World Health Organization Report on Infectious Diseases 2000

Since their discovery, antibiotics have completely transformed humanity's approach to infectious disease. Today, the use of antibiotics combined with improvements in sanitation, housing, and nutrition alongside the advent of widespread vaccination programmes, have led to a dramatic drop in once common infectious diseases that formerly laid low entire populations. Scourges that once struck terror into the hearts of millions – plague, whooping cough, polio and scarlet fever – have been, or are, on the verge of being controlled. Now, at the dawn of a new millennium, humanity is faced with another crisis. Formerly curable diseases such as gonorrhoea and typhoid are rapidly becoming difficult to treat, while old killers such as tuberculosis and malaria are now arrayed in the increasingly impenetrable armour of antimicrobial resistance.

This phenomenon is potentially containable. It is a deepening and complex problem accelerated by the overuse of antibiotics in developed nations and the paradoxical underuse of quality antimicrobials in developing nations owing to poverty and a resultant dearth of effective health care.

Last year's infectious diseases report, "Removing Obstacles to Healthy Development," demonstrated that communicable diseases remain a significant cause of disability, are responsible for continued high mortality and primarily afflict the world's most vulnerable populations.

This year's report focuses on the issue of drug resistance and how this disturbing development is closing the windows of opportunity to treat infectious diseases. By developing a global strategy to contain resistance and building alliances involving all healthcare providers – countries, governments, international organizations, non-governmental organizations and both the private and public health care sectors – we have an opportunity to launch a massive effort against infectious diseases that perpetuate poverty. Used wisely and widely, the drugs we have today can be made available to the world's poorest to prevent the health care catastrophes of tomorrow.

This is our challenge and must be our goal.

Dr Gro Harlem Brundtland
Director-General, WHO

Preface:      Our Window of Opportunity is Closing
Chapter 1:   A World Without Antibiotics
Chapter 2:   The Discovery of Antimicrobials
Chapter 3:   Factors Contributing to Resistance
Chapter 4:   The Big Guns of Resistance
Chapter 5:   Call to Action
Epilogue