• Saturday, 22 June 2024
THE STATESMAN OPINION: Antimicrobial Resistance, Another Pandemic In The Pipeline?

THE STATESMAN OPINION: Antimicrobial Resistance, Another Pandemic In The Pipeline?

By Dr. David Ouma

In the shadows of COVID-19 lurks yet another pandemic. As a healthcare provider, I can attest that Antimicrobial Resistance (AMR) is an escalating threat that is becoming all too real. Recently, I reviewed a sensitivity report for a strain of Klebsiella pneumoniae, which showed resistance to most antibiotics, including reserve antibiotics. This is particularly alarming as reserve antibiotics are reserved as a last resort when all other options have failed.

It is therefore crucial that we implement effective strategies to address AMR. Additionally, I recently encountered a young woman battling a multi-drug-resistant Urinary Tract Infection for over a year. Such incidents, and many others like them, confirm that AMR is a silent pandemic that is gradually becoming a significant public health crisis. Everyone needs to take action to prevent AMR from becoming the next global health crisis.

Antimicrobials are medications used to treat infections caused by viruses, fungi, parasites, and bacteria. Antimicrobial resistance occurs when microorganisms are no longer susceptible to the drugs used to treat them. AMR is a natural phenomenon that occurs when microorganisms change certain aspects of their genetic makeup to adapt to their host environment.

However, certain human actions accelerate this process, including the overuse and misuse of antimicrobial drugs in humans, animals, and agriculture, poor sanitation and hygiene, lack of access to clean water, inadequate healthcare services including infection control, and a lack of access to quality medicines.

The effects of AMR are devastating; previously treatable infections are now becoming very difficult to treat. A classic example is gonorrhea which has developed multi-resistant strains, also called superbug gonorrhea. This rise in AMR is causing longer hospital stays, higher healthcare costs, and in some cases, death. In fact, a report by the World Health Organization (WHO) warns that AMR could cause 10 million deaths by 2050, with Low- and Middle-Income Countries (LMICs) being the hardest afflicted.

In LMICs, Antimicrobial Resistance is aggravated by challenges including; weak healthcare systems, poor access to quality antimicrobial drugs, and limited resources. These countries also have a higher burden of infectious diseases like malaria, HIV, and tuberculosis requiring frequent use of antimicrobial agents and therefore higher propensity to overuse and misuse. Additionally, they have a high burden of poverty, malnutrition, and poor sanitation, contributing to the spread of infectious diseases and AMR. It is therefore imperative, especially in the developing world, that we take action to combat it.

It is evident that AMR poses a significant public health challenge that requires a multi-pronged approach to address. For Low- and Middle-Income Countries (LMICs), the initial step is to strengthen their healthcare systems to ensure the proper use of antimicrobial drugs. This can be achieved by promoting evidence-based medical practices through infrastructure improvements that enhance testing capabilities for bacterial isolates and sensitivity testing. These improvements will aid decision-making for the best therapeutic strategies. Furthermore, new policies and legislation can be implemented to address the availability of antimicrobial drugs

Common colds and flu are viral infections that do not respond to antibiotics, which are only effective against bacterial infections. Using antibiotics to treat viral infections is not only ineffective but also harmful, as it can lead to the development of AMR. Instead, supportive therapy with fluids, rest, and antihistamines can help alleviate symptoms and aid recovery.

While these positions are supported by science, the general public has continued to rely on over-the-counter accessibility of antibiotics for their colds and flu. Thus, Public awareness is a crucial step in reducing the misuse of antibiotics and combating AMR. This should be extended to education on the need to finish antibiotic doses as prescribed.

LMICs must also invest in research to anchor their public health surveillance and develop new antimicrobial drugs. The global pharmaceutical market is dominated by the US, Europe, and Japan; the global pharmaceutical industry therefore focuses on the development of drugs for diseases more prevalent in these countries. LMICs with a higher burden of infectious diseases and with a high propensity to develop AMR through disruptions in supply chains must shift focus on manufacturing to enhance the availability and affordability of these medications.

As the adage goes, prevention is better than cure. LMICs must develop infection prevention and control strategies. This can be achieved by interventions such as; the provision of clean water, improved sanitation, and enhanced availability of vaccinations. Additionally, Public health surveillance teams can be provided with more resources to enhance their response to public health emergencies like infectious disease outbreaks.

[The writer is a Pharmacotherapy Specialist, with an interest in Oncology.]

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