{"id":735922,"date":"2023-11-20T10:50:24","date_gmt":"2023-11-20T07:50:24","guid":{"rendered":"https:\/\/www.capitalfm.co.ke\/news\/?p=735922"},"modified":"2023-11-20T10:50:28","modified_gmt":"2023-11-20T07:50:28","slug":"antimicrobial-resistance-is-a-silent-killer-that-leads-to-5mn-deaths-a-year-solutions-must-include-the-poor","status":"publish","type":"post","link":"https:\/\/www.capitalfm.co.ke\/news\/2023\/11\/antimicrobial-resistance-is-a-silent-killer-that-leads-to-5mn-deaths-a-year-solutions-must-include-the-poor\/","title":{"rendered":"Antimicrobial resistance is a silent killer that leads to 5mn deaths a year. Solutions must include the\u00a0poor"},"content":{"rendered":"\n<p class=\"has-drop-cap\">Microbes such as bacteria, viruses, parasites and fungi form part of our everyday lives \u2013 they live in us, on us and around us.<\/p>\n\n\n\n<p>We need them for healthy digestion, immune function, and the synthesis of essential nutrients, and we depend on them for farming and industrial processes.<\/p>\n\n\n\n<p>But microbes also cause disease in people, animals and plants. That is why science has developed an arsenal of&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8995183\/\">antimicrobials<\/a>&nbsp;that kill them or slow their spread.<\/p>\n\n\n\n<p>Over time, microbes develop resistance to antimicrobials, and some eventually evolve into so-called \u201csuperbugs\u201d that no longer respond to the drugs. So we see more and more\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29773743\/\">untreatable infections<\/a>\u00a0appearing in hospitals and communities.<\/p>\n\n\n\n<p>This phenomenon, known as&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4768623\/\">antimicrobial resistance<\/a>&nbsp;(AMR), means that common illnesses and diseases may become life-threatening again.<\/p>\n\n\n\n<p>Recent figures show that antimicrobial resistance has been linked to&nbsp;<a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(21)02724-0\/fulltext\">close to 5 million deaths annually<\/a>&nbsp;\u2013 more than the total combined death toll of HIV\/AIDS and malaria.<\/p>\n\n\n\n<p>It is further estimated that deaths related to drug-resistance&nbsp;<a href=\"https:\/\/amr-review.org\/sites\/default\/files\/160525_Final%20paper_with%20cover.pdf\">could increase to 10 million per year<\/a>&nbsp;by 2050, overtaking cancer as a leading cause of death worldwide.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.who.int\/news-room\/events\/detail\/2023\/11\/18\/default-calendar\/world-amr-awareness-week-2023#:%7E:text=WAAW%20is%20celebrated%20from%2018,It%20affects%20us%20all.\">World AMR Awareness Week<\/a>&nbsp;aims to improve awareness and understanding of this silent killer.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Remembering the poor<\/h2>\n\n\n\n<p>We need urgent global action to counter antimicrobial resistance. However, current efforts that focus on solutions developed in high-income settings may not be suited to the&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6861125\/\">societal and economic challenges in low- and middle-income countries<\/a>.<\/p>\n\n\n\n<p>We are members of a multidisciplinary&nbsp;<a href=\"https:\/\/www.thebritishacademy.ac.uk\/projects\/just-transitions-to-contain-antibiotic-resistance-while-minimising-potential-burdens-and-harms\/\">Global Convening Programme<\/a>&nbsp;set up by&nbsp;<a href=\"https:\/\/www.thebritishacademy.ac.uk\/\">The British Academy<\/a>&nbsp;to look into solutions to this problem that are fair and inclusive. Our collective expertise includes epidemiology, ethics and human rights.<\/p>\n\n\n\n<p>If we want people to become less dependent on antibiotics, we must address&nbsp;<a href=\"https:\/\/www.nature.com\/articles\/s41586-021-03694-x\">the factors that create dependency on antibiotics in the first place<\/a>.<\/p>\n\n\n\n<p>Antimicrobial resistance is a global issue, but there are some regional differences.<\/p>\n\n\n\n<p><a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(21)02724-0\">Most human deaths from antimicrobial resistance occur in sub-Saharan Africa<\/a>. Drug resistance is a growing concern in&nbsp;<a href=\"https:\/\/hal.science\/hal-02559257\/file\/1-s2.0-S1473309918300719-main.pdf\">malaria<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30339803\/\">tuberculosis<\/a>&nbsp;in these regions.<\/p>\n\n\n\n<p>Low-income environments often go hand in hand with the use of cheap antimicrobials that may be of poor quality or even falsified. These create the&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK97126\/\">ideal conditions for resistance to emerge<\/a>.<\/p>\n\n\n\n<p>Many are sold over the counter for self-diagnosed ailments.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Antibiotics, animals and pandemic risk<\/h2>\n\n\n\n<p>Antibiotics are among the most widely used antimicrobials. Between 2000 and 2015 the use of antibiotics increased by&nbsp;<a href=\"https:\/\/www.pnas.org\/doi\/abs\/10.1073\/pnas.1717295115?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed\">65%<\/a>&nbsp;worldwide.<\/p>\n\n\n\n<p>Globally, however, more antibiotics are used in&nbsp;<a href=\"https:\/\/www.science.org\/doi\/10.1126\/science.aao1495\">animals<\/a>&nbsp;and agriculture than for human health. Of all antimicrobials,&nbsp;<a href=\"https:\/\/doi.org\/10.1371\/journal.pgph.0001305\">73%<\/a>&nbsp;are used in animals raised for food.<\/p>\n\n\n\n<p>In September 2016, the United Nations adopted a unanimous&nbsp;<a href=\"https:\/\/digitallibrary.un.org\/record\/845917\">resolution<\/a>&nbsp;recognising the inappropriate use of&nbsp;<a href=\"https:\/\/www.science.org\/doi\/10.1126\/science.aao1495\">antimicrobials in animals<\/a>&nbsp;as a leading cause of rising antimicrobial resistance.<\/p>\n\n\n\n<p>Farmers rely on antibiotics to prevent disease outbreaks and&nbsp;<a href=\"https:\/\/www.nature.com\/articles\/s41599-018-0152-2\">boost<\/a>&nbsp;production, especially where animals are kept in unhygienic and overcrowded conditions, and where farmers don\u2019t have access to veterinary care. There antibiotics serve as \u201c<a href=\"https:\/\/gh.bmj.com\/content\/4\/4\/e001590\">quick fixes<\/a>\u201d.<\/p>\n\n\n\n<p>In one study in rural Uganda a woman told researchers she was using left-over antibiotics to treat family members and her chickens. This repurposing of antibiotics is seen as a way to&nbsp;<a href=\"https:\/\/www.tandfonline.com\/doi\/full\/10.1080\/01459740.2022.2047676\">survive and make a living<\/a>.<\/p>\n\n\n\n<p>Experts warn that antimicrobial resistance in&nbsp;<a href=\"https:\/\/www.science.org\/doi\/10.1126\/science.aaw1944\">farm animals<\/a>, if unchecked, could lead to the&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9200017\/pdf\/JNMA-60-246-225.pdf\">next pandemic<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Everybody is exposed, everywhere<\/h2>\n\n\n\n<p>Environmental pollution in the form of&nbsp;<a href=\"https:\/\/wellcome.org\/sites\/default\/files\/antimicrobial-resistance-environment-report.pdf\">antimicrobial residues spreads<\/a>&nbsp;to soils, rivers, streams and oceans, as well as food and drinking water, and contributes to resistance. Everyone is exposed to antimicrobials, especially antibiotics, even if they don\u2019t take these medicines themselves.<\/p>\n\n\n\n<p>This kind of&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8995183\/\">pollution<\/a>&nbsp;is aggravated when antimicrobials are used and disposed of negligently.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The global response needs to be fair to all<\/h2>\n\n\n\n<p>We are calling for a new approach to antimicrobial resistance that prioritises&nbsp;<a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(23)01687-2\">equity and sustainability<\/a>.<\/p>\n\n\n\n<p>Policy options must be carefully considered with all those involved and by&nbsp;<a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2023.10.06.23296658v1\">embedding public and community voices<\/a>&nbsp;without having pre-determined solutions in mind.<\/p>\n\n\n\n<p>\u201cSimple\u201d solutions may disadvantage communities that shoulder the heaviest burden of infections and poor healthcare. For example, banning the over-the-counter sale of antibiotics may help to curb excessive use, but it could also deny life-saving treatment for people who have no other options. Similarly, without antibiotics, small-scale pig and poultry farmers may&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36762463\/\">no longer be able to make a living<\/a>.<\/p>\n\n\n\n<p>The solution we are working towards is fair and inclusive. It respects people and their traditions while also benefiting human health, animal welfare and the natural environment.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Authors:<\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li><a href=\"https:\/\/theconversation.com\/profiles\/marina-joubert-208875\">Marina Joubert<\/a> | Science Communication Researcher, Stellenbosch University<\/li>\n\n\n\n<li><a href=\"https:\/\/theconversation.com\/profiles\/phaik-yeong-cheah-1291834\">Phaik Yeong Cheah<\/a> | Professor of Global Health, University of Oxford<\/li>\n\n\n\n<li><a href=\"https:\/\/theconversation.com\/profiles\/sonia-lewycka-1393943\">Sonia Lewycka<\/a> | Epidemiologist, Oxford University Clinical Research Unit (OUCRU)<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Over time, microbes develop resistance to antimicrobials, and some eventually evolve into so-called \u201csuperbugs\u201d that no longer respond to the drugs. So we see more and more\u00a0untreatable infections\u00a0appearing in hospitals and communities.<\/p>\n","protected":false},"author":13945,"featured_media":735924,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1789,26],"tags":[18881,6107,1981,18880],"coauthors":[1730],"class_list":["post-735922","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-capital-health","category-top-stories","tag-acinetobacter-baumannii","tag-antimicrobial-resistance","tag-featured","tag-multidrug-resistant-pathogen"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.7.1 (Yoast SEO v25.7) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Antimicrobial resistance is a silent killer that leads to 5mn deaths a year. 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