“On the value of reframing antibiotic resistance as a disaster risk problem”
Dr. Maurizio Labbate1,2 & A/Prof. Dale Dominey-Howes3
1School of Medical and Molecular Biosciences, University of Technology, Sydney, Australia.
2The ithree Institute, University of Technology, Sydney, Australia.
3Asia – Pacific Natural Hazards Research Group, School of Geosciences, University of Sydney, Australia.
On the 1st May 2014 the World Health Organization in its first global assessment of antimicrobial resistance reported that antibiotic resistance has now reached alarming proportions and is no longer a future problem but a contemporary reality. This comes off the back of other urgent calls from leading authorities including the Deputy Director of the Center for Disease Control (CDC) who has publicly stated that we have now reached the “end of the antibiotic era” and the UK Chief Medical Officer, Professor Dame Sally Davies who called for antibiotic resistance to be placed on the risk register above the issue of terrorism. Increasingly, the tone of the language used by these organizations and individuals is reminiscent of that used by the disaster and emergency risk management communities to describe commonly occurring disasters such as earthquakes, fires, floods and storms.
Antibiotic resistant infections are rising fast and affect millions of people globally. Antibiotic resistance has become a slow onset disaster that like climate change has struggled to elicit the sort of coordinated international response that is required to deal with the magnitude of the emergency. Anthropogenic modification of the Earth’s climate system provides the foundation for sudden onset natural disasters such as hurricanes, wildfires and storms. Likewise, increasingly widespread antibiotic resistance is laying the foundation for the future occurrence of sudden onset bacterial epidemic and pandemic disasters.
Despite the finest efforts by medical and health policy makers and communities to control the antibiotic resistance problem, the issue has reached a critical tipping point. Given the current state of the antibiotic resistance problem and the likely near future of untreatable bacterial infections, we propose an alternative and novel policy perspective. With this is mind, we propose to make antibiotic a broader issue and reframe it as a disaster risk problem and engage the expertise of emergency managers. Governments and disaster policy makers across the world use the Emergency Risk Management process in the management of and preparation for natural disasters. This process is a systematic method that through engagement with multiple stakeholders identifies, analyses, evaluates and treats risks and takes an iterative approach with well-defined activities that lead to implementation of risk-treatment strategies tailored to a specific community’s risk profile. This policy and practice framework is an excellent mechanism for reaching out to communities and communicating complex messages – an area that needs to be enhanced.