|
Combat drug resistance: no action today means no cure tomorrow --Statement on World Health Day 2011 by WHO Director-General, Dr Margaret Chan
抗菌素耐药性：今天不采取行动，明天就无药可用 ——2011年世界卫生日致辞 世卫组织总干事 陈冯富珍
When the first antibiotics were introduced in the 1940s, they were hailed as “wonder drugs”, the miracles of modern medicine. And rightly so. Widespread infections that killed many millions of people every year could now be cured. Major diseases, like syphilis, gonorrhoea, leprosy, and tuberculosis, lost much of their sting. The risk of death from something so common as strep throat or a child’s scratched knee virtually vanished.
抗生素于上个世纪40年代首次现身时，被人们惊呼为“神药”，是现代医学的奇迹。情况也的确如此。曾经每年夺去数百万人生命的广泛存在的感染，现在得以治愈。梅毒、淋病、麻风和结核等主要疾病失去了锋芒。链球菌性咽喉炎或孩子划伤腿等常见病患造成死亡的风险基本上已不复存在。
The powerful impact of these medicines sparked a revolution in the discovery of new drugs. The human condition took a dramatic turn for the better, with significant jumps in life expectancy.
这些药物的巨大影响引发了一场发现新药的革命。人类的状况得到了极大好转，期望寿命有了显著提高。
The message on this World Health Day is loud and clear. The world is on the brink of losing these miracle cures.
今年世界卫生日传达的信息清晰而响亮：世界即将失去这些神药。
The emergence and spread of drug-resistant pathogens has accelerated. More and more essential medicines are failing. The therapeutic arsenal is shrinking. The speed with which these drugs are being lost far outpaces the development of replacement drugs. In fact, the R&D pipeline for new antimicrobials has practically run dry.
耐药病原体已经加速出现和蔓延。越来越多人们必需的药物正在失效。可供选择的治疗手段日益减少。我们失去这些药物的速度远远超过其替代药物的开发速度。新抗菌剂的研发线事实上已日趋枯竭。
The implications are equally clear. In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated. The implications go beyond a resurgence of deadly infections to threaten many other life-saving and life-prolonging interventions, like cancer treatments, sophisticated surgical operations, and organ transplantations. With hospitals now the hotbeds for highly-resistant pathogens, such procedures become hazardous.
其影响同样不言而喻。如不采取紧急的纠正和预防行动，世界将进入后抗生素时代，许多常见感染将不再有药可医，死亡将再次有增无减。其影响不仅仅是致命感染会卷土重来，还会威胁到其他许多挽救和延长生命的干预措施，如癌症治疗、复杂的外科手术、器官移植等。随着医院现在成了高度耐药病原体的温床，上述操作也变得风险重重。
While hospital “superbugs” make the biggest headlines, these especially deadly pathogens are just the extreme expression of a much broader, and more disturbing picture.
医院的“超级病菌”成了最引人注目的新闻，但这些致死性极强的病原体只是更大规模、更令人不安情况的冰山一角。
The development of resistance is a natural biological process that will occur, sooner or later, with every drug. The use of any antimicrobial for any infection, in any dose, and over any time period, forces microbes to either adapt or die in a phenomenon known as “selective pressure”. The microbes which adapt and survive carry genes for resistance, which can be passed on from one person to another and rapidly spread around the world.
出现耐药是每种药物迟早都会发生的自然生物过程。针对某种感染使用某一剂量的某种抗菌剂一段时间，会迫使微生物或是适应，或是死亡；这种现象称为“选择压力”。适应并存活下来的微生物携带耐药基因，可以从一个人传给另一个人，并在世界上快速蔓延开来。
This natural process has been vastly accelerated and amplified by a number of human practices, behaviours, and policy failures. Collectively, the world has failed to handle these fragile cures with appropriate care. We have assumed that miracle cures will last forever, with older drugs eventually failing only to be replaced by newer, better and more powerful ones. This is not at all the trend we are seeing.
人类的一些做法、行为和政策失误，大大加速并放大了这一自然过程。全世界都未能以恰当的谨慎来对待这些易受影响的药物。我们想当然地以为神药永远存在，旧药最终失效，而更新、更好、作用更强的药物会取代它们。但我们现在看到的趋势却并非如此。
Faulty practices and flawed assumptions have clearly made the inevitable development of drug resistance happen much sooner, rather than later. For some diseases, like malaria, our options are very limited as we have only a single class of effective drugs - artemisinin-based combination therapies - with which to treat more than 200 million falciparum cases each year. Although new drugs are under development, especially through the Medicines for Malaria Venture, a public-private partnership, early signals of artemisinin resistance have already been detected.
耐药性迟早都会出现，而错误的做法和站不住脚的假设明显地让它提前发生，而非延后。对疟疾等疾病，我们的选择余地十分有限，因为只有青篙素类复合制剂这一类有效药物，每年用来治疗2亿多恶性疟病例。尽管通过“疟疾药物开发项目”这一公私合作机制以及其他机制正在开发新药，但人们已经发现了青篙素耐药的早期征兆。
Similarly, gains in reducing child deaths due to diarrhoea and respiratory infections are at risk. And, while TB deaths are declining, in just the past year nearly half a million people developed multidrug-resistant TB, and a third of them died as a result. These are just a few of the stark warnings that must be heeded.
我们在减少腹泻及呼吸道感染造成的死亡儿童人数方面所取得的成就也同样面临危险。还有，结核造成的死亡人数不断下降，但仅去年就有近50万人出现了耐多药结核，并造成其中1/3的人死亡。这些只是我们必须注意的严峻警告中的一部分。
The responsibility for turning this situation around is entirely in our hands. Irrational and inappropriate use of antimicrobials is by far the biggest driver of drug resistance. This includes overuse, when drugs are dispensed too liberally, sometimes to “be on the safe side”, sometimes in response to patient demand, but often for doctors and pharmacists to make more money.
我们对转变目前的局势负有全责。抗菌剂的不合理及不当使用，目前是出现耐药的最主要原因。它包括发药过于随便导致的过度用药；有时是“为保险起见”，有时是因为患者要求，但经常是因为医生和药师想挣更多的钱。
This includes underuse, especially when economic hardship encourages patients to stop treatment as soon as they feel better, rather than complete the treatment course needed to fully kill the pathogen. This includes misuse, when drugs are given for the wrong disease, usually in the absence of a diagnostic test.
它还包括用药不足，尤其是患者因经济困难而感觉稍好就停止用药，而不是坚持完成杀死所有病原体所需的整个疗程。还包括用药与疾病不符（通常是在缺乏实验室诊断的情况下）导致的药物误用。
In many countries, this includes a failure to keep substandard products off the market, to ensure that antimicrobials are dispensed only by a licensed prescriber, and to stop over-the-counter sales of individual pills.
在许多国家，它还包括未能杜绝劣质药品进入市场，未能确保抗菌剂只能由合法注册的处方人员开出，未能阻止零散药片作为非处方药出售。
And this includes the massive routine use of antimicrobials, to promote growth and for prophylaxis, in the industrialized production of food. In several parts of the world, more than 50% in tonnage of all antimicrobial production is used in food-producing animals. In addition, veterinarians in some countries earn at least 40% of their income from the sale of drugs, creating a strong disincentive to limit their use. The problem arises when drugs used for food production are medically important for human health, as evidence shows that pathogens that have developed resistance to drugs in animals can be transmitted to humans.
它还包括在食品工业化生产中大量常规地使用抗菌剂来促进生长和防病。在世界不少地区，抗菌剂产量的总吨数中，有50%以上是用于产肉动物。此外，有些国家兽医的收入中，至少有40%来源于卖药，极不利于抗菌剂的限制使用。当用于食品生产的药物对人类健康有着重要意义时，问题就出现了，因为证据显示，动物中的耐药病原体可以传给人。
On this World Health Day, WHO is issuing a policy package to get everyone, especially governments and their drug regulatory systems, on the right track, with the right measures, quickly. Governments can make progress, working with health workers, pharmacists, civil society, patients, and industry. We all can plan and coordinate our response. We can expand surveillance efforts. We can improve drug regulatory and supply systems. We can foster improved use of medicines for human and animal health. We can actively prevent and control infections in health services and beyond. And, we must stimulate a robust pipeline for new antimicrobials, diagnostics and vaccines.
值此世界卫生日之际，世卫组织发布了一套政策，让每个人，尤其是政府及药品监管体系，端正方向，迅速采取正确措施。政府可与医务人员、药剂人员、民间团体、患者和企业合作，携手前进。我们所有人都可计划和协调自己的应对行动。我们可以扩大监测工作。我们可以改善药品监管供应系统。我们可以倡导改善人类与动物卫生中的用药。我们可以积极防控卫生服务内外的感染。我们必须鼓励建立针对新的抗菌剂、诊断工具及疫苗的强有力的研发线。
Drug resistance costs vast amounts of money, and affects vast numbers of lives. The trends are clear and ominous. No action today means no cure tomorrow. At a time of multiple calamities in the world, we cannot allow the loss of essential medicines – essential cures for many millions of people – to become the next global crisis.
耐药造成了巨大的经济损失，众多人的生命受到影响，这种不祥的趋势显而易见。今天不采取行动，就意味着明天无药可用。在这个世界发生着多重灾难的时刻，我们不能让失去数百万人所必需的基本药物成为下一次的全球危机。
 ↓下载资源↓
|
发表于 2017-5-30 21:09:02
收藏
分享
发表于 2018-11-28 20:58:13
