Global drug distribution programs one factor in hastening drug resistance, report says

A Center for Global Development (CGD) report released Tuesday details factors leading to increased drug resistance worldwide, including drug distribution programs in developing countries, Reuters reports. Expanded access to medicines is "clearly desirable," but it creates "challenges in preserving the efficacy of these drugs and ensuring they are used properly," the report says, noting that program operators - such as the WHO, foreign government and nonprofit groups - are "not paying enough attention" to the seriousness of drug resistance, according to the news service.

"Drug resistance is a natural occurrence, but careless practices in drug supply and use are hastening it unnecessarily," said CGD's Rachel Nugent, the report's lead author (Fox, 6/15).

According to a CGD press release (.pdf), other drivers of drug resistance include: technology gaps, weak health systems, inconsistent drug quality and the overuse of antibiotics in agriculture. The report notes how drug resistance increases the overall cost of treatment as well as the effect on children, who are particularly susceptible to infectious diseases. The press release says that 60 to 80 percent of dysentary cases among children in Latin America are "resistant to the drugs recommended to treat it."

"In many poor countries, drug expenditures range from 20 to 60 percent of total expenditure on health," according to the release, which adds that "alternatives [to first-line drugs] are more costly and require greater medical oversight. Curing one patient of extensively drug-resistant TB costs the same as curing 200 patients with ordinary TB" (6/15).

According to Reuters, "[s]ince 2006 donors have spent more than $1.5 billion on specialized drugs to treat resistant bacteria and viruses, and this could worsen" as drug access continues to increase. "The number of people being treated for HIV/AIDS, for example, increased 10-fold between 2002 and 2007; there was an 8-fold rise in deliveries of (drugs) for malaria treatment between 2005 and 2006, and the Stop TB Partnership's Global Drug Facility has expanded access to drugs for TB patients, offering nearly 14 million patient treatments in 93 countries since 2001," the news service writes.

In countries with the highest use of antibiotics, the report found that between 75 percent and 90 percent of Streptococcus pneumoniae strains have become drug-resistant. In addition, "methicillin-resistant Staphylococcus aureas, or MRSA, now cause more than 50 percent of staph infections in U.S. hospitals," the news service writes (6/15).

To address the problem, "the report calls for collective action by a variety of players in a shared global push to fight drug resistance," according to the CGD press release. Recommendations include: creating a "network of multi-disease surveillance laboratories to track the emergence and spread of resistant strains" and share information; establishing stronger drug quality control measures; strengthening regional networks to regulate drugs; and expanding research and development about drug resistance (6/15).