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Asian Tribune is published by World Institute For Asian Studies|Powered by WIAS Vol. 12 No. 2403

WHO prioritized AMR: A key issue tackled through multi-sectoral partnership

By Manjari Peiris from Sri Lanka

Antimicrobial resistance (AMR) is a multi-sectoral problem affecting human and animal health, agriculture, as well as the global environment and trade. Clean water, sustainable food production and poverty alleviation are but a few of the challenges it poses.

The Citizens News Service (CNS) involving e Learning session along with direct interface with experts on range of issues related to antimicrobial resistance (AMR).

It is learnt that AMR threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. The cost of healthcare for patients with resistant infections is higher than care for patients with non-resistant infections due to longer duration of illness, additional tests and use of more expensive drugs.

Dr. Hayleus Getahun, Coordinator, UN Inter Agency Coordinator on AMR explained that Antimicrobial resistance is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others. (WHO)

As regards the magnitude of AMR;

Mortality data on AMR, viz. 700,000 annual deaths, 230,000 deaths from drug resistant TB in 2017, 214,000 neonatal sepsis deaths, 34,000 deaths from HIV drug resistance in SSA, AND morbidity data, viz. 558,000 incident drug resistant TB cases in 2017, 2 million antibiotic resistant infections per year in the US.

The environment is the key to antibiotic resistance. Bacteria in soil, rivers and sea water can develop resistance through contact with resistant bacteria, antibiotics and disinfectant agents released by human activity. People and livestock can then be exposed to more resistant bacteria through food, water and air. Up to 75% of antibiotics used in aquaculture may be lost into the surrounding environment. 70% of antibiotics are used by animals. Manure fertilizers cause antibiotic contamination in surface runoff, groundwater and drainage networks. Human antibiotic use jumped 36% in the 2000s.

Antimicrobial use for livestock will jump 67% by 2030. Antibiotics are increasingly used to boost animal growth in intensive farming, especially in developing countries. Antibiotics also can be absorbed by plants and crops. Major waste flows including wastewater, manures and agricultural run-off contain antibiotic residues.

Antibiotics are now grouped to 3 categories:

ACCESS Antibiotics that should be available at all times

WATCH Antibiotics recommended as first- or second-choice treatments for a small number of infections

RESERVE Antibiotics that are last-resort options

No one can completely avoid the risk of resistant infections, but some people are at greater risk than others (for example, people with chronic illnesses). If antibiotics lose their effectiveness, then we lose the ability to treat infections and control public health threats.

Many medical advances are dependent on the ability to fight infections using antibiotics, including joint replacements, organ transplants, cancer therapy, and treatment of chronic diseases like diabetes, asthma, and rheumatoid arthritis.

Antimicrobial resistance is occurring everywhere in the world, compromising our ability to treat infectious diseases, as well as undermining many other advances in health and medicine. The goal of the draft global action plan is to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality assured, used in a responsible way and accessible to all who need them.

To achieve this goal, the global action plan of the WHO sets out five strategic objectives;

• to improve awareness and understanding of antimicrobial resistance;

• to strengthen knowledge through surveillance and research;

• to reduce the incidence of infection;

• to optimize the use of antimicrobial agents; and

• develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.

Development of this plan was guided by the advice of countries and key stakeholders, based on several multi-stakeholder consultations at different global and regional forums.

Antimicrobial Resistance is a result of failed health systems and WHO as custodian of global health has prioritized AMR as a key issue that should be tackled through multi-sectoral partnership and in One Health context says Raneri Guerra, Assistant Director General, of the World Health Organization.

- Asian Tribune -

WHO prioritized AMR: A key issue tackled through multi-sectoral partnership
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