Antimicrobial resistance (AMR) occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials. All classes of microbes can evolve resistance where the drugs are no longer effective. Fungi evolve antifungal resistance, viruses evolve antiviral resistance, protozoa evolve antiprotozoal resistance, and bacteria evolve antibiotic resistance. Together all of these come under the umbrella of antimicrobial resistance. Microbes resistant to multiple antimicrobials are called multidrug resistant (MDR) and are sometimes referred to as superbugs. Although antimicrobial resistance is a naturally occurring process, it is often the result of improper usage of the drugs and management of the infections.
Antimalarial medications or simply antimalarials are a type of antiparasitic chemical agent, often naturally derived, that can be used to treat or to prevent malaria, in the latter case, most often aiming at two susceptible target groups, young children and pregnant women. As of 2018, modern treatments, including for severe malaria, continued to depend on therapies deriving historically from quinine and artesunate, both parenteral (injectable) drugs, expanding from there into the many classes of available modern drugs. Incidence and distribution of the disease is expected to remain high, globally, for many years to come; moreover, known antimalarial drugs have repeatedly been observed to elicit resistance in the malaria parasite—including for combination therapies featuring artemisinin, a drug of last resort, where resistance has now been observed in Southeast Asia. As such, the needs for new antimalarial agents and new strategies of treatment remain important priorities in tropical medicine. As well, despite very positive outcomes from many modern treatments, serious side effects can impact some individuals taking standard doses.
Artemisinin and its semisynthetic derivatives are a group of drugs used in the treatment of malaria due to Plasmodium falciparum. It was discovered in 1972 by Tu Youyou, who shared the 2015 Nobel Prize in Physiology or Medicine for her discovery. Artemisinin-based combination therapies (ACTs) are now standard treatment worldwide for P. falciparum malaria as well as malaria due to other species of Plasmodium. Artemisinin is extracted from the plant Artemisia annua a herb employed in Chinese traditional medicine. A precursor compound can be produced using a genetically engineered yeast, which is much more efficient than using the plant.
Artesunate (AS) is a medication used to treat malaria. The intravenous form is preferred to quinine for severe malaria. Often it is used as part of combination therapy, such as artesunate plus mefloquine. It is not used for the prevention of malaria. Artesunate can be given by injection into a vein, injection into a muscle, by mouth, and by rectum.
The Alliance for the Prudent Use of Antibiotics (APUA) is a non-profit organization founded in 1981 by Stuart B. Levy (1938–2019), Professor of Medicine at Tufts University and headquartered in Boston, Massachusetts. APUA's mission is to strengthen society's defenses against infectious disease by promoting appropriate access and use to antimicrobial agents and controlling antimicrobial resistance on a worldwide basis. APUA has a network of affiliated chapters in over 50 countries, and conducts applied antimicrobial resistance research, education, capacity building and advocacy at the global and grassroots levels.
Multiple drug resistance (MDR), multidrug resistance or multiresistance is antimicrobial resistance shown by a species of microorganism to at least one antimicrobial drug in three or more antimicrobial categories. Antimicrobial categories are classifications of antimicrobial agents based on their mode of action and specific to target organisms. The MDR types most threatening to public health are MDR bacteria that resist multiple antibiotics; other types include MDR viruses, parasites.
Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.
The Drugs for Neglected Diseases initiative (DNDi) is a collaborative, patients' needs-driven, non-profit drug research and development (R&D) organization that is developing new treatments for neglected diseases, notably leishmaniasis, sleeping sickness, Chagas disease, malaria, filarial diseases, mycetoma, paediatric HIV, cryptococcal meningitis, hepatitis C, and dengue. DNDi's malaria activities were transferred to Medicines for Malaria Venture (MMV) in 2015.
Unitaid is a global health initiative that works with partners to bring about innovations to prevent, diagnose and treat major diseases in low- and middle-income countries, with an emphasis on tuberculosis, malaria, and HIV/AIDS and its deadly co-infections. Founded in 2006, the organization funds the final stages of research and development of new drugs, diagnostics and disease-prevention tools, helps produce data supporting guidelines for their use, and works to allow more affordable generic medicines to enter the marketplace in low- and middle-income countries. Hosted by the World Health Organization (WHO) in Geneva, Unitaid was established by the governments of Brazil, Chile, France, Norway and the United Kingdom.
Thailand has had "a long and successful history of health development," according to the World Health Organization. Life expectancy is averaged at seventy years. Non-communicable diseases form the major burden of morbidity and mortality, while infectious diseases including malaria and tuberculosis, as well as traffic accidents, are also important public health issues.
The Affordable Medicines Facility-malaria (AMFm) is a financing mechanism intended to expand access to affordable and effective antimalarial medication. It works primarily through the commercial private sector, in addition to the public and non-governmental organization sectors which are the more traditional routes for development assistance in malaria control. Its goal is to drive down the price of the most effective malaria medicines so that millions of people can afford to buy them. The program has been called "one of the most important recent advances in fighting malaria" and "a triumph of international cooperation." The AMFm is hosted and managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria in Geneva, Switzerland.
Antibiotic use in livestock is the use of antibiotics for any purpose in the husbandry of livestock, which includes treatment when ill (therapeutic), treatment of a group of animals when at least one is diagnosed with clinical infection (metaphylaxis), and preventative treatment (prophylaxis). Antibiotics are an important tool to treat animal as well as human disease, safeguard animal health and welfare, and support food safety. However, used irresponsibly, this may lead to antibiotic resistance which may impact human, animal and environmental health.
Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) is a global nonprofit partnership focused on supporting the development of new antibacterial products. Its mission is to strengthen the pipeline of vaccines, rapid diagnostics, antibiotics and non-traditional products to prevent, diagnose and treat life-threatening bacterial infections.
Kevin Outterson is a lawyer, a professor of law and the Austin B. Fletcher Professor Boston University School of Law (2023-present). He is also the executive director of Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator, a global non-profit partnership that supports companies developing new antibiotics, diagnostics, vaccines and other products to address drug-resistant bacterial infections.
Adrianus Mattheus Dondorp is a Dutch intensivist, infectious diseases physician, and head of the Mahidol Oxford Tropical Medicine Research Unit in Bangkok. He is best known for his research in severe falciparum malaria, a disease that requires intensive care in hospital. He chairs the World Health Organization Technical Expert Group on antimalarial medication drug resistance and containment.
Antimicrobial resistance (AMR) directly kills about 1,600 people each year in Australia. This is a currently serious threat to both humans and animals in the country. Antimicrobial resistance occurs when a microorganism evolves and gains the ability to become more resistant or completely resistant to the medicine that was previously used to treat it. Drug-resistant bacteria are increasingly difficult to treat, requiring replacement or higher-dose drugs that may be more expensive or more toxic. Resistance can develop through one of the three mechanisms: natural resistant ability in some types of microorganisms, a mutation in genes or receiving the resistance from another species. Antibodies appear naturally due to random mutations, or more often after gradual accumulation over time, and because of abuse of antibiotics. Multidrug-resistance, or MDR, are the microorganisms that are resistant to many types of antimicrobials. "Superbugs" is the term also used for multidrug-resistant microbes, or totally drug-resistant (TDR).
The Society of Infectious Diseases Pharmacists (SIDP) is a non-profit organization comprising pharmacists and other allied health professionals specializing in infectious diseases and antimicrobial stewardship. According to the Board of Pharmaceutical Specialties, clinical pharmacists specializing in infectious diseases are trained in microbiology and pharmacology to develop, implement, and monitor drug regimens. These regimens incorporate the pharmacodynamics and pharmacokinetics of antimicrobials for patients.
Ramanan Laxminarayan Ph.D., M.P.H., FIDSA is an economist and an epidemiologist. He is founder and director of the One Health Trust – formerly known as the Center for Disease Dynamics, Economics & Policy (CDDEP) – in Washington, D.C., and director of the World Health Organization Collaborating Center for Antimicrobial Resistance. Laxminarayan is a senior research scholar at Princeton University, an affiliate professor at the University of Washington, a senior associate at the Johns Hopkins Bloomberg School of Public Health, and a visiting professor at the University of Strathclyde. In 2023, he was appointed an honorary visiting professor at the National University of Singapore Saw Swee Hock School of Public Health. His research on epidemiological models of infectious diseases and economic analysis of drug resistance, and research on public health gets attention from leaders and policymakers worldwide. He served on the President Obama's Council of Advisors on Science and Technology’s antimicrobial resistance working group. He served as a voting member of the U.S. Presidential Advisory Council on Combating Antimicrobial Resistance from 2015 to 2023. He has served as chairperson of the Global Antibiotic Research and Development Partnership (GARDP), a not-for-profit organization dedicated to developing new antimicrobials, since its founding. GARDP was created by the World Health Organization and the Drugs for Neglected Diseases Initiative (DNDi).
Alison Helen Holmes is a British infectious diseases specialist, who is a professor at Imperial College London and the University of Liverpool. Holmes serves as Director of the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance and Consultant at Hammersmith Hospital. Holmes is on the Executive Committee of the International Society of Infectious Diseases, and she serves on a variety of World Health Organization (WHO) expert groups related to antimicrobial use, Antimicrobial Resistance (AMR), infection prevention and sepsis. Her research considers how to mitigate antimicrobial resistance.
Sanjeev Krishna,, is a British physician and parasitologist whose research focuses on affordable diagnosis and treatment of diseases such as COVID-19, malaria, Ebola, African trypanosomiasis, leishmaniasis, and colorectal cancer. Krishna is Professor of Medicine and Molecular Parasitology at St George's, University of London and St George's Hospital.
