Antimicrobial Resistance in Developing Countries

Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.

"Antimicrobial Resistance in Developing Countries, edited by Drs. Anibal Sosa and Denis Byarugaba, and their associate editors is unique in focusing on antimicrobial resistance as it relates to, and threatens developing countries. It is curious that it has taken this long to produce a book dedicated to antibiotic resistance in this part of the world. One can ask "why?", since resistance is and has been so common there. In fact, whereas resistance has been addressed for the past four decades by experts in the industrialized world, studies describing the problem and the public health situation in the developing world have lagged behind. Although we have learned much from studies of the genetics and molecular biology of the problem from investigations in industrialized countries, it is in developing countries where more studies and efforts are needed. With travel encouraging the transport of microbes, the information in this book will have wide sweeping benefit, not only for developing countries, but also for the world at large. Surveillance of resistance and the prevention of resistance need attention on a worldwide basis. Improving antibiotic use requires a global effort".

Prof. Stuart B. Levy

Tufts University School of Medicine

The Alliance for Prudent Use of Antibiotics Boston, MA