Sharleen Mohammed Correspondent
A major threat to public health all over the world today is the rise of harmful “super-bug” bacteria that are very difficult to kill with antibiotics. Although antibiotic-resistant bacteria may not have attracted much attention, the illnesses and deaths related to super-bugs may possibly surpass those well-known diseases like AIDS. Last week Zimbabwe joined hands with some of the world’s foremost experts on antibiotic resistance and called for an awareness week campaign to reduce the growing number of deaths due to limited access to effective antibiotics.

This is also the first time that a “One Health issue”, a concept which involves the health of humans, animals and the environment, is being discussed at a high-level forum.

According to the World Health Organisation (WHO) antibiotics are designed to fight infections and heal by killing or slowing down the growth of bacteria, and become resistant partially from improper use and overuse of antibiotics by humans.

In a commentary published on the July 16 in The Lancet, antibiotic resistance is responsible for more than 700 000 deaths worldwide each year, including 214 000 neonatal sepsis deaths.

“And while insufficient access and delays in access to antibiotics currently causes more deaths than antibiotic resistance, an increasing number of antibiotic-resistance related deaths are being reported in many countries,” reads the report.

The report notes that drug resistance was occurring globally and affecting many different infectious agents.

“In particular, high-level antibiotic resistance in the bacteria responsible for bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections, and gonorrhoea was becoming widespread.

Providing sustainable access to effective antimicrobials is an essential component for achieving many of the UN’s Sustainable Development Goals.

Stanley Midzi of the World Health Organisation (WHO) said gonorrhoea was recently added to the list of diseases that have become global threats.

Midzi added that bacteria, not humans, become antibiotic resistant and these bacteria may then infect humans and are harder to treat than non-resistant bacteria.

“Sexually transmitted infections (STIs) are back to haunt us once again, when your patients get infected, you have to juggle around medicines to prescribe to a patient suffering from the disease,” he said.

“Some of the strains can only be tackled by a combination of drugs since there is no longer a single cure that can be used to treat a particular disease as no new molecules for the disease had been made in the past 10 years.

He highlighted that experts ignored the area since the introduction of condoms, with the general perception that the nation was moving towards an STI-free era.

“Nearly 700 000 people around the world die each year because of drug resistance, adding that if unchecked, the figure could rise to one million deaths annually with medical costs rising by over $100 trillion, as more expensive drugs would be used,” Midzi revealed.

Health and Child Care deputy minister Aldrin Musiiwa said the issue of anti-microbial resistant drugs needed to be addressed urgently.

“We have noted emerging cases of multiple drug resistance among TB and malaria patients. There has also been resistance to first or second line medicines for HIV, forcing us to change to more expensive medications.

“Anti-microbial resistance is like a time bomb which will cause more deaths than the HIV pandemic and TB infections combined in sub-Saharan Africa if left unattended.

Musiiwa said antimicrobial agents had saved millions of lives and improved the outcomes for countless patients since these medicines were introduced in the 1930s.

The health Ministry has joined forces with the Medicines Control Authority of Zimbabwe, African Treatment Access Movement and the Veterinary Public Health in an effort to develop an antimicrobial resistance national action plan.

Project co-coordinator Dr Sekesai Zinyowera said the project would cover both humans and livestock in Zimbabwe.

“This is for both human beings and animals as both are being affected by the microbial bugs and the bugs spread from human beings to animals,” she said.

“These bugs might affect one if they fail to use medication correctly or fail to finish the course prescribed by medical practitioners,” she added.

Ministry of Health and Child Care deputy director of pharmacy services Newman Madzikwa said the aim of the project was to combat the generation of microbial resistance.

“What we trying to do here is fight the generation of microbial resistance, which is why we joined hands with the Veterinary Service,” he said.

The Health ministry, in partnership with the Consumer Council of Zimbabwe, requires at least $200 000 to develop a National Action Plan against the usage of antibiotics in livestock.

Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality

The Ministry’s director of epidemiology and disease control, Portia Manangazira, said antibiotic resistance was rising to dangerously high levels and without urgent action, the world was heading towards a post-antibiotic era in which important medicines would stop working and common infections and minor injuries would start killing people again.

“The campaign against what has been considered excessive clinical use has been generally evenly directed at human and animal medicine, but there has been a concerted attack on the agricultural use of antibiotics, based on the assumption that all such usage is imprudent since it might act as an important source of resistance in bacteria affecting humans.”

She said if measures were not taken urgently to reduce global consumption of antibiotics, simple infections would kill people.

“Consumers have an important role to play in persuading food companies to make the changes that are needed to stop this global public health threat and protect our medicines for the future,” Mananganzira said.

According to a global report, Antimicrobial resistance (AMR) is one of the major issues facing society, by 2050, if not tackled; it will kill more people than cancer, and cost, globally, more than the size of the current global economy.

The aim of the research is to understand how AMR is introduced into natural soil bacteria, for example from manures applied by farmers or exposure to domesticated or wild animal and bird faecal droppings, and how this transfer takes place in different soil types.

The vast majority is used on healthy animals to promote growth, or prevent disease in crowded or unsanitary conditions. The meat and poultry production industry argues, however, that there is no harm in this.

According to the US’ Consumer Union, a key question is can antibiotic use in animals promote the development of hard-to-treat antibiotic-resistant superbugs that make people sick?

“And if it can, are the illnesses rare occurrences, and the risks theoretical, or could current usage in animals pose a serious threat to human health,” it poses.

Chris Webb, Marketing Executive at Biorex Food Diagnostics, concluded that the threat to public health from the overuse of antibiotics in food animals is real and growing.

It is said humans are at risk both due to potential presence of super-bugs in meat and poultry, and to the general migration of super-bugs into the environment, where they can transmit their genetic immunity to antibiotics to other bacteria, including bacteria that make people sick.

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