Rising deaths from drug-resistant infections

The continual emergence and spread of genes, which cause antimicrobial resistance (AMR), as contained in a recent medical science report is a cause for serious concern going by the fact that antibiotics has become firmly entrenched as an important life saver worldwide. If a solution is not found to AMR, the resistance can wipe off age-old gain of antibiotics to human existence and wellbeing. The various ministries of health and related agencies in Nigeria will be doing a world of good to the populace by embarking on appropriate enlightenment to reduce, if not eliminate the incidence.

Although antibiotics continue to be an essential tool in modern medicine, there are dangers associated with its use. According to experts, while antibiotics have saved millions of lives as estimates show that they increase the average human lifespan by 23 years, the benefits derived from this magic bullet are speedily being eroded by the continual emergence and spread of genes, which cause antimicrobial resistance (AMR).

The recent statistics released, show that AMR is not a problem of the future; it is a present, though sometimes hidden, danger as – already at least 700,000 people die annually from drug-resistant infections. In addition, it is projected that by 2050, drug-resistant microbes could lead to ten million deaths yearly if appropriate measures are not taken. Furthermore, the global health body, World Health Organisation (WHO), stated that there are 15 priority antibiotic-resistant pathogens causing the greatest threat to human and animal health; four of these have been detected in Nigeria.

Antimicrobial resistance (AMR) occurs when disease-causing micro-organisms mutate over time, meaning that they are harder to treat because they can resist the drug’s effects even when it is of adequate composition, taken at the appropriate dose, for the correct duration and for the right disease condition.  This results in bacterial infections becoming more difficult to treat, or in some cases, impossible.

On the causes, AMR develops and spreads due to antibiotic misuse; for example, patients taking antibiotics when they have a common cold which is viral in origin. This may not be unconnected with the ease which people access antibiotics as seven out of 10 persons in Nigeria access antibiotics outside licensed health facilities or pharmacies, while many patients in hospitals are over prescribed for antibiotics that have a higher risk of bacterial resistance selection.

Another factor that is worsening AMR is the overuse of antibiotics in livestock and fish farming. In the animal health sector, antimicrobials are available in the open markets without restriction, hence the misuse of these products, especially in food-producing animals. Residues of these antimicrobials in eggs, milk and meat, when consumed by humans, can potentially cause cancers, allergies, and mutations. Others include lack of clean water and sanitation which encourages the spread of disease-causing germs, inadequate infection prevention and control, especially in health facilities, and counterfeit or adulterated drugs.

Antimicrobial resistance also has socio-economic consequences. It may lead to more expensive and intensive care and prolonged hospital admission. Expensive and intensive treatments add to the direct monetary effects of AMR on health care via escalation in resource utilisation. Similarly, AMR is also associated with the loss of livestock and increased cost of livestock production that indirectly affect the livelihood of farmers, which in turn have a deleterious impact on Gross Domestic Product (GDP).

This outlook suggests that AMR is a silent pandemic and must be addressed as a matter of urgency, or the death toll and other health and socio-economic consequences will continue unabated as crucial medicines become ineffective. Hence, it is critical yearly, to increase awareness on antimicrobial agents used for the treatment of infections.

Thus, the prioritisation of prevention as a measure to sensitise the world on antimicrobial resistance is appropriate to commemorate World Antimicrobial Awareness Week (WAAW) celebrated between November 18 and 24, this year. This may be a possible explanation for this year’s theme of “Preventing antimicrobial resistance together” aimed at encouraging all and sundry to join the ‘train’ in order to contain AMR. Recognising that human, animal, food and environmental health are closely interconnected calls for a coordinated multisectoral approach.

This emphasises the need to adopt the “One Health” approach, bringing together multiple sectors (governments, private sector, civil society and academia) and other stakeholders engaged in human, animal and plant health and the environment to work together in designing and implementing programmes, policies, legislation and research to attain better public health outcomes.

In line with this year’s theme, preventing AMR resistance and averting the catastrophe occasioned by it requires a concerted effort and collaboration among practitioners of human health, animal husbandry and environmental health. Therefore, Nigeria should optimise collaboration and coordination between relevant sectors including regulatory authorities and components of the healthcare delivery system; and adoption and practice of standardised infection prevention and control practices in the community and health facilities.

It is also important to enforce existing legal frameworks to regulate antimicrobial use; and improve surveillance and response. As such government should enable the right ministries, departments and agencies (MDAs) through the provision of diagnostics and other necessary resources needed to function effectively.

Again, Nigerians should stop self medication; governments should ensure improved access to quality and affordable health care in order to enhance access to professional treatment and appropriate medications; and health care professionals should at all times ensure proper laboratory investigations to avoid wrong diagnosis and inappropriate prescription practices.

Achieving these requires prioritising national action plans to scale-up financing and capacity-building efforts; putting in place stronger regulatory systems and support awareness programmes for responsible and prudent use of antimicrobials by professionals in human, animal and plant health; investing in research and development for new technologies to combat antimicrobial resistance; and phasing out the use of antimicrobials as growth promoters in agriculture.