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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.
人類的一些做法、行為和政策失誤，大大加速并放大了這一自然過程。全世界都未能以恰當?shù)闹斏鱽韺Υ@些易受影響的藥物。我們想當然地以為神藥永遠存在，舊藥最終失效，而更新、更好、作用更強的藥物會取代它們。但我們現(xiàn)在看到的趨勢卻并非如此。
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.
耐藥性遲早都會出現(xiàn)，而錯誤的做法和站不住腳的假設明顯地讓它提前發(fā)生，而非延后。對瘧疾等疾病，我們的選擇余地十分有限，因為只有青篙素類復合制劑這一類有效藥物，每年用來治療2億多惡性瘧病例。盡管通過“瘧疾藥物開發(fā)項目”這一公私合作機制以及其他機制正在開發(fā)新藥，但人們已經發(fā)現(xiàn)了青篙素耐藥的早期征兆。
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.
我們在減少腹瀉及呼吸道感染造成的死亡兒童人數(shù)方面所取得的成就也同樣面臨危險。還有，結核造成的死亡人數(shù)不斷下降，但僅去年就有近50萬人出現(xiàn)了耐多藥結核，并造成其中1/3的人死亡。這些只是我們必須注意的嚴峻警告中的一部分。
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.
我們對轉變目前的局勢負有全責。抗菌劑的不合理及不當使用，目前是出現(xiàn)耐藥的最主要原因。它包括發(fā)藥過于隨便導致的過度用藥；有時是“為保險起見”，有時是因為患者要求，但經常是因為醫(yī)生和藥師想掙更多的錢。
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.
它還包括用藥不足，尤其是患者因經濟困難而感覺稍好就停止用藥，而不是堅持完成殺死所有病原體所需的整個療程。還包括用藥與疾病不符（通常是在缺乏實驗室診斷的情況下）導致的藥物誤用。
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.
在許多國家，它還包括未能杜絕劣質藥品進入市場，未能確保抗菌劑只能由合法注冊的處方人員開出，未能阻止零散藥片作為非處方藥出售。
