By Abujah Racheal
In a world where modern medicine has revolutionised healthcare, a looming crisis threatens the very foundation of our well-being. Antimicrobial Resistance (AMR) has emerged, silently undermining humans’ ability to combat infectious diseases.
The interconnected effects of AMR on humans, the environment, and animals, call for the urgent need for action.
Ms Sarah Bakole, a 31-year-old woman, who contracted a urinary tract infection (UTI), which, according to health experts, is easily treatable with antibiotics, had the infection spiral out of control due to the presence of resistant bacteria.
Bakole experienced excruciating pain, prolonged suffering, and faced the risk of life-threatening complications.
According to her, her doctor said that her story is not unique as millions of people worldwide are falling victim to AMR, as common infections become increasingly difficult to treat.
“The consequences are dire, with mortality rates rising and healthcare costs skyrocketing,” she said.
According to the World Health Organisation (WHO), AMR occurs when bacteria, viruses, fungi, and parasites cease to react to antimicrobial agents.
Antimicrobials, essential for treating infections, face a threat known as AMR. This occurs when microbes stop responding to these medicines, posing risks to human, animal, and plant health.
Due to this drug resistance, antibiotics and other antimicrobial treatments lose their effectiveness, making infections challenging or impossible to treat.
This heightens the danger of disease transmission, severe illness, and fatality.
The WHO said that human activities, particularly the misuse of antimicrobials, accelerate this process.
AMR jeopardises medical procedures, agricultural productivity, and food security globally, impacting economies and health systems.
The health organisation attribute to such factors such as poor sanitation, limited access to healthcare, and lack of awareness.
Data obtained from the Institute for Health Metrics and Evaluation shows the impact of AMR in Nigeria. In 2019, 64,500 deaths in the country were attributable to AMR, with 263,400 deaths associated with it.
It said Nigeria ranks 185th globally in age-standardised mortality due to AMR and is the 13th highest in the Western Sub-Saharan Africa region.
The number of AMR-related deaths in Nigeria exceeds those from various other causes, including enteric and respiratory infections, tuberculosis, maternal and neonatal disorders, neglected tropical diseases, malaria, and cardiovascular diseases.
Medical experts say five significant pathogens in Nigeria contribute to AMR-related deaths: Streptococcus pneumonia, Klebsiella pneumonia, Escherichia coli, Staphylococcus aureus, and Group B Streptococcus.
These pathogens cause various infections, such as lower respiratory infections, meningitis, bloodstream infections, and intra-abdominal infections.
According to the Institute for Health Metrics and Evaluation, they used 471 million records across 7,585 study-location years to estimate AMR comprehensively.
Ms Eunice Adeosun, an aquatic ecosystems scholar said researches reveal alarming levels of antibiotic residues in rivers and oceans.
She said this is as a result of improper disposal of pharmaceutical waste and agricultural runoff in the country.
“This residues act as a breeding ground for AMR, allowing bacteria to thrive and spread.
“As a result, marine life is being exposed to antibiotics, leading to the development of resistant strains that can potentially be transmitted to humans.
“The delicate balance of our ecosystems is under threat, with potential consequences for the entire planet,” she said.
She said that one of the leading culprits of antibiotic resistance is the agricultural industry, through its widespread use of antibiotics.
“They also contribute to antifungal resistance,” she said.
Mr Gambo Babagida, a veterinarian at Kuje Local Government Area, Federal Capital Territory, said he witnessed the devastating effects of AMR on animals.
Babangida said that overuse and misuse of antibiotics in livestock farming have led to the emergence of resistant strains, compromising animal health and welfare.
“This not only affects the livelihoods of farmers but also poses a significant risk to human health,” he said.
He said that efforts to promote responsible antibiotic use and implement alternative strategies highlight the urgent need for a One Health approach, recognising the interconnectedness of human, animal, and environmental health.
“AMR is a multifaceted crisis that permeates every aspect of our lives. Governments, healthcare professionals, industries, and individuals must come together to address this crisis.
“By promoting responsible antibiotic use, investing in research, and implementing effective policies, we can safeguard our future and ensure that our fight against infectious diseases remains effective,” he said.
He said the time to act is now before the silent threat of AMR becomes an irreversible reality.
Nigeria, Dr Salman Polycarp, an epidemiologist, said that a comprehensive approach was needed to address AMR challenge in Nigeria.
Polycarp said that this includes establishing a national policy on AMR, improving implementation and regulation of healthcare policies, and strengthening supply chains.
Others, he said, include exploring track and trace technology, establishing a National Infection Prevention and Control (IPC) coordinating body, and enhancing research and development capacity.
“Regulatory agencies should enforce standards, and AMR should be mainstreamed into public discussions and education.
“Communication strategies should be participatory and culturally respectful, involving religious and traditional leaders in community mobilization efforts,” he said.
The WHO Representative in Nigeria, Dr Walter Mulombo, said AMR was affecting health, the economy, and development of the country across sectors.
“The recently developed AMR situation analysis report further highlighted it.
“WHO has declared AMR as one of the top 10 global public health threats facing humanity with nearly five million human deaths estimated to be associated with bacterial AMR worldwide in 2019, he said.
Mulombo said that AMR remained at the top of the list as the biggest contributor to overall child mortality in Nigeria even ahead of HIV, TB or Malaria.
“GDP loss attributable to AMR in developing countries like Nigeria has been forecasted to be at 5-7 per cent by 2050.
“Furthermore, AMR is central to several core SDGs apart from SDG-3 including SDG-1 (No poverty), SDG-2 (Zero hunger), SDG-6 (clean water and sanitation), SDG 8 (decent work and economic growth), SDG-12 (responsible consumption and production) and SDG-17 (partnerships for the goals) and other SDGs,” he said.
Dr Tochi Okwor, AMR&IPC Coordinator at NCDC, said that the country has prioritised AMR in its public health agenda, with the agency leading the charge since 2016.
Okwor said that the National Action Plan (NAP) focuses on key pillars aligned with the WHO Global Action Plan on AMR, including increasing awareness, building a One Health surveillance system, intensifying infection prevention, promoting rational antimicrobial use, and researching alternatives.
“A multi-sectoral expert panel aims to operationalise One Health approaches through strategic interventions,” she said.
“There is an approval by 64th National Council on Health, the AMR Governance manual for national and sub-national response as well to improve coordination, funding, and programming of AMR at sub-national level.
“We are working to standardise the approach on how to implement NAP-2.0 at the sub-national level’’, she said.
She, however, advised Nigerians to do their part in curbing AMR by not insisting on antibiotics when diagnosed with a viral infection.
“If you are taking antibiotics to treat bacterial infections, complete your treatment as prescribed by your physician.
“When antibiotics are prescribed, finish the course of the medicines. Don’t stop it in between. It can lead to bacterial resistance leading to huge problems in the future,” she said. (NANFeatures)
