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WHO multi-country survey reveals widespread public misunderstanding about antibiotic resistance

‘Antibiotics: Handle with care’

‘Antibiotics: Handle with care’

As the World Health Organization (WHO) ramps up its fight against antibiotic resistance, a new multi-country survey shows people are confused about this major threat to public health and do not understand how to prevent it from growing.

Antibiotic resistance happens when bacteria change and become resistant to the antibiotics used to treat the infections they cause. Over-use and misuse of antibiotics increase the development of resistant bacteria, and this survey points out some of the practices, gaps in understanding and misconceptions which contribute to this phenomenon. Find out more about the cause of antibiotic resistance at our new series on antibiotic resistance here.


Almost two thirds (64%) of some 10 000 people who were surveyed across 12 countries say they know antibiotic resistance is an issue that could affect them and their families, but how it affects them and what they can do to address it are not well understood. For example, 64% of respondents believe antibiotics can be used to treat colds and flu, despite the fact that antibiotics have no impact on viruses. Close to one third (32%) of people surveyed believe they should stop taking antibiotics when they feel better, rather than completing the prescribed course of treatment.

“The rise of antibiotic resistance is a global health crisis, and governments now recognize it as one of the greatest challenges for public health today. It is reaching dangerously high levels in all parts of the world,” says Dr Margaret Chan, WHO Director-General, in launching the survey findings today. “Antibiotic resistance is compromising our ability to treat infectious diseases and undermining many advances in medicine.”

The survey findings coincide with the launch of a new WHO campaign ‘Antibiotics: Handle with care’—a global initiative to improve understanding of the problem and change the way antibiotics are used.

“The findings of this survey point to the urgent need to improve understanding around antibiotic resistance,” says Dr Keiji Fukuda, Special Representative of the Director-General for Antimicrobial Resistance. “This campaign is just one of the ways we are working with governments, health authorities and other partners to reduce antibiotic resistance. One of the biggest health challenges of the 21st century will require global behaviour change by individuals and societies.”

The multi-country survey included 14 questions on the use of antibiotics, knowledge of antibiotics and of antibiotic resistance, and used a mix of online and face-to-face interviews. It was conducted in 12 countries: Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, the Russian Federation, Serbia, South Africa, Sudan and Viet Nam. While not claiming to be exhaustive, this and other surveys will help WHO and partners to determine the key gaps in public understanding of this problem and misconceptions about how to use antibiotics to be addressed through the campaign.

Some common misconceptions revealed by the survey include:

Three quarters (76%) of respondents think that antibiotic resistance happens when the body becomes resistant to antibiotics. In fact bacteria—not humans or animals—become resistant to antibiotics and their spread causes hard-to-treat infections.

Two thirds (66%) of respondents believe that individuals are not at risk of a drug-resistant infection if they personally take their antibiotics as prescribed. Nearly half (44%) of people surveyed think antibiotic resistance is only a problem for people who take antibiotics regularly. In fact, anyone, of any age, in any country can get an antibiotic-resistant infection.

More than half (57%) of respondents feel there is not much they can do to stop antibiotic resistance, while nearly two thirds (64%) believe medical experts will solve the problem before it becomes too serious.

Another key finding of the survey was that almost three quarters (73%) of respondents say farmers should give fewer antibiotics to food-producing animals.

To address this growing problem, a global action plan to tackle antimicrobial resistance was endorsed at the World Health Assembly in May 2015. One of the plan’s five objectives is to improve awareness and understanding of antibiotic resistance through effective communication, education and training.

KEY FINDINGS OF THE SURVEY BY COUNTRY

Barbados (507 face-to-face interviews)

Only 35% of respondents say they have taken antibiotics within the past six months—the lowest proportion of any country included in the survey; of those who have taken antibiotics, 91% say they were prescribed or provided by a doctor or nurse.
Fewer than half of respondents (43%) have heard of the term ‘antibiotic resistance’; and fewer than half (46%)—less than any other country in the survey—believe that many infections are becoming increasingly resistant to treatment by antibiotics.
Only 27% of respondents agree with the statements ‘Antibiotic resistance is one of the biggest problems the world faces’ and that ‘Experts will solve the problem’—the lowest proportion of all participating countries for both questions.

China (1,002 online interviews)

57% of respondents report taking antibiotics within the past six months; 74% say they were prescribed or provided by a doctor or nurse; 5% say they purchased them on the internet.
More than half (53%) of respondents wrongly believe that they should stop taking antibiotics when they feel better, rather than taking the full course as directed.
61% of respondents think, incorrectly, that colds and flu can be treated by antibiotics.
Two thirds (67%) of respondents are familiar with the term ‘antibiotic resistance’ and three quarters (75%) say it is ‘one of the biggest problems in the world’.
83% of respondents say that farmers should give fewer antibiotics to animals—the highest proportion of any country in the survey.

Egypt (511 face-to-face interviews)

More than three quarters (76%) of respondents say they have taken antibiotics within the past six months, and 72% say they were prescribed or provided by a doctor or nurse.
55% of respondents incorrectly think that they should stop taking antibiotics when they feel better, rather than taking the full course; and more than three quarters (76%) wrongly believe that antibiotics can be used to treat colds and flu.
Less than one quarter (22%) of respondents have heard of the term ‘antibiotic resistance’—the lowest proportion of any country included in the survey.

India (1,023 online interviews)

More than three quarters (76%) of respondents report having taken antibiotics within the past six months; 90% say they were prescribed or provided by a doctor or nurse.
Three quarters (75%) of respondents think, incorrectly, that colds and flu can be treated with antibiotics; and only 58% know that they should stop taking antibiotics only when they finish the course as directed.
While 75% agree that antibiotic resistance is one of the biggest problems in the world, 72% of respondents believe experts will solve the problem before it becomes too serious.

Indonesia (1,027 online interviews)

Two thirds (66%) of respondents report having taken antibiotics in the past six months; 83% of respondents say they were prescribed or provided by a doctor or nurse.
More than three quarters (76%) of respondents know that they should only stop taking antibiotics when they have taken all of them as directed, but 63% incorrectly think they can be used to treat colds and flu.
84% of respondents are familiar with the term ‘antibiotic resistance’ and two thirds (67%) believe that many infections are becoming increasingly resistant to treatment by antibiotics.

Mexico (1,001 online interviews)

Three quarters (75%) of respondents report having taken antibiotics within the past six months; 92% say they were prescribed by a doctor or nurse; and 97% say they got them from a pharmacy or medical store.
The majority of respondents (83%) accurately identify that bladder/urinary tract infections (UTIs) can be treated with antibiotics, but 61% wrongly believe that colds and flu can be treated with antibiotics.
89% of respondents in Mexico say they have heard of the term ‘antibiotic resistance’ and 84% believe many infections are becoming increasingly resistant to treatment by antibiotics—a higher proportion than any other country included in the survey on both questions.

Nigeria (664 face-to-face interviews)

Almost three quarters (73%) of respondents report taking antibiotics within the past six months; 75% of respondents state they were prescribed or provided by a doctor or nurse; 5% say they bought them from a stall or hawker.
More respondents in Nigeria than any other country included in the survey correctly identify that antibiotics do not work for colds and flu (47%), however 44% of respondents think they do.
Only 38% of respondents have heard of the term ‘antibiotic resistance’—the second lowest proportion of all the countries surveyed.

Russian Federation (1,007 online interviews)

A little more than half of respondents (56%) report having taken antibiotics within the past six months; the same proportion (56%) say their most recent course of antibiotics was prescribed or provided by a doctor or nurse—the lowest proportion of any country included in the survey.
Two thirds (67%) of respondents incorrectly think colds and flu can be treated with antibiotics, and more than one quarter (26%) think they should stop taking antibiotics when they feel better rather than taking the full course as directed.
Awareness of the term ‘antibiotic resistance’ was high among respondents at 82%.
71% think antibiotics are widely used in agriculture in their country and 81% say that farmers should give fewer antibiotics to animals.

Serbia (510 face-to-face interviews)

Fewer than half (48%) of respondents say they have taken antibiotics within the past six months; 81% say they were prescribed or provided by a doctor or nurse.
The majority of respondents (83%) accurately identify that bladder infections/UTIs can be treated with antibiotics, but more than two thirds (68%) wrongly believe that colds and flu can be treated with antibiotics.
Only 60% of respondents in Serbia have heard of the term ‘antibiotic resistance’ and only one third (33%) think it is one of the biggest problems the world faces.
81% of respondents say that farmers should give fewer antibiotics to animals.

South Africa (1,002 online interviews)

65% of respondents say they have taken antibiotics within the past six months; a higher proportion of people than any other country included in the survey (93%) say their last course of antibiotics was prescribed or provided by a doctor or nurse, and 95% say they had advice from a medical professional on how to take them.
87% of respondents know they should only stop taking antibiotics when they finish the course of treatment—a higher proportion than any other country included in the survey.
The same proportion (87%) of respondents—and again more than any other country in the survey—recognize that the statement ‘It’s OK to use antibiotics that were given to a friend of family member, as long as they were used to treat the same illness’ is false. It is a practice which can encourage the development of resistance.

Sudan (518 face-to-face interviews)

More than three quarters (76%) of respondents report having taken antibiotics within the past six months; 91% say they were prescribed or provided by a doctor or nurse.
62% of respondents incorrectly think they should stop taking antibiotics when they feel better—more than any other country included in the survey—and 80% think antibiotics can be used to treat colds and flu. Both of these statements are incorrect. These are practices which encourage the development of antibiotic resistance.
94% of respondents agree that people should use antibiotics only when prescribed, and 79% believe that antibiotic resistance is one of the biggest problems the world faces—the highest percentages on both questions of any of the countries where the survey was undertaken.
Viet Nam (1,000 online interviews)

71% of respondents state they have taken antibiotics within the past six months; three quarters (75%) report they were prescribed or provided by a doctor or nurse.
86% of respondents think that the body becomes resistant to antibiotics (whereas in fact it is bacteria)—a higher proportion than any other country included in the survey.
83% think that many infections are becoming increasingly resistant to antibiotics.
70% of respondents think that antibiotics are widely used in agriculture in their country and almost three quarters (74%) agree that ‘antibiotic resistance is one of the biggest problems the world faces’.

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World Mental Health Day 2015 – Dignity in mental health. Check out the Mental Health Atlas country profiles


World Mental Health Day - Dignity

World Mental Health Day – Dignity

Today as you may know is World Mental Health Day 2015 this year’s theme is “Dignity in mental health” You might be interested in our World Mental Health Day infographic which can be found here.

Thousands of people with mental health conditions around the world are deprived of their human rights. As well as being discriminated against, stigmatized and marginalized, they are also subject to emotional and physical abuse in both mental health facilities and the community. Poor quality care due to a lack of qualified health professionals and dilapidated facilities leads to further violations.


This year, the World Health Organisation will be raising awareness of what can be, and is being, done to ensure that people with mental health conditions can continue to live with dignity, through human rights-oriented policy and law, training of health professionals, respect for informed consent to treatment, inclusion in decision-making processes, and public information campaigns.

To find out about the state of mental health provision in your country have a look at Mental Health Atlas-2014 country profiles.

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Child mortality rates plunge by more than half since 1990 but global MDG target missed by wide margin


16,000 children under 5 years old die each day

Child mortality rates have plummeted to less than half of what they were in 1990,

Child mortality rates

Child mortality rates

according to a new report released today. Under-five deaths have dropped from 12.7 million per year in 1990 to 5.9 million in 2015. This is the first year the figure has gone below the 6 million mark.

New estimates in Levels and Trends in Child Mortality Report 2015 released by UNICEF, the World Health Organization, the World Bank Group, and the Population Division of UNDESA, indicate that although the global progress has been substantial, 16,000 children under five still die every day. And the 53 per cent drop in under-five mortality is not enough to meet the Millennium Development Goal of a two-thirds reduction between 1990 and 2015.

“We have to acknowledge tremendous global progress, especially since 2000 when many countries have tripled the rate of reduction of under-five mortality,” said UNICEF Deputy Executive Director Geeta Rao Gupta. “But the far too large number of children still dying from preventable causes before their fifth birthday – and indeed within their first month of life – should impel us to redouble our efforts to do what we know needs to be done. We cannot continue to fail them.”


The report notes that the biggest challenge remains in the period at or around birth. A massive 45 per cent of under-five deaths occur in the neonatal period – the first 28 days of life. Prematurity, pneumonia, complications during labour and delivery, diarrhoea, sepsis, and malaria are leading causes of deaths of children under 5 years old. Nearly half of all under-five deaths are associated with undernutrition.

However, most child deaths are easily preventable by proven and readily available interventions. The rate of reduction of child mortality can speed up considerably by concentrating on regions with the highest levels – sub-Saharan Africa and Southern Asia – and ensuring a targeted focus on newborns.

“We know how to prevent unnecessary newborn mortality. Quality care around the time of childbirth including simple affordable steps like ensuring early skin-to-skin contact, exclusive breastfeeding and extra care for small and sick babies can save thousands of lives every year,”  noted Dr Flavia Bustreo, Assistant Director General at WHO. “The Global Strategy for Women’s, Children’s and Adolescents’ Health, to be launched at the UN General Assembly this month, will be a major catalyst for giving all newborns the best chance at a healthy start in life.”

The report highlights that a child’s chance of survival is still vastly different based on where he or she is born. Sub-Saharan Africa has the highest under-five mortality rate in the world with 1 child in 12 dying before his or her fifth birthday – more than 12 times higher than the 1 in 147 average in high-income countries. In 2000-2015, the region has overall accelerated its annual rate of reduction of under-five mortality to about two and a half times what it was in 1990-2000. Despite low incomes, Eritrea, Ethiopia, Liberia, Madagascar, Malawi, Mozambique, Niger, Rwanda, Uganda, and Tanzania have all met the MDG target.

Sub-Saharan Africa as a whole, however, continues to confront the immense challenge of a burgeoning under-five population – projected to increase by almost 30 per cent in the next 15 years – coupled with persistent poverty in many countries.

“This new report confirms a key finding of the 2015 Revision of the World Population Prospects on the remarkable decline in child mortality globally during the 15-year MDG era,” said UN Under-Secretary-General for Economic and Social Affairs Mr. Wu Hongbo. “Rapid improvements since 2000 have saved the lives of millions of children. However, this progress will need to continue and even accelerate further, especially in high-mortality countries of sub-Saharan Africa, if we are to reach the proposed child survival target of the 2030 Agenda for Sustainable Development.”

“Many countries have made extraordinary progress in cutting their child mortality rates. However, we still have much to do before 2030 to ensure that all women and children have access to the care they need,” said Dr Tim Evans, Senior Director of Health, Nutrition and Population at the World Bank Group. “The recently launched Global Financing Facility in Support of Every Woman Every Child with its focus on smarter, scaled and sustainable financing will help countries deliver essential health services and accelerate reductions in child mortality.”

Among the report’s findings:

  • Roughly one-third of the world’s countries – 62 in all – have actually met the MDG target to reduce under-five mortality by two-thirds, while another 74 have reduced rates by at least half.
  • The world as a whole has been accelerating progress in reducing under-five mortality – its annual rate of reduction increased from 1.8 per cent in 1990-2000 to 3.9 per cent in 2000-2015.
  • 10 of the 12 low income countries which have reduced under-five mortality rates by at least two-thirds are in Africa.
  • 5 in 10 global under-five deaths occur in sub-Saharan Africa and another 3 in 10 occur in Southern Asia.
  • 45 per cent of all under-five deaths happen during the first 28 days of life. 1 million neonatal deaths occur on the day of birth, and close to 2 million children die in the first week of life.
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Roll Back Malaria – a great initiative for World Malaria Day!


World Malaria Day 2015

World Malaria Day 2015

Today is , as you may know, World Malaria Day 2015. We covered the day last year here.

Despite dramatic declines in malaria cases and deaths since 2000, more than half a million lives are still lost to this preventable disease each year.

At least three quarters of malaria deaths occur in children under 5. Yet in 2013, only about one in five African children with malaria received effective treatment for the disease, 15 million pregnant women did not receive a single dose of the recommended preventive drugs, and an estimated 278 million people in Africa still live in households without a single insecticide-treated bed net.

“As we celebrate World Malaria Day on April 25, we must recognize the urgent need to expand prevention measures and quality-assured diagnostic testing and treatment to reduce the human suffering caused by malaria,” says Dr Hiroki Nakatani, World Health Organisation (WHO) Assistant Director-General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases.

WHO also recommends that the most vulnerable groups in malaria-endemic areas of sub-Saharan Africa—pregnant women, children under 5, and infants—receive preventive treatment to reduce the risk of malaria infection. Preventive treatments are highly cost-effective, with the potential to save tens of thousands of lives each year. Coverage with such treatments, however, remains low and needs to be significantly scaled up.

The need to urgently address gaps in preventive treatment for malaria is also being highlighted by the Roll Back Malaria (RBM) Partnership, which has issued a global call to action to increase national coverage with preventive treatment in pregnancy.


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World Health Day 2015 – Five keys to safer food


World Health Day - Five keys to safer food

World Health Day – Five keys to safer food

Today, April 7th, is World Health Day.

This year’s theme is “From farm to plate, make food safe”.

As part of this The World Health Organisation have launched a campaign called “Five keys to safer food”.

Above is this poster they have prepared to promote the campaign. We would be very grateful if you would like and share to help us get the message out to as many people as possible.

Many thanks in advance.


WHO share ““Food production has been industrialized and its trade and distribution have been globalized,” says WHO Director-General Dr Margaret Chan. “These changes introduce multiple new opportunities for food to become contaminated with harmful bacteria, viruses, parasites, or chemicals.”

Dr Chan adds: “A local food safety problem can rapidly become an international emergency. Investigation of an outbreak of foodborne disease is vastly more complicated when a single plate or package of food contains ingredients from multiple countries.”

Unsafe food can contain harmful bacteria, viruses, parasites or chemical substances, and cause more than 200 diseases – ranging from diarrhoea to cancers. Examples of unsafe food include under-cooked foods of animal origin, fruits and vegetables contaminated with faeces, and shellfish containing marine biotoxins.

Today, WHO is issuing the first findings from what is a broader ongoing analysis of the global burden of foodborne diseases. The full results of this research, being undertaken by WHO’s Foodborne Disease Burden Epidemiology Reference Group (FERG), are expected to be released in October 2015.

Some important results are related to enteric infections caused by viruses, bacteria and protozoa that enter the body by ingestion of contaminated food. The initial FERG figures, from 2010, show that:
• there were an estimated 582 million cases of 22 different foodborne enteric diseases and 351 000 associated deaths;
• the enteric disease agents responsible for most deaths were Salmonella Typhi (52 000 deaths), enteropathogenic E. coli (37 000) and norovirus (35 000);
• the African region recorded the highest disease burden for enteric foodborne disease, followed by South-East Asia;
• over 40% people suffering from enteric diseases caused by contaminated food were children aged under 5 years.

Unsafe food also poses major economic risks, especially in a globalized world. Germany’s 2011 E.coli outbreak reportedly caused US$ 1.3 billion in losses for farmers and industries and US$ 236 million in emergency aid payments to 22 European Union Member States.

Efforts to prevent such emergencies can be strengthened, however, through development of robust food safety systems that drive collective government and public action to safeguard against chemical or microbial contamination of food. Global and national level measures can be taken, including using international platforms, like the joint WHO-FAO International Food Safety Authorities Network (INFOSAN), to ensure effective and rapid communication during food safety emergencies.

At the consumer end of the food supply chain, the public plays important roles in promoting food safety, from practising safe food hygiene and learning how to take care when cooking specific foods that may be hazardous (like raw chicken), to reading the labels when buying and preparing food. The WHO Five Keys to Safer Food explain the basic principles that each individual should know all over the world to prevent foodborne diseases.

“It often takes a crisis for the collective consciousness on food safety to be stirred and any serious response to be taken,” says Dr Kazuaki Miyagishima, Director of WHO’s Department of Food Safety and Zoonoses. “The impacts on public health and economies can be great. A sustainable response, therefore, is needed that ensures standards, checks and networks are in place to protect against food safety risks.”

WHO is working to ensure access to adequate, safe, nutritious food for everyone. The Organization supports countries to prevent, detect and respond to foodborne disease outbreaks—in line with the Codex Alimentarius, a collection of international food standards, guidelines and codes of practice covering all the main foods. Food safety is a cross-cutting issue and shared responsibility that requires participation of non-public health sectors (i.e. agriculture, trade and commerce, environment, tourism) and support of major international and regional agencies and organizations active in the fields of food, emergency aid, and education.
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