Antimicrobial resistance ? a public health issue?

Abstract

With any decision to label a disease a public health issue comes an implicit understanding that action must be taken and that there should be a government intervention or management plan ? but there is no standard definition of what constitutes a public health issue. Most often the factors considered are the number of cases, the vulnerability of the affected group and rapidity of spread, and the levels of morbidity and mortality caused. The cost to the community ? either directly in managing the disease or in loss of work or productivity ? is also an important factor. We can all think of infectious diseases that fit these criteria; meningococcal meningitis, because it kills young healthy adults and children rapidly; pandemic influenza because it has the potential to kill many rapidly; sexually transmitted diseases carrying with them social stigma and the potential to cause sterility; tuberculosis with its transmissability and protracted and potentially lethal course; and food borne infections causing large outbreaks. Where does antimicrobial resistance (AMR) fit in this and is it a public health issue? To answer this question we must look at the evidence.