Reflections on a 30th Anniversary
Stuart B. Levy, M.D.
APUA Chairman and President
Professor of Molecular Biology & Microbiology and of Medicine
Director of the Center for Adaptation Genetics and Drug Resistance
Tufts University School of Medicine
Ten years ago, the 20th Anniversary celebration for APUA took place in Chicago. How timely that we return to this city for our 30th Anniversary. In the context of the remarks I made in 2001, let us look back three decades, from the origins of APUA to the current and accomplished activities of our organization.
Founded in 1981, APUA emerged from a meeting in the Dominican Republic, when individuals from developing and industrialized countries came together to discuss a common problem most evident in developing countries – resistance to antibiotics. The issue was made more critical in resource-poor countries where new antibiotics emerging in the industrialized nations were too costly and not readily available to treat individuals with multidrug-resistant infections in developing nations. Consequently, lives were lost that might have been saved.
Discussions at the meeting in Santo Domingo urged greater awareness of the problem. There was a push to establish an organization that was global, which dealt with the issue of antibiotic resistance. What emerged was the Alliance for the Prudent Use of Antibiotics. The words were carefully chosen. It arose on the heels of a time-coordinated press release simultaneously in four countries (Mexico, Brazil, Dominican Republic, and the United States).
By an “alliance,” it was meant that there would be different groups as well as individuals, which would address local problems and mount efforts in their own countries. These groups would then, join together to form an international organization which dealt with this problem locally and internationally, helping each other.
We have grown enormously since 1981, and certainly over the past decade, with successful funding from foundations and government and non-government public health institutions such as The Bill and Melinda Gates Foundation, the Department of Homeland Security, the Agency for International Development, the Centers for Disease Control and Prevention, and the National Institutes of Health. A number of reports have been issued, including the 2001 book accompanying the WHO report on containment of antimicrobial resistance, summarizing the recommendations of 25 different expert groups for dealing with resistance. Studies have examined public attitudes toward antibiotics and resistance. Others have looked at commensal bacteria as reservoirs of drug resistance genes. We have also examined the impact of antibacterial-surface household products on the control of microbes versus their effect on selecting microbes that are resistant not only to the biocide, but also to antibiotics.
Unfortunately, we have still not made definitive progress in our quest to remove antibiotics from animal feeds. This is not the case in Europe, where the EU has banned this practice and has continued to raise animals for food production without the need for supplementation of the feed. We can hope that, with activities such as PAMTA, the STAAR Act, and other initiatives coming through Congress, as well as the activities of the FDA and the Food Safety Bill, we shall see the removal of antibiotics from animal feeds in the United States and other countries that have not yet followed Europe’s initiative.
As in other areas, the advancement in Internet activities and social networking has helped in our efforts to increase awareness of antibiotic resistance and proper use of antibiotics. APUA now has its own blog and Twitter account. We have membership in over 100 countries, and have now, in the last 10 years, gone from about 22 country chapters to 66, with a large number of them in the developing world, including Africa. The APUA Newsletter has been continually published since the beginnings of APUA. It remains our first and longest-sustained product and is now electronically distributed free to outside members and non-members all over the world. In some places, it is the only piece of current information on antibiotics and resistance available to individuals in remote parts of the world.
With increasing awareness of this issue, and the continued concern expressed by the World Health Organization (including dedication of World Health Day to the issue of antibiotic resistance this year), we can look forward to advancement in these activities over the next years. I optimistically hope to report on our 40th Anniversary that we have, in fact, overcome many of the obstacles we currently face, and that many others have been improved upon.
Speaking for myself, the Board, and other staff members here at APUA, I thank you for your continued support, and welcome your comments and news of local activities where we can help.
Stuart B. Levy
Click for more information on 30th anniversary events (September 18, 2011)
Click to return to front page of the APUA Clinical Newsletter Vol. 29 No. 2