‘Unless checked, antimicrobial resistance will cause more deaths annually than cancer’

Everyone has a role to play in combating AMR. Individuals and farmers can help by using antibiotics only when prescribed by a healthcare professional, completing the full course of treatment, and practicing good hygiene to prevent infections.

COMMENT | Dr JacksonTwebaze Ndahayo  | Antimicrobial resistance (AMR) poses a significant threat to global health, jeopardizing decades of progress in modern medicine. AMR occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve mechanisms to resist the effects of antimicrobial drugs, including antibiotics, antivirals, antifungals, and antiparasitics. This resistance renders standard treatments ineffective, leading to persistent infections and an increased risk of spread to others.

The discovery of antibiotics revolutionized healthcare, saving millions of lives and enabling complex surgeries and treatments. However, the overuse and misuse of these life-saving drugs have accelerated the development of resistant strains of pathogens. The rise of AMR is now one of the most urgent public health threats, with projections estimating that, if left unchecked, AMR could cause 10 million deaths annually by 2050, surpassing cancer as a leading cause of death.

The Science Behind AMR

AMR arises through a variety of mechanisms, primarily driven by genetic mutations and the acquisition of resistance genes from other organisms. Resistance can be intrinsic, where the bacteria naturally resist certain antibiotics, or acquired, where they gain resistance through mutations or horizontal gene transfer. The latter occurs when bacteria share genetic material, often via plasmids, which carry resistance genes. For example, Methicillin-resistant Staphylococcus aureus (MRSA) is a well-known “superbug” that has developed resistance to multiple antibiotics, making it a formidable challenge in healthcare settings.

Factors Contributing to AMR

One of the leading causes of AMR is the overuse and misuse of antibiotics in human and veterinary medicine. Patients often demand antibiotics for viral infections, against which these drugs are ineffective, or fail to complete prescribed courses, giving bacteria a chance to survive and adapt. In agriculture, antibiotics are frequently used not only to treat sick animals but also as growth promoters, further contributing to resistance. Environmental contamination from pharmaceutical manufacturing and improper disposal of antibiotics also plays a significant role. Poor infection prevention and control measures in hospitals and clinics can exacerbate the spread of resistant bacteria. Healthcare-associated infections (HAIs) are often caused by resistant strains due to the high use of antibiotics in these environments.

Global Impact of AMR

The health consequences of AMR are profound, leading to longer hospital stays, higher medical costs, and increased mortality. The economic impact is also significant, with estimates suggesting that AMR could reduce global GDP by 2-3.5% by 2050. Furthermore, the effectiveness of medical procedures, such as surgeries, cancer treatments, and organ transplants, relies heavily on effective antibiotics to prevent and treat infections. The rise of “superbugs” like MRSA, carbapenem-resistant Enterobacteriaceae (CRE), and multidrug-resistant tuberculosis (MDR-TB) threatens to undermine these medical advancements.

#Raise #awareness #AMR pic.twitter.com/T80R3HRbaq

— Dr. Twebaze Ndahayo Jackson (@DrNdahayo) August 28, 2024

Current Efforts to Combat AMR

Recognizing the severity of the AMR threat, the World Health Organization (WHO) developed a global action plan in 2015, focusing on improving awareness, strengthening surveillance, reducing infection rates, optimizing antibiotic use, and encouraging the development of new antibiotics. Many countries have since implemented national strategies to combat AMR, including antimicrobial stewardship programs and public awareness campaigns.

Surveillance programs, such as the Global Antimicrobial Resistance Surveillance System (GLASS) and national antimicrobial surveillance systems, play a crucial role in tracking the spread of resistance and informing policy decisions. Healthcare professionals are also increasingly aware of their role in prescribing antibiotics responsibly and educating patients on the importance of adhering to prescribed treatments.

Challenges in Tackling AMR

Despite the efforts, significant challenges remain. The development of new antibiotics has slowed dramatically, with few new drugs reaching the market in recent decades. This is partly due to the high cost and complexity of developing new antibiotics, coupled with the relatively low financial return compared to other pharmaceuticals.

Inadequate regulatory frameworks and the lack of enforcement in many countries further exacerbate the problem, leading to the unregulated sale of antibiotics and inappropriate use. Low- and middle-income countries, where access to healthcare is limited, often face additional challenges in combating AMR due to a lack of resources and infrastructure.

The pharmaceutical industry’s role is also under scrutiny, as there is a need for greater investment in antibiotic research and development. However, the financial incentives are often insufficient to drive the development of new drugs, leading to calls for new models of funding and collaboration.

The Future of AMR

To combat AMR, innovation in antibiotic development is essential. Researchers are exploring alternative therapies, such as bacteriophage therapy, which uses viruses to target specific bacteria, and probiotics, which aim to restore healthy microbial balance. Advances in diagnostics are also crucial, enabling rapid identification of resistant infections and guiding appropriate treatment.

Technology and artificial intelligence (AI) are playing an increasingly important role in AMR management. AI can help predict resistance patterns, identify potential new antibiotics, and optimize treatment regimens. Additionally, global cooperation and data sharing are vital to tackling this global threat effectively.

Call to Action

Everyone has a role to play in combating AMR. Individuals and farmers can help by using antibiotics only when prescribed by a healthcare professional, completing the full course of treatment, and practicing good hygiene to prevent infections. Policymakers must prioritize the development of robust regulatory frameworks, support research and development, and promote international collaboration.

The future of healthcare depends on our ability to address AMR effectively. Without immediate and coordinated action, the world faces a post-antibiotic era where common infections and minor injuries could once again be fatal.

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Dr. Jackson Twebaze Ndahayo, District Veterinary Officer, Butaleja