Dr. Francis SANWO

Antimicrobials – including antibiotics, antivirals, antifungals and antiparasitics – are medicines used to prevent and treat infections in humans, animals and plants.

What is antimicrobial resistance?

Antimicrobial Resistance (AMR)  earlier refer to as antibiotic resistance  occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.

Antimicrobial resistance is one of the biggest threats to global health, food security, and development today. It can affect anyone, of any age, in any country. AMR occurs naturally over time, usually through genetic changes. Antimicrobial resistant organisms are found in people, animals, food, plants and the environment (in water, soil and air). They can spread from person to person or between people and animals, including from food of animal origin. The main drivers of antimicrobial resistance include the misuse and overuse of antimicrobials; lack of access to clean water, sanitation and hygiene (WASH) for both humans and animals; poor infection and disease prevention and control in health-care facilities and farms; poor access to quality, affordable medicines, vaccines and diagnostics; lack of awareness and knowledge; and lack of enforcement of legislation. A growing number of infections – such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis – are becoming harder to treat as the antibiotics used to treat them become less effective.

 It requires urgent multisectoral action in order to achieve the Sustainable Development Goals (SDGs).

WHO has declared that AMR is one of the top 10 global public health threats facing humanity.

The cost of AMR to the economy is significant. In addition to death and disability, prolonged illness results in longer hospital stays, the need for more expensive medicines and financial challenges for those impacted.

Without effective antimicrobials, the success of modern medicine in treating infections, including during major surgery and cancer chemotherapy, would be at increased risk.

The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behaviour change, antibiotic resistance will remain a major threat. Behaviour changes must also include actions to reduce the spread of infections through vaccination, hand washing, practising safer sex, and good food hygiene.

Why is antimicrobial resistance a global concern?

The emergence and spread of drug-resistant pathogens that have acquired new resistance mechanisms, leading to antimicrobial resistance, continues to threaten our ability to treat common infections. Especially alarming is the rapid global spread of multi- and pan-resistant bacteria (also known as “superbugs”) that cause infections that are not treatable with existing antimicrobial medicines such as antibiotics.

Antibiotics are becoming increasingly ineffective as drug-resistance spreads globally leading to more difficult to treat infections and death. However, if people do not change the way antibiotics are used now, these new antibiotics will suffer the same fate as the current ones and become ineffective. 

Without effective tools for the prevention and adequate treatment of drug-resistant infections and improved access to existing and new quality-assured antimicrobials, the number of people for whom treatment is failing or who die of infections will increase. Medical procedures, such as surgery, including caesarean sections or hip replacements, cancer chemotherapy, and organ transplantation, will become more risky.

Prevention and Control

Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as poor infection prevention and control. Steps can be taken at all levels of society to reduce the impact and limit the spread of resistance.

Individuals. To prevent and control the spread of antibiotic resistance, individuals can:

Only use antibiotics when prescribed by a certified health professional.

Never demand antibiotics if your health worker says you don’t need them.

Always follow your health worker’s advice when using antibiotics.

Never share or use leftover antibiotics.

Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.

Prepare food hygienically, following the WHO Five Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials).

Policy Makers. To prevent and control the spread of antibiotic resistance, policy makers can:

Ensure a robust national action plan to tackle antibiotic resistance is in place.

Improve surveillance of antibiotic-resistant infections.

Strengthen policies, programmes, and implementation of infection prevention and control measures.

Regulate and promote the appropriate use and disposal of quality medicines.

Make information available on the impact of antibiotic resistance.

Health Professionals. To prevent and control the spread of antibiotic resistance, health professionals can:

Prevent infections by ensuring your hands, instruments, and environment are clean.

Only prescribe and dispense antibiotics when they are needed, according to current guidelines.

Report antibiotic-resistant infections to surveillance teams.

Talk to your patients about how to take antibiotics correctly, antibiotic resistance and the dangers of misuse.

Talk to your patients about preventing infections (for example, vaccination, hand washing, safer sex, and covering nose and mouth when sneezing).

Healthcare Industry. To prevent and control the spread of antibiotic resistance, the health industry can:

Invest in research and development of new antibiotics, vaccines, diagnostics and other tools.

Agriculture Sector. To prevent and control the spread of antibiotic resistance, the agriculture sector can:

Only give antibiotics to animals under veterinary supervision.

Not use antibiotics for growth promotion or to prevent diseases in healthy animals.

Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when available.

Promote and apply good practices at all steps of production and processing of foods from animal and plant sources.

Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare.