Antimicrobial Resistance: One of the Major Public Health Issues
By Adebisi Yusuff Adebayo
Development of resistance against antimicrobial agents is known to be one of the greatest global public health problems of the twenty-first century. According to The Center for Diseases Control (CDC), drug resistance (AMR) is the 2nd most expressive global health threat in 2014. Irrational use of antimicrobials provides advantageous conditions for resistant microbes to spread and also to thrive and replicate.
A recent report was made by Economist Jim O' Neil where he suggested that the cost of antimicrobials globally due to resistance could lead to loss of 10,000,000 lives a year by 2050 and cost one hundred trillion USD annually.
Antimicrobial resistance is one of the major global public health problems. The problem is becoming serious since most of the antimicrobials are already in their last line of use. Drugs are known to improve the quality of lives and ensure increase in life span of patients which further stresses the need to address antimicrobial resistance in healthcare.
Antimicrobial resistance has become a great problem evident in increase in death rate, higher healthcare cost and prolonged hospital stay due to the fact that microbes are developing resistance to the drugs which have once been proven to show therapeutic actions.
This can affect anyone, in any country and of any age. There are a lot of factors that contribute to this. Antimicrobial resistances are seriously on a war path and obviously have gained edge. Their actions are evidently propelling the development of resistance to medicinal agents.
Rampant inappropriate use of antibiotics among the population and livestock by the farmers, circulation of counterfeit drugs and substandard prescriptions together with poor diagnosis, or lack of it are adding fuel to the already fired path of resistance.
In various regions of the world, antibiotics can be purchased over the counter with little or no medical advice by most of patent medicine dealers basically due to lack of knowledge.
African countries have high load of infectious diseases (e.g. the air and water-borne diseases) especially the Sub Saharan region of Africa among its population and the use of medicinal agents with antimicrobial effects especially antibiotics has been widely used to treat various infections.
A growing number of infections such as gonorrhea, malaria, typhoid, tuberculosis, etc. are becoming difficult to treat. Indiscriminate and irrational use of antibiotics has led to bacteria developing resistance against the drugs. Antimicrobial resistance indeed raises concern on the long term sustainable effectiveness of most antibiotics used to treat various infectious diseases, it's potential impact on the country's health and how it affects the global health and economy at large.
Antibiotics resistance thrive more in areas where antibiotics can be purchased for animal or human use without a prescription. This made the emergence and spread of resistance worse. Also, in countries that do not have or do not strictly follow the standard treatment guidelines, irrational use of antibiotics is also rampant. Without urgent action, minor injuries and common infections will claim more lives in years to come which is termed post-antibiotics era.
Antibiotics resistance also poses modern medicine at risk since organ transplantations, chemotherapy and surgeries become much more dangerous without effective antibiotics. To prevent and control the spread of antibiotic resistance, we all have roles to play ranging from individuals, policy makers, health professionals, healthcare industry to the agricultural sector.
As an individual, we have major role to play in curtailing this threat by ensuring that we only use antibiotics when prescribed by a certified healthcare professional, avoiding overuse of antibiotics, never sharing antibiotics with friends or family members, following the advice given by healthcare professionals on the use of antibiotics, practicing regular hand washing, preparing food under hygienic condition, practicing safe sex and being vaccinated up to date.
The role that needs to be played by the policy maker in controlling antibiotic resistance cannot be overemphasized. Policy makers should ensure robust nation plan, improve antibiotic-resistant infections surveillance, make information available about antibiotic resistance, regulate and ensure appropriate medicine use and disposal and also strengthen policies, programmes and implementation of infection and control measures.
Health professionals can also help prevent infections by ensuring their hands, instruments, and environments are clean. They should only prescribe and dispense antibiotics when they are needed, according to current standard treatment guidelines. They should endeavor to report antibiotic-resistant infections to surveillance teams and also talk to their patients about how to take antibiotics correctly, antibiotic resistance and the dangers of misuse. Healthcare professionals should also talk to their patients about preventing infections (for example, vaccination, hand washing, safer sex, and covering nose and mouth when sneezing). Another way to prevent and control the spread of antibiotics resistance is by investing in research and development of new antibiotics, vaccines, diagnostics and other tools by the healthcare industry.
The Agriculture sector is also a major area to be addressed in order to curtail and control the spread of antibiotic resistance. Antibiotics should be given only to animals under veterinary supervision; not using antibiotics for growth promotion or to prevent diseases. Animals should be vaccinated to reduce the need for antibiotics and use alternatives to antibiotics when available. Promote and apply good practices at all steps of production and processing of foods from animal and plant sources. Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare.
Adebisi Yusuff Adebayo is a student of University of Ibadan,Ibadan Nigeria and in charge of publicity of 7th IPSF African Pharmaceutical symposium