from noncommunicable diseases (NCDs) like heart disease and stroke, diabetes, cancer and chronic lung disease. On 19-20 September 2011, global leaders are meeting at the United Nations in New York to turn the tide on NCDs.

Source: WHO

Cerebral Coenurosis in Sheep in Ethiopia

In a survey carried out in Addis Ababa (Ethiopia) from November 2010 to March 2011, 4.7% (21/445) sheep were found affected with coenurosis. The prevalence of Coenurus cerebralis was 2.7% in males and 5.1% in females, though the difference was not statistically significant (p>0.05).. Postmortem examination revealed 1 to 5 cysts in each animal. The great majority of the cysts (94.4%) were located in the cerebral hemisphere while 5.4% were on both sides of the middle cerebellar hemisphere. A retrospective analysis of sheep slaughtered at the Institute during the last 13 years revealed 3.4% to 8.9% prevalence of the disease. Total annual financial loss due to condemnation of slaughtered animal brain or carcass was estimated at 8330 Ethiopian Birr (490 US$). The study indicates coenurosis to be an important parasitic disease resulting in great economic loss. 

Authors:
Asefa Deressa, Tesham Tilahun*, Ayele Tadesse*, Gashaw Gebrewold, Mekoro Beyene, Sileshi Negatu*
Ethiopian Health and Nutrition Research Institute, Addis Ababa, *Gondar University, Faculty of Veterinary Medicine, Addis Ababa, Ethiopia.

Contributing author: Asefa Deressa, EHNRI, Addis Ababa

Bird Flu rears its head again

29 August 2011, Rome 

FAO today urged heightened readiness and surveillance against a possible major resurgence of the H5N1 Highly Pathogenic Avian Influenza amid signs that a mutant strain of the deadly Bird Flu virus is spreading in Asia and beyond, with unpredictable risks to human health. 

The H5N1 virus has infected 565 people since it first appeared in 2003, killing 331 of them, according to WHO figures. The latest death occurred earlier this month in Cambodia, which has registered eight cases of human infection this year - all of them fatal.  Since 2003, H5N1 has killed or forced the culling of more than 400 million domestic poultry and caused an estimated $20 billion of economic damage across the globe before it was eliminated from most of the 63 countries infected at its peak in 2006. However, the virus remained endemic in six nations, although the number of outbreaks in domestic poultry and wild bird populations shrank steadily from an annual peak of 4000 to just 302 in mid 2008. But outbreaks have risen progressively since, with almost 800 cases recorded in 2010-2011. 

Source: FAO

Reward Scheme for Whistle Blowers for Information on Cases of Food Adulteration

The Food Safety and Standards Authority of India is in the process of drafting a reward scheme for whistle blowers for information on cases of food adulteration. It has invited suggestions from all stakeholders including public in this regard by 07-09-2011. 

Source: The Food Safety and Standards Authority of India

The Food Safety and Standards Regulations Come into Force

Ministry of Health and Family Welfare (Food Safety and Standards Authority of India) has notified the Food Safety and Standards Regulations, 2011 in the Gazette of India dated 1st August 2011. The following Regulations come in force on or after 5th August 2011.

• Food Safety and Standards (Licensing and Registration of Food Businesses) Regulations, 2011 
• Food Safety and Standards (Packaging and Labelling) Regulations, 2011 
• Food Safety and Standards (Food Products Standards and Food Additives) Regulations, 2011 (Part I, Part II) 
• Food Safety and Standards (Prohibition and Restrictions on Sales) Regulation, 2011 
• Food Safety and Standards (Contaminants, Toxins and Residues) Regulations, 2011 
• Food Safety and Standards (Laboratory and Sample Analysis) Regulations, 2011

New Method to Detect 20 Drugs in Cow, Goat and Human Milk

A Spanish-Moroccan research team has developed a method that makes it possible to simultaneously detect 20 pharmaceutical products in cow, goat and human milk. The samples of the three types of milk studied showed that they all contain anti-inflammatories, although the largest number of drugs was found in whole cows' milk. Up to 20 kinds of antibiotics, anti-inflammatories, antiseptics, lipid regulators, beta-blockers and hormones can be detected simultaneously in various kinds of milk, thanks to a new method developed by researchers at the universities of Jaén and Córdoba in Spain and the Abdelmalek Essaadi University in Morocco. The scientists believe the new methodology will help to provide a more effective way of determining the presence of these kinds of contaminants in milk or other products. Food quality control laboratories could use this new tool to detect these drugs before they enter the food chain.

Source: 

Toxic chemicals in fruits and vegetables

Fruits and vegetables constitute a key food commodity. Toxic and hazardous chemicals like calcium carbide or ethephon and oxytocin are reportedly being used for artificial ripening of fruits and for increasing the size of fruits and vegetables, respectively. Calcium carbide more commonly known as ‘masala’ is carcinogenic and banned under PFA Rules, 1955. Ethephon is a pesticide; so not recommended as a ripening enhancer. Oxytocin is a mammalian hormone used as a drug in veterinary services; its application is not advised in fresh fruits and vegetables. 

Advice to consumers

• Select fruits and vegetables without spots or necrosis (lesions) and any abnormality.
• Wash fruits and vegetables thoroughly with water (preferably) running potable water before eating and cooking.
• Purchase fruits and vegetables from known dealers.
• Peeling of fruits before consumption and vegetables before cooking will reduce exposure to pesticide.
• Do not buy and consume cut fruits from open market.
• Throw away fruits and vegetables infected by mould/fungus.
• To minimize the hazards of pesticide residues, discard the outer leaves of leafy vegetables such as lettuce and cabbage.
• Do not wash fruits and vegetables with detergents as they may get absorbed inside.
• Ensure the quality of fruits and vegetables by sending them to voluntary testing laboratories.
• Wash your hands with soap and potable water, use clean utensil and clean cutting board with stainless steel knives.

Source: Food Safety and Standards Authority of India 

Environmental Security: Human and Animal Health - New book released

Dr. Hardeep Kumar, Vice Chancellor, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar at a University function released the book “Environmental Security: Human and Animal Health” edited by Dr. Sudhi Ranjan Garg, Professor, Department of Veterinary Public Health & Epidemiology, College of Veterinary Sciences, Hisar. Encompassing the spirit of ‘One Health’, the book has 39 chapters dealing with important environmental issues, wherein the experts from varied disciplines across the country have envisaged futuristic visionary strategies for protection of health of human beings as well as animals. 

Environmental Security: Human and Animal Health (ISBN: 978-81-8189-171-6; IBDC Publishers, Lucknow)

Contents

1.        Pollution and Risk to Human and Animal Health - A. M. Paturkar

2.        Heavy Metal Toxicity - M. H. Fulekar and Anamika S.

3.        Animal Health Risks due to Inorganic Chemical Pollutants - D. Swarup and H. P. Dwivedi

4.        Arsenic Poisoning and Remedies - P. S. Anand, K. M. Popat and D. Gangadharan

5.        Remediation of Toxic Heavy Metal Pollutants in the Environment - R. C. Patra and M. Megharaj

6.        Bioleaching of Metals from Sulphidic Minerals - Shailesh R. Dave and Devayani R. Tipre

7.        Distillery Effluent Treatment Technologies - T. N. Bhavanishankar

8.        Bioremediation and Decolourisation of Post-Methanated Distillery Effluent - Ram Chandra, Sangeeta Yadav and R. N. Bharagava

9.        Synthetic Dyes in the Textile Industry Effluent - M. V. Kulkarni and V. P. Zope

10.     Tannery Waste and its Remediation - S. S. Bhattacharya, M. Chakrabarti and Rintu Banerjee

11.     Advanced Technologies for Wastewater Treatment - Tapas Nandy, M. Karthik and Pravin Manekar

12.     Water Pollution and Health - M. N. Brahmbhatt

13.     Household Water Treatment for Developing Countries - M. Mansoor Ahammed

14.     Air Pollution Risk Assessment - P. Piplatkar, D. G. Gajghate and Vaishali Khaparde

15.     Vehicular Pollution and Health - Sopan T. Ingle and Nilesh D. Wagh

16.     Polynuclear Aromatic Hydrocarbons in Ambient Air - Vaishali Khaparde, P. Piplatkar and D. G. Gajghate

17.     Urban Air Pollution and Health Risk : A Kolkata Case Study - Mrinal K. Ghose

18.     Acid Rain - Asha B. Chelani, D. G. Gajghate, S. D. Joshi and S. Devotta

19.     Indoor Air Pollution and Health - Priyanka Kulshreshtha and Mukesh Khare

20.     Health Risk from Asbestos in the Environment - Iqbal Ahmad and Huma Siddiqui

21.     Drug Resistant Bacteria in the Environment - B. R. Singh

22.     Laboratory Biosafety Concepts for Environmental Protection - H. V. Murugkar and S. C. Dubey

23.     Environmental Concerns and Health Implications of Cyanobacterial Toxins - Lalita N. Sangolkar, Sarika S. Maske and Tapan Chakrabarti

24.     Plant Toxicosis : Livestock and Human Health Risk - A. Sahoo

25.     Impact of Genetically Modified Organisms on Biotic and Abiotic Environments - H. Rahman and R. Karuppaiyan

26.     Microbial Bioassay for Impact Analysis of Environmental Toxicants - Raj K. Upreti and Manoj K. Upreti

27.     Biotechnology in Waste Treatment and Pollution Abatement - Shireen Meher Kotay and Debabrata Das

28.     Bioremediation of Wastes in Aquaculture - S. V. Alavandi

29.     Household Waste Management - Sudesh Gandhi and Veena Sangwan

30.     Integrated Management of Municipal Solid Waste - T. V. Ramachandra

31.     Solid Waste Management by Vermitechnology - V. K. Garg and Renuka Gupta

32.     Mitigation of Methane Emission from Livestock - K. K. Singhal and Madhu Mohini

33.     Environmental Health Hazards from Stray Animals - Diwakar D. Kulkarni

34.     Scavenger Animals and Environmental Safety - Gaya Prasad and Minakshi

35.     Mitigation of Pollution from Fallen Animal Carcasses - S. R. Garg and V. J. Jadhav

36.     Use of Laser in Environmental Pollution Detection and Abatement - Jyotsna Dutta Majumdar

37.     Biological Monitoring of Occupational Exposure to Pollutants - V. K. Bhatnagar and Glenn Talaska

38.     Transcriptomic and Proteomic Approaches to Environmental Health Management - Swati Kotwal

39.     Urban Greenery towards Environmental Improvement and Sustainability - Pradeep Chaudhry and Vindhya P. Tewari

Publication of new book - “Environmental Security: Human and Animal Health”

Thinking outside the box is paramount to focus clearly on the risks and challenges brought about by the human-animal-environment interactions. Forging collaborations between physicians, veterinarians and the other scientific health professionals is essential to achieve the health targets, as the environment health is not a domain restricted to a single discipline. Encompassing the spirit of One Health, the book entitled “Environmental Security: Human and Animal Health” edited by Prof. Sudhi Ranjan Garg has been published by the IBDC Publishers, Lucknow. The book will be released shortly. It contains analytical views of the experts from varied disciplines that not only assess the current situation but also provide futuristic visionary strategies. 

The book will be equally useful to the academicians, teachers, research workers, technocrats, managers, administrators, and the students of all disciplines related to environment health. It is sure to provide innovative insight to the health planners, policy makers and pollution control agencies to drive real and profound change in global survival. 

Climate change and health

Key facts

• Climate change affects the fundamental requirements for health – clean air, safe drinking water, sufficient food and secure shelter.
• The global warming that has occurred since the 1970s was causing over 140 000 excess deaths annually by the year 2004.
• Many of the major killers such as diarrhoeal diseases, malnutrition, malaria and dengue are highly climate-sensitive and are expected to worsen as the climate changes.
• Areas with weak health infrastructure – mostly in developing countries – will be the least able to cope without assistance to prepare and respond.
• Reducing emissions of greenhouse gases through better transport, food and energy-use choices can result in improved health.

Source: WHO Fact Sheet No. 266

Voluntary unpaid blood donations increase, saving more lives

The number of countries collecting all their blood supplies from voluntary unpaid donors increased by more than 50% between 2002 and 2008, according to new global data from WHO, released on World Blood Donor Day, 14 June.
World Blood Donor Day is celebrated each year to highlight the contribution voluntary unpaid blood donors make to public health. This year's slogan, "More blood, more life" aims to encourage still more people to come forward to give blood and save more lives.
"WHO's goal is for all countries to obtain all blood supplies from voluntary unpaid donations by 2020," says Dr. Neelam Dhingra, Coordinator, Blood Transfusion Safety at WHO. "Nine years ago, 39 countries were obtaining all their blood supplies from voluntary unpaid donors: in 2008 that figure had gone up to 62. We hope that World Blood Donor Day will encourage more people in more countries to become regular voluntary blood donors."

Source: WHO

Pigs susceptible to virulent ebolavirus can transmit the virus to other animals

Canadian investigators have shown that a species of ebolavirus from Zaire that is highly virulent in humans can replicate in pigs, cause disease, and be transmitted to animals previously unexposed to the virus. The findings are published in The Journal of Infectious Diseases and are now available online. In order to prevent human outbreaks of Ebola hemorrhagic fever, it is important to identify animal species that replicate and transmit the virus to other animals and, potentially, people. Zaire ebolavirus, one of several species of the virus, has a fatality rate as high as 90 percent in humans. Antibodies to another species not associated with human disease, known as Reston ebolavirus, have been found in pig farmers in the Philippines, suggesting pigs may be able to transmit virulent ebolavirus to humans as well.

Source:

 

Discovery of new MRSA strain in milk

A new strain of meticillin-resistant Staphylococcus aureus (MRSA) has been discovered by scientists at the University of Cambridge Veterinary School. The findings are published in the journal The Lancet Infectious Diseases. 
The new strain has been identified in milk from dairy cows and in humans. It had not previously been detected because its genetic makeup differs from previous strains and the ‘gold standard’ molecular tests  currently used to identify MRSA do not detect this strain.


Source:  British Veterinary Association

Air quality and health

Key facts

• Air pollution is a major environmental risk to health and is estimated to cause approximately 2 million premature deaths worldwide per year.
• Exposure to air pollutants is largely beyond the control of individuals and requires action by public authorities at the national, regional and even international levels.
• The WHO Air quality guidelines represent the most widely agreed and up-to-date assessment of health effects of air pollution, recommending targets for air quality at which the health risks are significantly reduced.
• By reducing particulate matter (PM₁₀) pollution from 70 to 20 micrograms per cubic metre, we can cut air quality related deaths by around 15%.
• By reducing air pollution levels, we can help countries reduce the global burden of disease from respiratory infections, heart disease, and lung cancer.
• The WHO guidelines provide interim targets for countries that still have very high levels of air pollution to encourage the gradual cutting down of emissions. These interim targets are: a maximum of three days a year with up to 150 micrograms of PM₁₀ per cubic metre (for short term peaks of air pollution), and 70 micrograms per cubic metre for long term exposures to PM₁₀.
• More than half of the burden from air pollution on human health is borne by people in developing countries. In many cities, the average annual levels of PM₁₀ (the main source of which is the burning of fossil fuels) exceed 70 micrograms per cubic metre. The guidelines say that, to prevent ill health, those levels should be lower than 20 micrograms per cubic metre.

Source: World Health Organization Media Centre, Fact Sheets

World Veterinary Day Special

Contribution of veterinarians in public health activities

Veterinarian’s role in public health is well known. For instance, the work of the French veterinarian, Gaston Ramon, in the development of diphtheria toxoid has drastically reduced the incidence of diphtheria in children. The fundamental studies of Daniel E. Salmon and Theobald Smith on porcine salmonellosis resulted in the discovery of the first killed vaccine which formed the basis of the methods employed on a gigantic scale to protect human beings against cholera, plague and typhoid fever. The establishment and practice of modern principles of food hygiene for dairy and meat industries is another significant activity through which the veterinarians have been actively contributing to public health worldwide. These principles are applicable to several other food industries as well. In modern times, the veterinarians are making remarkable contribution in public health programmes worldwide.

Like in the developed nations, in India too, veterinary graduates and postgraduates are quite knowledgeable regarding a number of public health problems, their causes, transmission pathways, and the measures for their prevention and control. They are imparted specialized training and are taught several courses in the field of Veterinary Public Health at undergraduate and postgraduate levels under the Minimum Standards of Veterinary Education Regulations prescribed by the Veterinary Council of India. The veterinarians have a detailed practical knowledge of zoonotic disease control and hygienic production, inspection and quality assurance of animal products like milk, meat, eggs, fish etc., environmental health etc.

Sadly, the potential of extensive veterinary workforce in public health programmes remains largely unutilized in India despite their resourcefulness and close proximity to rural folks. They can make significant contribution in the national food safety, food security and international trade through their involvement in food inspection and quality control programmes. The veterinarians can also collaborate with public health specialists (medical professionals) quite meaningfully and effectively in the areas like epidemiology, control and prevention of zoonotic diseases and environmental health problems.

It is high time to use the services of veterinary professionals to combat the public health problems more fiercely.

Inputs:

Dr. Ashwani Kumar

Professor & Former HOD, Veterinary Public Health, College of Veterinary Sciences, Hisar

Former Professor, Veterinary Public Health, Faculty of Veterinary Sciences, Mekelle University, Mekelle, Ethiopia

Three killed in new Chinese milk scare

http://www.dairyreporter.com/

By Guy Montague-Jones, 08 April 2011

Nitrate-tainted milk has killed three people and made 35 others ill in the latest food safety scandal to hit the Chinese dairy industry, according to state media.

Early reports indicate that the victims were poisoned by nitrate, a chemical used in the curing of meat, after drinking bulk milk from two farms in Gansu province, in north-west China. The sick, most of whom are children under 14, are being treated in hospitals in Pingliang city. Officials said that one of them is in a critical condition and the others are stable. The two farms at the centre of the scare have been sealed off and senior managers are being interrogated, according to media reports.

Section 144 on dogs in Mizo town

Diseases transmissible from monkeys

Forest is a natural habitat of wildlife along with a variety of plants and insects that harbour countless microorganisms. A large majority of emerging and reemerging zoonotic infections may find their origin in wildlife. The distance between humans and wildlife has greatly diminished due to the anthropogenic activities such as:

·      Encroachment on wildlife habitat resulting in migration of wild animals

·      Forest clearing and forest fires

·      Changes in agricultural and animal husbandry practices

·      Wildlife trade

·      Translocation of wild animals

·      Ecotourism

·      Exotic pets and petting zoo animals

Zoonotic infections in primates (including monkeys) have great implications. Major non-human primate zoonotic infections are listed below.

·   Parasitic infections- Entamoeba histolytica, E. polecki, Giardia, Cryptosporidia, Plasmodium spp., Oesophagostomum bifurcum, Schistosoma mansoni, S. Mekongi, Bartiella studen, B. mucronata

·    Bacterial infections- Campylobacter, Salmonella, Shigella, Leptospira, Francisella tularensis, Mycobacterium tuberculosis, M. bovis, M. avium, M. paratuberculosis, M. scrofulaceum, M. intercellulae, M. kansasii, M. gordnae, M. africanum, M. leprae

·     Viral infections- Hepatitis A, Monkey pox, Tana pox, Yaba pox, Measles, Marburg, Ebola, Simian Immunodeficiency, Herpes Simian B virus     

Care to be taken in case of monkey bite or scratch wounds

As a first aid, all bite or scratch wounds should be immediately and thoroughly scrubbed and cleansed with soap and water. A 0.25% hypochlorite solution wash followed by washing with detergent containing chlorhexidine or povidone-iodine for 15 minutes is recommended. Immediately thereafter, medical advice should be sought for further line of action.


Inputs

Dr. K. G. Narayan
Retired Dean
Veterinary College, Ranchi

Antimicrobial Resistance

Key facts 

          

•  Infections caused by resistant microorganisms often fail to respond to conventional treatment, resulting in prolonged illness and greater risk of death.
• About 440 000 new cases of multidrug-resistant tuberculosis (MDR-TB) emerge annually, causing at least 150 000 deaths.
•  Resistance to earlier generation antimalarial medicines such as chloroquine and sulfadoxine-pyrimethamine is widespread in most malaria-endemic countries.
• A high percentage of hospital-acquired infections are caused by highly resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA).
• Inappropriate and irrational use of antimicrobial medicines provides favourable conditions for resistant microorganisms to emerge, spread and persist.

What drives antimicrobial resistance (AMR)?

Inappropriate and irrational use of medicines provides favourable conditions for resistant microorganisms to emerge and spread. For example, when patients do not take the full course of a prescribed antimicrobial or when poor quality antimicrobials are used, resistant microorganisms can emerge and spread.

Underlying factors that drive AMR include:

• inadequate national commitment to a comprehensive and coordinated response, ill-defined accountability and insufficient engagement of communities;
• weak or absent surveillance and monitoring systems;
• inadequate systems to ensure quality and uninterrupted supply of medicines
• inappropriate and irrational use of medicines, including in animal husbandry:
• poor infection prevention and control practices;
• depleted arsenals of diagnostics, medicines and vaccines as well as insufficient research and development on new products.

Combat drug resistance - No action today, no cure tomorrow

The emergence of AMR is a complex problem driven by many interconnected factors; single, isolated interventions have little impact. A global and national multi-sectoral response is urgently needed to combat the growing threat of AMR.

WHO has selected combating antimicrobial resistance as the theme for World Health Day 2011. On this day, WHO issues an international call for concerted action to halt the spread of antimicrobial resistance and recommends a six-point policy package for governments.

WHO calls on all key stakeholders, including policy-makers and planners, the public and patients, practitioners and prescribers, pharmacists and dispensers, and the pharmaceutical industry, to act and take responsibility for combating antimicrobial resistance.

Source: WHO Fact sheet N°194, February 2011, WHO Media center

Inputs: Prof. Sudhi Ranjan Garg