Manila, 12 October 2011-Amid threats that antibiotics and other essential medicines may lose their power to cure disease, countries in the Western Pacific Region today pledged to support the World Health Organization (WHO) in its efforts to fight drug resistance.

WHO has warned that the world may already be returning to an era when there were no effective drug treatments for many infections. This is the result of the misuse and irrational use of drugs-a major driver of drug resistance.

At this year's annual meeting of the WHO Regional Committee for the Western Pacific, the Organization's governing body in the Region, meeting in Manila, Member States vowed to take immediate action to improve their response to the increasing problem of drug resistance in areas where action has been inadequate.

A six-point policy package adopted by the Committee includes:

- committing to develop a master plan to combat antimicrobial resistance;
- strengthening surveillance and laboratory capacity;
- ensuring uninterrupted access to essential medicines of guaranteed quality;
- promoting the rational use of medicines in patient care and animal husbandry;
- enhancing infection prevention and control; and
- fostering innovation and research to develop new tools and drugs.

WHO said that while the development of antimicrobial resistance to drugs is inevitable, the misuse and poor management of drugs accelerates resistance. Overprescription is a major problem. It is estimated that in many settings 50%-70% of the antibiotics prescribed by health workers are unnecessary.

"The misuse and irrational use of drugs are weakening the fight against diseases, such as tuberculosis and malaria, that should have been contained decades ago," said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. "At the same time, other age-old diseases are on the rise, with the possibility of no cure."

The six-point package seeks to engage all WHO's 194 Member States and the global health community to promote action for change. While there have been efforts to deal with the critical issue of drug resistance in the past, implementation and commitment has lagged. Action to combat antimicrobial resistance has been fragmented in many settings, often focusing on only one aspect of the problem instead of following a comprehensive national plan. There is also need for a more comprehensive antimicrobial surveillance systems to encompass most, if not all, major disease-causing bacteria.

Antimicrobial resistance is both a medical and financial catastrophe as second-line treatments are much more expensive. The difference in cost between first- and second-line drugs is a 175-fold increase for tuberculosis drugs, a two fold to 60-fold increase for antibiotics, and a three fold to 500-fold increase for antimalarial drugs.

Considerable data on antimicrobial resistance exist globally and regionally. For example:

- The resistance of gonococcus to penicillin and quinolones is over 50% in much of the Western Pacific Region and six countries show patterns of resistance to third-generation cephalosporins.
- Fifty-seven countries worldwide have reported at least one case of extensively drug-resistant tuberculosis and 120 000 individuals per year in the Western Pacific Region are estimated to have multidrug-resistant tuberculosis.
- Early signs of resistance to artemisinin-combination therapy for malaria treatment have been noted on the Cambodian-Thai border-the area where chloroquine-resistance began several decades ago.