Answering the Challenges Posed by Antimicrobial Resistance
We fail to consider antimicrobial resistance serious because it is not easy to understand and glamorous. Credit: Bigstock.
Sep 21 2022 (IPS). Staphylococcus Aureus is the cause of skin infections that can lead to death if they become drug resistant. Estimates regarding the most common resistant variation, methicillin-resistant Staphylococcus aureus (MRSA), exceed 100,000 deaths globally in 2019.
But up until recently, we did not have a solid grasp on how much of a problem MRSA—or any other antimicrobial resistant pathogen—was in Africa. Our colleagues discovered that MRSA was responsible in 40% of all Staph infections. We tested 187,000 samples from 14 countries.
Africa, just like all other continents, has an AMR issue. Africa is unique because we have not invested the resources and capacity necessary to identify the problem and how to fix it. MRSA is a prime example. We still don’t know what’s causing the bacteria to become resistant, nor do we know the full extent of the problem.
The World Health Organization (WHO) has repeatedly stated that AMR is a global health priority—and is in fact one of the leading public health threats of the 21st century. A recent study revealed that almost 1.3 million people died in 2019 from antimicrobial resistant bacterial infection, with Africa accounting for the highest death toll.
AMR is something we are not taking seriously. Perhaps it isn’t glamorous or relatable. The technology currently used to identify resistant pathogens does not look futuristic or fancy. AMR is not a matter of expensive treatments or miracle cures. Instead, we have bacterias and other pathogens and have learned to ignore the good old medicines that once worked.
This problem seems to not be a priority for the global health and pharmaceutical industries. Compare that to the urgency of solving COVID-19, which has been embraced—and interventions such as diagnostics subsidized—by governments eager to end the pandemic. COVID-19 has seen innovations appear almost every other week.
Why can’t we mobilize resources and passion for AMR? Are resistant pathogens too boring to tackle? Is it too difficult for innovation to solve? Are AMR’s prospects of quick wins and a quick return on investment too low, especially in comparison to COVID-19 and other infectious disease outbreaks like COVID-19?
The World Health Organization (WHO) has repeatedly stated that AMR is a global health priority—and is in fact one of the leading public health threats of the 21st century. A recent studyIn 2019, almost 1.3 million people died due to antimicrobial resistant bacterial infection. The highest death rate was in Africa. AMR is a common problem. has also been identifiedin foodborne disease in Africa, isolated from animals or animal products.
Collectively, these numbers suggest that the burden of AMR might be on the level of—or greater than—that of HIV/AIDS or COVID-19. The growing threat of AMR is likely to take a heavy toll on Africa’s health systems and poses a major threat to progress made in attaining public health goals set by individual nations, the African Union and the United Nations. We don’t have enough information about AMR to know how effective antimicrobials work. This also means that we cannot identify the cause of AMR infections so that we can design effective interventions.
We just completed a project that we are proud to announce. gathered dataThese 14 countries have been surveyed for the most serious pathogens. They reveal shocking details about the AMR crisis in Africa and how it is not being reported or detected. Even with the most advanced methods, less than two percent can conduct bacteriology tests in the 14 countries that were examined.
We have provided critical information to national stakeholders to help them advance their AMR policies. We also provided basic electronic tools to over 300 health professionals to help them continue this vital surveillance. A strengthened workforce is crucial, but many continent-wide health facilities are struggling to access electricity and poor connectivity.
Our work has exposed the terrible reality of AMR surveillance, and made concrete recommendations for improving it that are in line with the new African Union and Africa Center for Disease Control’s (CDC) public health ambitions. The challenge lies in finding the funding to expand this initiative across the entire African continent.
AMR containment requires a long-term focus—especially in Africa, where health systems are chronically underfunded, while also being disproportionately challenged by infectious threats. This problem requires more funding, and not just international aid.
We urge African governments not to forget the past commitmentsincrease domestic funding for their health systems, and to solve the AMR crisis in particular. We also ask global stakeholders and bilateral funding agencies to put their priority on improving the health conditions of Africans. This could mean paying more attention locally to relevant evidence that will inform investments, and less attention profit-driven markets interventions. It also means prioritizing the scaling-up of technologies, strategies, and innovations that have been proven to work.
AMR is a sign that we need to fix African health systems. The work must begin now.
The authors of this opinion piece are Dr Pascale Ondoa and Dr Yewande Alimi – Dr Pascale OndoaDirector of science and new initiatives at the African Society for Laboratory Medicine, (ASLM). Dr Yewande AlimiThe coordinator of the Africa Center for Disease Control (CDC), antimicrobial resistant programme.
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