Answering the challenges of antimicrobial resistance

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We don’t take antimicrobial resistance seriously, maybe because it’s not glamorous and recognizable. Credit: Bigstock.
  • Opinion
  • Inter Press Service

But until recently, we didn’t have a good idea how much of a problem MRSA — or any other antimicrobial resistant pathogen — was in Africa. It turned out that after testing 187,000 samples from 14 countries for antibiotic resistance, our colleagues found that 40% of all staph infections were MRSA.

Africa, like any other continent, has an AMR problem. But Africa stands out because we haven’t invested in the capacity and resources needed to identify or resolve the magnitude of the problem. Take MRSA. We still don’t know what causes the bacteria to become resistant, nor do we know the full extent of the problem.

We don’t take AMR seriously, maybe because it’s not glamorous and recognizable. The technology we currently use to identify resistant pathogens doesn’t look fancy or futuristic. Fighting AMR does not require miracle drugs, expensive treatments or expensive diagnostic tests. Instead, we have bacteria and other pathogens that are commonplace and have learned how to shake off the good old drugs that used to work.

The global health and pharmaceutical industry does not seem to find solving this problem very profitable. Contrast that with the urgency of solving COVID-19, which has been embraced — and subsidized interventions like diagnostics — by governments eager to end the pandemic. The COVID-19 response is characterized by innovations that pop up literally every other week.

Why can’t we mobilize resources and passion for AMR? Are resistant pathogens too boring? Is it too difficult to solve through innovations? Does this make the prospects for quick wins and a quick return on investment too elusive for AMR, especially when compared to COVID-19 or other infectious disease outbreaks?

The World Health Organization (WHO) has repeatedly stated that AMR is a global health priority – and in fact one of the greatest threats to public health of the 21st century. A recent study estimates that nearly 1.3 million people died in 2019 as a result of antimicrobial-resistant bacterial infections, with Africa bearing the largest burden of deaths. A high prevalence of AMR has also been identified in foodborne pathogens isolated from animals and animal products in Africa.

Taken together, these figures suggest that the burden of AMR could be at 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 African health systems and poses a major threat to progress towards achieving the public health goals set by individual countries, the African Union and the United Nations. And the lack of accurate AMR information limits our ability to understand how well commonly used antimicrobials actually work. This also means that we cannot determine the causes of AMR infections and design effective interventions in response.

We have just completed a project that has collected data on many of the most terrifying pathogens in 14 countries, revealing stark insights into the under-detected and under-reported depth of the AMR crisis across Africa. Less than two percent of medical labs in the 14 countries surveyed are able to perform bacteriological tests, even using conventional methods developed more than 30 years ago.

While providing key information to national stakeholders to advance their policies on AMR, we have also trained and provided basic electronic tools to more than 300 health professionals to continue this important oversight. While a strengthened workforce is critical, many health facilities across the continent are dealing with interrupted access to electricity, poor connectivity and severe, ongoing staff shortages.

Our work has visualized the dire realities of the AMR surveillance situation and provided concrete recommendations for improvement that align with the new continental public health ambition of the African Union and the Africa Center for Disease Control (CDC). The challenge is to find the funding to extend this initiative to the entire African continent.

AMR control requires a long-term focus, especially in Africa, where health systems are chronically underfunded, while also being disproportionately challenged by infectious threats. More money needs to be spent on the problem and this should not come from international aid alone.

We urge African governments to deliver on past commitments and increase domestic funding for their health systems in general and for solving the AMR crisis in particular. We also call on bilateral funders and global stakeholders to focus their priorities on improving the health of African peoples. This may require a greater focus on locally relevant evidence to inform investments and less focus on profit-driven market interventions, as well as prioritizing the scaling up of technologies and strategies that are proven to work, whether they are innovations or not.

If we contain AMR, we need to fix Africa’s health systems. The work begins now.

The authors of this opinion piece are Dr Pascale Ondoa and Dr Yewande Alimi – Doctor Pascale Ondoa is the director of science and new initiatives of the African Society for Laboratory Medicine (ASLM) and Dr Yewande Alimic is the Africa Center for Disease Control (CDC) Antimicrobial Resistance Program Coordinator.

© Inter Press Service (2022) — All rights reservedOriginal source: Inter Press Service



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