The continued increase in the use and misuse of antimicrobial medicines has seen countries in sub-Saharan Africa recording the highest rates of death associated with drug resistance, a development which experts fear could reverse the gains recorded in the control of diseases such as HIV, malaria, tuberculosis and sexually transmitted infections.
Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites mutate over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death.
As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.
The evolution comes especially when drugs are misused or wrongly used.
A surviving microbe from an infection survives the treatment and that is the one that breeds and spreads.
This is one reason why those on antibiotics and other treatments are told to finish the course, even after they feel well, to ensure that there are no survivors.
In her world anti-microbial awareness week 2022 message, World Health Organisation regional director for Africa Dr Matshidiso Moeti said the region was recording drug resistance death rates of 99 per 100 000 population, which exceeded previous global projections of 700 000 annual deaths from drug resistance.
“The global and regional burden is alarming, but it is sub-Saharan African countries that bear the heaviest burden of resistant bacterial infections,” she said. “In 2019, 4,95 million deaths globally were attributed to drug-resistant bacterial infections, with 1,27 million directly related to AMR — more than HIV/AIDS and malaria combined.
“Compounding the challenge is that more than half of all deaths recorded in the WHO African region are caused by communicable diseases managed with antimicrobial medicines. As such, AMR puts at risk decades of advances towards the control of diseases such as malaria, HIV, tuberculosis and sexually-transmitted infections.”
Reports also suggested that the management of Covid-19 patients with antibiotics had fueled the global AMR threat.
Although Covid-19 is a virus, not a bacterium, some doctors were prescribing anti-biotics to ensure there were no secondary bacteria infections taking advantage of the patient’s weakness.
The World AMR awareness week runs from November 18 to 24 every year, and is meant to raise awareness of the risks posed by overuse and misuse of antimicrobials, including antibiotics, and to encourage their more responsible use.
In the spirit of the One Health approach, this year’s theme, “Preventing Antimicrobial Resistance Together”, calls for urgent multi-sectoral action to preserve the efficacy of this fundamental component of modern medicine.
Dr Moeti said lack of effective antimicrobials would also negatively impact treatment of diseases in animals, with potentially dire consequences for food security, and overall economic growth.
“While AMR does occur naturally, the concern lies with the current high rates of development and spread,” she said.
“Other than misuse and overuse of antimicrobials in human and animal health, other drivers include: limited availability and uptake of vaccines; limited diagnostic capacity to support appropriate treatment; lack of access to clean water, sanitation and hygiene; poor infection prevention and control practices; poor disposal practices; and the presence of antimicrobials in the environment and water bodies.”
Guided by the Global Action Plan on AMR, and in line with WHO’s 13th General Programme of Work, WHO in the African region supported regional and national interventions to combat AMR.
So far, 39 countries have developed national action plans to counter the threat, with 30 approved by national authorities.
Dr Moeti called on African member states to commit investment towards sustainable local financing and implementation of AMR national action plans focused on infection prevention and control, clean water, sanitation, and hygiene in their communities, as well as the establishment of multi-sectoral coordination mechanisms to counter the risks.
“Build resilient health systems by maintaining the critical balance between addressing AMR and maintaining access to vital medicines,” she said. “Strengthen surveillance and laboratory capacity for detection, prevention and response to AMR through existing global and regional strategies and policies, including Universal Health Coverage and the International Health Regulations.”
Dr Moeti said Africans had a role to play in containing the threat of AMR by improving their health-seeking behaviours, not self-medicating but rather seeking professional advice in the event of illness, and ensuring that any prescribed treatment courses are completed. – The Herald
