daniel chigunwe
Rumbidzayi Zinyuke
Health Buzz
Imagine a world where diseases and infections are impossible to treat.
A world where all the medicines that have been manufactured for centuries can no longer work. Either on humans or on animals. Even on plants.
What sort of world would that be? Definitely one of pain and death.
This paints a ruthless picture, but one that could become reality in the next few years if the world does not address the issue of antimicrobial resistance (AMR).
This week, Zimbabwe joins the rest of the world to commemorate World Antimicrobial Resistance Awareness Week running from of November 18 to 24.
The campaign is observed every year to improve awareness and understanding of AMR and encourage best practices in coming up with strategies to reduce its further emergence and spread.
AMR happens when germs like bacteria or fungi evolve and stop responding or respond less to treatment.
This is mostly because of the rise in the misuse and overuse of antibiotics, antivirals, anti-fungals and antiprotozoal medications, which lead to drug resistance in humans, animals and plants alike.
Data shows that in 2019, over 1,27 million deaths globally, were directly related to antimicrobial resistance, almost equalling HIV/AIDS and malaria combined, which caused 860 000 and 640 000 deaths, respectively.
Compared to other regions, Sub-Saharan Africa has the highest AMR-associated deaths at 99 deaths per 100 000 far exceeding previous global projections of 700 000 annual deaths from AMR.
Additionally, about 214 000 neonatal sepsis deaths annually are directly attributable to drug-resistant pathogens.
Projections show that if decisive action is not taken immediately, the world will be facing a catastrophe by 2050 and Africa will lose millions of lives yearly and this will consequently result in countries losing an average 2 to 3,5 percent in Gross Domestic Product (GDP).
According to deputy director general of Africa Centres for Disease Control and Prevention for Africa, Dr Ahmed Ouma Ogwell, AMR is a critical threat to health security and economic growth.
“It is projected that millions of Africans could succumb to antimicrobial resistance by 2050 if important steps are not taken. In Africa, AMR has already been documented to be a bigger problem than HIV, malaria, and tuberculosis combined. AMR stands as one of the leading public health challenges of the 21st century, with Africa having the world’s highest mortality rate from AMR infections, resulting in over 27 deaths per 100,000,” he said.
It is often believed that humans are the only ones affected by drug resistance and this is understood to only come from the medicines they take. But human, animal life and the environment are inextricably intertwined.
It, therefore, means AMR will affect every one of these aspects.
Studies have shown that when antibiotics spill into the soil and waterways, resistant strains of bacteria can emerge in the environment.
They in turn can infect animals and humans that come into contact with them.
Also, antibiotic resistant bacteria of treated animals can be present in manure and, therefore, be disseminated into the environment and to wildlife.
The same phenomenon can be observed in human health as well, with antimicrobial resistance emerging from misuse of antibiotics in people.
New resistant strains of bacteria have been shown to dangerously affect hospital patients all over the world.
Food and Agriculture Organisation regional representative Mr Abebe Haile-Gabriel says the drivers of AMR in the food and agriculture sector include unregulated antimicrobial sales in veterinary pharmacies, misuse of antimicrobials as growth promoters in the unsustainable intensification of livestock production, or as preventative medicine for diseases, unintended uses of medicated feed by farmers, the proliferation of poor-quality veterinary medicines, and poor farm biosecurity and disease prevention measures.
“Antimicrobials used anywhere in the world impacts Africa because of the continent’s high dependence on food imports. If left unaddressed, AMR may force tens of millions more people into extreme poverty, hunger and malnutrition, and could cripple livelihoods. Therefore, it is crucial to implement measures, from farm to fork, to reduce the spread of drug-resistant microbes and use antimicrobial drugs more responsibly and only when needed,” he said.
So, does this mean we should stop using antibiotics?
No. Antibiotics are vital to global health, and to stop using them when medically justified, is not an option.
But countries do need to make sure that they actively come up with policies and strategies to combat this public health threat.
This can only be done through a collective whole of society approach which will see governments, development partners, the private sector and communities coming together.
Lands, Agriculture, Fisheries, Water and Rural Development Minister, Dr Anxious Masuka, said AMR was a complex issue that demands unified action.
“It is a one health issue, encompassing the interconnectedness of human health, animal health, environmental health, and agricultural practices,” he said. “To effectively combat AMR, we need a concerted effort from various sectors, with human health and environmental conservation, and agriculture leading the charge.
“We must work together across disciplines and boundaries to develop strategies that promote responsible antibiotic use, strengthen infection prevention and control measures, and preserve the effectiveness of these life-saving medications.”
Zimbabwe launched its AMR One Health national action plan in 2017 and has just finalised the second review of the plan.
But more needs to be done.
It should be everyone’s responsibility to preserve the efficacy of antimicrobial medicines.
The WHO believes that this can be achieved through strengthening the One Health collaborative approach.
It also calls for countries to enhance regulation of antimicrobials.
As the United Nations resident coordinator Mr Edward Kallon said, the threat from AMR in Sub Saharan Africa is mostly due to the growing un-regulated and inappropriate use of antimicrobials across sectors as well as the lack of policies to guide procurement and use of medicines.
This has led to the proliferation of substandard and falsified medicines.
“These negative antecedents, put at risk several sustainable development goals related to health, agriculture, animals, the environment, and food security. There is a need for the reinforcement of surveillance systems to monitor resistance patterns, enhance regulatory frameworks, and promote education and awareness campaigns to empower individuals with the knowledge needed to take action,” he said.
Communities, armed with knowledge on antimicrobial resistance can lead the fight to reduce AMR.
Access to clean water, sanitation and hygiene could reduce AMR cases by 60 percent.
Experts believe having access to clean water, sanitation, and hygiene, as well as good infection prevention and control measures, such as handwashing and vaccination reduce the likelihood of infection in the first place, so that antibiotics may not need to be used.
Farmers should also know how to safely use antimicrobials in the production of food.
At the end of the day, educating communities on AMR will go a long way in the fight against this scourge.
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