Antibiotics for human and animal use are widely available in  China without a prescription, leading to overuse and antimicrobial  resistance.

Antibiotics for human and animal use are widely available in China without a prescription, leading to overuse and antimicrobial resistance.

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China tackles antimicrobial resistance

BEIJING—China, the world’s largest consumer of human and animal antibiotics, has pledged to step up research and development into new antimicrobials and to rein in overuse of existing medicines to counter growing global antimicrobial resistance.

As part of a national action plan unveiled on 26 August, the Chinese central government said that it would mobilize the efforts of 14 ministries and departments including health, food and drugs, and agriculture. By 2020, the government aims to develop new antimicrobials, make sales of the drugs by prescription only, ramp up surveillance of human and veterinary usage, and increase training and education for both medical professionals and consumers on their proper use. No details were available on funding or new drug development.

According to a May report from the Wellcome Trust in London, antimicrobial resistance in China could cause 1 million premature deaths annually by 2050 and cost the country $20 trillion. Antibiotics are currently widely available without prescriptions in China for both human and livestock use. The country accounts for half the world’s annual antimicrobial drug consumption. “Antimicrobial resistance is a problem created by human behavior—largely through the inappropriate use of antimicrobials in health care, as well as in animal husbandry,”  Bernhard Schwartländer, World Health Organization (WHO) representative in China, said in a press release. “That’s why this National Action Plan is so significant—it lays out a comprehensive approach to tackling the problem,” Schwartländer said. In the press release, WHO cited several critical issues that have fostered antibiotic resistance in China. Physicians and veterinarians lack access to rapid diagnostics, and as a result fall back on antibiotics when they are not necessary or useful. Availability of the drugs without prescription vastly increases overuse, as does hospitals’ reliance on sales of the drugs for profit. Consumers and farmers also demand quick and easy access to antimicrobials and use them too frequently, rendering the drugs less useful.

Widespread overuse of the drugs in China already has been faulted for creating potentially catastrophic results. In a paper published in The Lancet Infectious Diseases in November 2015, Chinese researchers at South China Agricultural University, Guangzhou, reported finding resistance to colistin, which is often the antibiotic of last resort. Resistance to the drug had not emerged in part because it was typically only used when other drugs had failed. The researchers found that the gene conferring drug resistance has spread among bacteria in China, where colistin is widely fed to livestock as a prophylactic.

Global antimicrobial resistance will be on the table for discussion at the G-20 summit in Hangzhou, China, this week.