- Antimicrobial agents, therefore, play a critical role in safeguarding human health, animal health, food security and global trade.
- Consequently, overuse and misuse of antimicrobials are prevalent
Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines.
Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria.
This Antimicrobial resistance occurs when disease-causing microorganisms such as bacteria, viruses, fungi and parasites are no longer responsive to previously effective antimicrobial agents. Antimicrobial agents used to treat various infectious diseases in animals and plants are the same or similar to those used in humans.
Their availability and use in both sectors has been and is essential for public health, national wealth creation, food security, food safety, human and animal welfare, protection of livelihoods, and sustainability of animal and plant production.
Antimicrobial agents, therefore, play a critical role in safeguarding human health, animal health, food security and global trade.
Since their introduction in the 1940s, they have revolutionized the ability to treat infectious diseases. However, when microorganisms become resistant to medicines, the options for treating the diseases they cause are reduced.
The driving force escalating rates of resistance is the injudicious use of antibiotics in patients, in livestock and agriculture, and its unchecked release into the environment.
These forces raise and increase the spread of resistant pathogens that may emerge by mutations or acquisition of plasmids carrying resistance genes. Counterfeiting of antimicrobials has also contributed to the accelerated development of AMR in microorganisms that cause diseases.
In one study, prior antibiotic exposure was the key independent risk factor for the acquisition of antibiotic multi-resistance.
Broad-spectrum antibiotics have the unintended consequence of selecting multidrug-resistant pathogens and increasing the likelihood of infection by fungi and Clostridium difficile.
AMR is a global concern for both the Public Health and Agriculture Sectors. Globally it is projected that by 2050, the health consequences and economic costs of AMR are estimated at 10 million annual human fatalities and a 2 to 3.5 per cent decrease (USD 100 trillion) in global Gross Domestic Product (GDP) if inadequately mitigated.
In 2016, WHO called for immediate and concerted efforts to mitigate this threat to global health
AMR requires immediate and urgent attention and action as the direct consequences of infection with resistant microorganisms can be severe including longer illnesses, increased mortality, prolonged hospital stays and increased costs.
The indirect impact of AMR spans beyond health risks and has wide implications on the development agenda. AMR will drain global and national economies with increased economic losses due to reduced productivity caused by the sickness of both humans and animals.
Therefore, AMR increases morbidity, mortality, and health care costs, threatens health security, food security and negatively impacts trade and economies.
To counter the effects of AMR, long term investment in financial and technical support is required to strengthen public health systems to ensure appropriate use and access to antimicrobial agents.
This calls for concerted action on a global and national scale to prevent the world from returning to a pre-antibiotic era in which common infections will once again kill with abandon.
In livestock production little or no access to affordable veterinary services including consultancies and laboratory testing has often been cited as an important factor leading to over the counter purchase of antimicrobials and their subsequent use without a prescription in feed, water or treatment.
Although there are major challenges in capacity for laboratories in human and animal health to conduct routine surveillance there are efforts underway supported by the development partners to improve infrastructure especially for cross border monitoring of disease outbreaks and these efforts can be enhanced to include surveillance on antimicrobial use and resistance.
The privatization of veterinary and extension services has resulted in a scenario where the prevalence of animal diseases is high; poor husbandry practices are adopted; low-income households do not access services; unqualified personnel administering medicine to animals and operate small unlicensed retail outlets for agricultural products and veterinary medicines.
Currently, the availability of antimicrobial agents over the counter without prescription is common malpractice both in human and animal health.
In many regions of the country, there is evidence of uncontrolled access, and OTC dispensing of antimicrobials without prescription and sometimes in the open market to the general public.
Consequently, overuse and misuse of antimicrobials are prevalent. Apart from misuse, sale of counterfeits, substandard drugs and smuggling of drugs through the porous borders pose a challenge to controlled access to antimicrobials for humans.
Dr. Simon Topisia, veterinary 0ficer,KENDAT