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Kudakwashe Pembere
Correspondent
For Zimbabwe to deal with Antimicrobial Resistance (AMR), uniformity of data is needed to inform and guide policy makers in coming up with interventions and investment to mobilise resources for One Health.
According to the World Health Organisation, AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines.
As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability and death.
One Health is an approach that recognises that the health of people is closely connected to the health of animals and our shared environment.
Uniform reporting of data across all elements of One Health namely animal, environment and human health is a major hindrance to the fight against AMR among African Union Member States.
AMR experts from the Africa Union participated in a virtual meeting recently where the issue of data stood out.
Recommendations from this meeting are going to be presented by the AU representatives to be present at the United Nations General Assembly meeting in September this year.
Mapping Antimicrobial Resistance and Antimicrobial use Partnership (MAAP) project manager Dr Watipaso Kasambara highlighted that human health sector data could be used to create a baseline for other One Health elements but stressed the need for more focus on animal health data.
“But beyond that, looking at data sources, for example, thinking about surveillance data, clinical data, and epidemiological data, so our group really explored this further, and one of the things that we highlighted is, yes, we need information and data on AMR, or consumption,” she said.
It was also noted that data was necessary to ascertain the cost of inaction with regards to the AMR response.
“It is impossible for us to know the cost if we do not even know the data, or if we do not know the data sources we are looking at,” she said.
Some experts say lack of data in Zimbabwe is affecting efforts to come up with an investment or economic case for AMR.
“We should look at the implication, the cost implication of the impact of AMR, thinking about hospitalisation costs, healthcare costs, surgical costs, bed costs, for example, and we are able to tie this to make s an economic case for AMR,” added Dr Kasambara.
There was also a suggestion of the need to have an Africa AMR data repository.
“There was also this suggestion around the data repository at the continental level, where there must be push to look at ways to improve data quality, whether it is in producing guideline, guiding documents and common protocols at a continental level, that will also lead to the continent having a strong data repository of quality data.
Africa CDC AMR expert Dr Yewande Alimi noted that at the UNGA, the Africa Union delegation should reflect on low-cost preventive interventions which can be used in the fight against AMR.
“We are seeing that theme around financing resource mobilisation whereby we can define measures for adequate sustainable AMR funding, including the scope to existing financial instrument. I think one of them being the pandemic fund, which many people are moving to.
“But beyond that, a few things are unique to the African continent that the global targets are not taken consideration of. One of them is cost-effective preventive interventions, such as increasing Water, Sanitation and Hygiene (WASH) and Infection Prevention and Control (IPC).
“This is not really reflected in the global conversations and the need for Africa Union to really drive this agenda,” she said.
While many African countries display a paucity of data on AMR, a local AMR expert Dr Tinashe Hodobo argues that Zimbabwe is doing surveillance in human health and animal health.
“The statement that there is a lack of One Health data in the country is not entirely accurate. Diseases, including those of One Health concern, are being monitored in humans, animals, and pathogens found in food that can affect humans,” he said.
Efforts are being made to ensure surveillance is being done in human and animal AMR data while works are underway to ensure that the environment will be included.
“Although this data exists, it may not be reaching all stakeholders. Surveillance efforts in both humans and animals are ongoing, ensuring that the data is being collected,” he said.
Dr Hodobo added that there was limited analysis of this data generated daily in scientific journals.
“One issue contributing to the perceived lack of data is the limited analysis and publication of this information in scientific journals, which results in a lack of online visibility. Consequently, researchers relying on online sources might incorrectly conclude that the data does not exist, despite it being generated daily,” he said.
For the animal health sector which is part of the food chain, the Food and Agriculture Organisation (FAO)has been working with Zimbabwe’s agriculture ministry, extension officers and the veterinary department in various districts across the country such as Mutare, Masvingo, Murehwa and establishing farmer field schools.
At these farmer field schools, poultry farmers are taught the prudent care of their chickens to minimise AMR.
Among the lessons taught are biosecurity measures and the use of alternatives to antibiotics in the treatment of sick chicken.
African Union Inter-Africa Bureau for Animal Resources (AU-IBAR), coordinator, Mr John Oppong-Otoo, highlighted the challenges posed by the increasing antimicrobial resistance.
“The rise of antimicrobial resistance complicates the treatment of infections, leading to longer hospital stays, increased mortality rates, and higher healthcare costs. In countries with limited resources and healthcare infrastructure, the burden of AMR can be especially challenging to manage. The environmental dimension of AMR cannot be overlooked.
“The discharge of antimicrobial residues from agricultural runoff, pharmaceutical manufacturing, and improper disposal of unused medications can contribute to the spread of resistance genes in soil, water, and air, impacting ecosystems and potentially exacerbating the problem,” he said.
When it comes to ruminants such as the cattle, the Zimbabwean Government reintroduced a vaccine for the fight against January disease or theileriosis.
Zimbabwe is also a recipient of the Fleming Fund and a grant consortium of FAO, Biomedical Research and Training Institute.
In partnerships with WHO, 14 human and animal health laboratories in three provinces (Bulawayo, Mutare and Masvingo) were rehabilitated in 2022.
To improve awareness for health professionals, Zimbabwe introduced an AMR module for nurses so they can educate the public about this issue.
In November last year, 106 registered nurses, primary care nurses, and midwifery educators in Zimbabwe received training on topics such as AMR in HIV, AMR in malaria, AMR in fungal, AMR in bacteria, sample collection, the role of nurses in the fight against AMR, the structure of bacteria, viruses, fungi, protozoa, and antimicrobial stewardship.
Online Reporter