HK can educate Asia on misuse of antibiotics

PUBLISHED : Tuesday, 12 April, 2011, 12:00am
UPDATED : Tuesday, 12 April, 2011, 12:00am


When the World Health Organisation dedicates World Health Day each year, it tends to focus on things that can make the world a safer place, like road safety, child health or combating climate change. This year, it chose something that has already made the world far safer - antibiotics, but in this case the sensible use of them. That is because of growing evidence that unless they are prescribed and used responsibly, antibiotics could become part of the problem rather than the solution.

The problem is superbugs, so called because they are resistant to all but a tiny handful of antibiotics of last resort and in some cases to all of them. Medical authorities are in no doubt that this is because of the misuse of antibiotics, typically overuse such as taking them for viral illnesses like colds or flu for which they are useless, or not taking them or completing courses as directed by doctors. Experts say most antibiotics could become useless in five years without steps to curb misuse. Hong Kong is no exception to a worldwide trend of resistance. This newspaper reported last year that the most common example in our hospitals, methicillin-resistant Staphylococcus aureus, or MRSA, affects 9,000 patients a year and kills more than 200. At that time, the Centre for Health Protection stepped up an alert over a superbug gene, NDM-1, which first emerged in South Asia and has been declared a global health threat. NDM-1 can make common bacteria such as E coli resistant to nearly all known antibiotics and, as been seen in DNA patterns, is easily copied and passed on.

Since Hong Kong hosts superbugs and is at the crossroads of Asia, it may seem surprising that a leading European expert sees the city as a regional rallying point against antibiotic resistance. But Herman Goossens, founder and vice-chairman of the Belgian Antibiotic Co-ordination Committee, cites Hong Kong's unique experience in fighting Sars and bird flu as reason to believe it can emulate Belgium's leadership in campaigning against misuse of antibiotics and fighting drug resistance.

The World Health Organisation says diseases due to drug resistance will be a leading threat this decade. Experience elsewhere indicates that education - especially to dispel common misconceptions - and transparency are key to hopes that Hong Kong can lead the way in containing antibiotic resistance. A Centre for Health Protection survey shows that about one in three Hong Kong people believe that antibiotics can cure flu and two in three think they can cure viral infections. A 10-year campaign in Belgium to dispel such myths and educate both the public and doctors in the use of fewer antibiotics has seen resistance from pneumonia-causing bacteria drop by up to 11 per cent, prompting European countries, the US and Canada to develop similar campaigns.

The head of the University of Hong Kong's Centre for Infection, Professor Ho Pak-leung, says the single most important step is to make figures on drug resistance transparent to the public. After Britain made its MRSA infection rates public in 2005, blood infections fell from 7,700 to 1,800 in five years. Hong Kong's figures are not always readily available, perhaps to avoid triggering irrational fears about entering hospitals, a common point of transmission. In the long run, ignorance and misconception pose greater risks to public health. Hong Kong should take up the challenge of leading Asia's response to the misuse of antibiotics by setting an example in public education and transparency.