The issue of sustainability
The increasing demand for healthcare, rising healthcare and medicine costs and technological developments that are succeeding each other at breakneck speed, are putting pressure on the Dutch healthcare system. Yet the greatest challenge of our modern Western society is not in the organisation of our healthcare system. The spreading of antimicrobial resistance (AMR) is the greatest threat to current public health; a social sustainability issue for which we need to find a sustainable solution. Better yesterday than today.
The aging society and the increase in invasive medical interventions raise the number of care- associated infections. Without effective antibiotics, we cannot remedy these infections, perform operations, do transplants and perform intensive care therapy. If policy doesn’t change, simple operations or treatment in an intensive care unit will become life-threatening in the future. Moreover, in that case we will simply no longer be able to operate patients in ten years' time.
In order to pass our system on to the next generation, we have to approach and treat antibiotic resistance as a social problem. Developing new and especially smart antibiotics to combat resistance is good, but at the same time it is like ‘a band-aid on the wound’. So far, against every newly developed antibiotic within no time resistance has developed. Therefore, it is an illusion to think that we can put an end to antibiotic resistance. We can, however, ensure that dangerous micro-organisms that are resistant do not spread and that infections for patients remain manageable. If we co-operate interdisciplinary and transdisciplinary, we can provide insight into the numerous causes underlying the spreading of antimicrobial resistance and develop effective methods for infection and resistance prevention.
A sustainable approach is the prevention of the spreading of antimicrobial resistance that keeps the circulation of specific multiresistant micro-organisms below the epidemic threshold. This requires multiple and complex interventions. The Aletta Jacobs School of Public Health transboundary works on the problem within the theme of Sustainability, and investigates antimicrobial resistance from different disciplines. We also work together with stakeholders from Leeuwarden to Oldenburg: bacteria do not stop at the borders of provinces or countries. Within the theme of Sustainability, the focus in the next five years will be on the microbiological comparison of antimicrobial resistance in the border regions, interventional modelling of the EPI network and the development of appropriate infection prevention.
Only when governments, companies, health insurers, care – and educational institutions join forces to form a collective policy, we can continue to offer safe and affordable care in the future. And exactly that is what we strive for within the Aletta Jacobs School of Public Health.