Editorials

Globalisation and antibiotic resistance

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c5116 (Published 21 September 2010) Cite this as: BMJ 2010;341:c5116
  1. Anthony So, director, program on global health and technology access 1,
  2. Melissa Furlong, associate in research1,
  3. Andreas Heddini, executive director of ReAct (action on antibiotic resistance)2
  1. 1Sanford School of Public Policy and Duke Global Health Institute, Duke University, Durham, NC 27708, USA
  2. 2Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  1. anthony.so{at}duke.edu

    Hospitals engaged in medical tourism can turn crisis into opportunity

    The global spread of bacteria carrying the New Delhi metallo-β-lactamase-1 (NDM-1) enzyme through India, Pakistan, and the United Kingdom—and now half a dozen other countries—has sparked much media coverage.1 The outbreak’s importance stems from the broad resistance to all antibiotics except tigecycline and colistin seen in bacterial strains carrying the gene for NDM-1 and from the ready transmission across borders.

    The original report of NDM-1 cautioned against medical tourism, suggesting the costs of contracting treatment resistant infection outside the UK might well outweigh the savings of lower priced care abroad. The naming of NDM-1 after New Delhi—its purported place of discovery—further vexed Indian government officials worried about potential fallout for the country’s burgeoning medical tourism industry. This added drama has distracted attention from what ought to be the main plot of this story.

    Modern advances in health care, from organ transplants to cancer chemotherapy, are reliant on effective antibiotics and vulnerable to resistance. Multidrug resistant strains are no longer an isolated phenomenon, nor confined by political borders. To India’s credit, the government is preparing a policy on rational use of antibiotics.2 Healthcare leaders gather on 22 September 2010 for the World Medical …

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