Myth: New drugs accelerate resistance
9 October 2001
If we introduce new medicines into poor countries, we will accelerate the development of resistance. We don't necessarily need new drugs but we need to better use the ones we have. Drug resistance is often perceived as a problem restricted to a few diseases in poor countries. It is, however, an inescapable phenomenon in both the industrialized and developing world, due to the normal genetic survival mechanism of most parasites, bacteria, and viruses. Resistance to drugs will inevitably develop, and can do so despite good drug management and high compliance to treatment. For example, in the Moyo district of Uganda, sleeping sickness patients have been treated with the 50-year old drug melarsoprol for more than ten years. In spite of strict drug management and good compliance, recent studies have shown resistance in excess of 30%. In this case, although introducing combinations of drugs may forestall resistance, new drugs will also be needed. In general, two things are required in the fight against drug resistance. Existing therapies must be used rationally in order to delay the onset of resistance, and new drugs must continuously be developed to create future therapeutic choices to face the inevitability of drug resistance. As with sleeping sickness, the neglect of tuberculosis and malaria drug research in the last thirty years has made treatment increasingly difficult and led to a situation where, in some instances, treatment is becoming less effective. Finally, fear of inducing resistance has never been a sufficient reason to withhold necessary treatment in the industrialized world. It should not be considered justifiable in the developing world.