China announced a State-level plan on Aug 25 to curb antimicrobial resistance, high-lighting the first multisector effort involving 14 ministries and agencies, including health, agriculture, food and drug, and environmental protection.

Previously, major measures fighting antimicrobial resistance, such as stricter control of antibiotic use at medical facilities, were initiated by the health authority.

However, that’s far from enough, said Xiao Yonghong, a professor at the Institute of Clinical Pharmacology at Peking University and an adviser on the issue to the National Health and Family Planning Commission.

“It’s a long overdue initiative and demonstrates the government’s recognition of the challenge and the resolution to change systematically,” he said. The World Health Organization defines antimicrobial resistance as “resistance of a microorganism to an anti-microbial drug that was originally effective for treatment of infections caused by it”.

A report in the United Kingdom, the “Global Review on AMR”, estimated that by 2050, antimicrobial resistance, including antibiotic resistance, could result in 1 million premature deaths in China per year.

It also called for joint efforts internationally to tackle the global challenge of AMR, which can spread in part through international trade.

Xiao said the upcoming G20 Leaders Summit in Hangzhou, Zhejiang province, will include a session on fighting AMR through global cooperation. The effort must start within each country, he added.

Under the plan, the Chinese government will intensify international cooperation and exchanges to prevent and control drug-resistant bacteria in the next five years.

Martin Taylor, coordinator for health systems and security at the WHO’s China office, said the WHO welcomes China’s move to introduce a multisector action plan to fight antimicrobial resistance. He said the plan demonstrates China’s global leadership on the issue before the G20 summit of international leaders.

Taylor said China faces many problems that lead to AMR.

There are not enough rapid diagnostic tests to allow physicians to prescribe the correct antibiotic, and over-the-counter sales of antibiotics without prescriptions in some pharmacies continue, he said. Moreover, Taylor cited an over-reliance on antibiotics for prevention and treatment of infections and said hospitals generate revenue from the sale of drugs including antibiotics.

Additionally, the public still demands antibiotics when they might not be needed, and the full course of treatment is not always completed, he said.

In response, the Chinese government also pledged in the new plan to integrate measures to intensify over-sight in research and development, production, distribution and application of antibiotics in the next five years.

All retail drugstores in China should sell antibiotics only when provided with prescriptions by 2020, the plan says. Major public hospitals are required to establish a management mechanism to strictly control antibiotic use.

On the agriculture side, veterinarians and employees of poultry and livestock industries will be required to finish training on the proper use of antibiotics by 2020.

Xiao said regularly feeding antibiotics to food animals fosters a breeding ground for drug-resistant pathogens that might threaten humans via the food chain.

To raise public awareness, the plan calls for all primary and middle school students to be educated on the issue by 2020.

“The more you eat antibiotics, the greater the risk of developing AMR,” Xiao warned.

In addition, it is expected that one or two new antibiotic drugs, and at least five new testing devices developed by Chinese companies or institutes, will be developed and made available by 2020, according to the plan.