Antibiotic resistance is a global problem. The best efforts of individual countries cannot manage the problem completely without extensive international co-operation. While the willingness exists, there is no effective and co-ordinated international system to monitor the emergence of antibiotic-resistant bacteria.

This is cause for serious concern. In many of the world's countries, antibiotics are less tightly controlled and are available over-the-counter without prescription. This leads to amateur dosage and expansion of antibiotic resistance. Similarly, the sanitation standards for foods and food handling are sometimes not as high as those in Canada. With a trend to import more products as part of the globalization of the economy, we place an even greater burden on our regulatory inspection system.

About two-thirds of all oral antibiotics worldwide are obtained without a prescription and are inappropriately used against diseases such as TB, malaria, pneumonia and more routine child infections. These practices contribute to antimicrobial resistance and the severe, nearly impossible to treat hospital-acquired infections.*

Nordic nations - particularly Denmark, Sweden, Norway and Finland - are recognized for their particularly active campaigns to communicate with their own health care professionals as part of an effort to reduce antimicrobial resistance.

* The Global Infectious Disease Threat and Its Implications for the United States - NIE 99-17D, January 2000 - John C. Gannon, Chairman, National Intelligence Council