Erick Venant: World Antimicrobial Awareness Week 2020
By Erick Venant, founder of RBA Initiative.
My name is Erick Venant and I am the founder and CEO of Roll Back Antimicrobials Resistance Initiative. As a young pharmacist, I am determined to achieve our organisational goals and promote ways to help prevent antimicrobial resistance. We all have a part to play! The work we do at RBA Initiative is playing an important role in inspiring others to combat antimicrobial resistance, both at national and international levels. To mark World Antimicrobial Awareness Week 2020, I would like to share some more insight in the problem and action you can take to help.
World Antimicrobial Awareness Week (WAAW) aims to increase the awareness of global antimicrobial resistance and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of drug-resistant infections. The slogan for WAAW 2020 is "antimicrobials: handle with care" and is applicable to all sectors. The theme for the human health sector specifically is “united to preserve antimicrobials."
Antimicrobial resistance is a complex problem that can affect anyone, of any age, in any country. To address the issue of antimicrobial resistance, coordinated action is required.
Antimicrobials vs antibiotics
Antimicrobials are used to fight diseases in humans, animals and plants and include antibiotic, antiviral, antifungal and antiparasitic medicines. Resistance development to all these medicines is known as antimicrobial resistance.
Antibiotics are a type of antimicrobial medicine alongside antivirals, antifungals and antiparasitic agents used to treat bacterial infections only. Resistance development in bacteria only is known antibiotic resistance.
How does antimicrobial resistance happen?
Antimicrobial resistance occurs when microorganisms such as bacteria, viruses, fungi, and parasites resist the effects of medications. This makes common infections harder to treat and increases the risk of diseases spreading, severe illness and death. Antimicrobial resistance does not mean the body is becoming resistant to antimicrobials – it is that microorganisms have become resistant to the drugs designed to kill them.
Antimicrobial resistance occurs naturally over time, usually through genetic changes. However, the misuse and overuse of antimicrobials are rapidly accelerating this process. In many places, antimicrobials are overused and misused in both people and animals, and often given without professional oversight. One example of misuse is when antibiotics (which do not work against viruses), are taken by people to treat viral infections like colds and flu. Another example is when antimicrobials are used as growth promoters in animals or to prevent diseases in healthy creatures. This causes microorganisms to develop resiliency - rather than being killed off, they continue to grow.
Why is antimicrobial resistance a danger?
Antimicrobials play an essential role in combatting infectious diseases in both human and veterinary medicine. However, The World Health Organization (WHO) has declared that antimicrobial resistance is now one of the top 10 global public health threats. Drug resistant infections kill around 700,000 people worldwide each year and, according to a report by the UN, the number could increase to 10 million per year by 2050.
As well as affecting multiple Sustainable Development Goals (SDGs), antimicrobial resistance also has serious economic consequences: the world bank predicts that 24.1 million people could fall into extreme poverty by 2050 because of this problem.
Other negative effects of antimicrobial resistance include:
• Increased costs of health care, leading to further economic burden on families and societies
• Failure to treat and prevent basic infections conditions, resulting in prolonged illness and even death
• More pressure on hospitals, with patients spending more (and unnecessary) time in health care centres
• Risking a delay in the achievement of modern medicine, including cancer chemotherapy and surgery Challenging food safety: when food animals develop resistant organisms, resistant genes can be further transferred to human pathogens - for example, when animals are slaughtered and processed for food, resistant bacteria can contaminate meat or other animal products. Animal waste can also contain resistant bacteria and affect fruits and vegetables that have been in contact with water, soil or fertilizer that contains the waste.
• Challenging food security: effective antimicrobials play an important role in food animal production for the treatment and control of diseases. When animals get sick, antimicrobials are needed to treat infections, and untreatable infections (as a result of antimicrobial resistance) threaten sustainable food production. If infections cannot be treated, animal deaths will increase, and production capacity will be limited.
What does antimicrobial resistance mean in the context of global pandemics such as COVID-19?
COVID-19 threatens to further exacerbate antimicrobial resistance due to many people across the globe resorting to self-medication, as well as a significant increase in the overuse of antibiotics. Coronavirus is a virus and therefore antibiotics should not be used as means of prevention or treatment. There may be cases where, if someone is hospitalised for COVID-19, they may receive antibiotics to treat a possible bacterial co-infection - however, this increase in the use of antimicrobials is likely to further accelerate antimicrobial resistance.
Additionally, due to the significant increase in hospital admissions during the pandemic so far, there is a risk that healthcare-associated infections may rise, including the transmission of resistant organisms. The constant movement of people, goods and animals puts every country at a risk during a global pandemic, and we must work together with collective efforts in tackling such global health challenges.
What can we do to help combat antimicrobial resistance?
Antimicrobial resistance is already happening; it’s a problem with no boundaries and is causing a fear of untreatable infections amongst communities. The good news however is that we can all do something to turn the tide and help make the world free from the fear of untreatable infections. COVID-19 has already taught us many lessons and proven the significance of implementing simple measures to prevent the spread of infections.
We must use the ‘one health’ approach in tackling antimicrobial resistance. This incorporates the connection between people, animals and the environment.
Some of the actions you can take to help combat antimicrobial resistance are:
• Taking antimicrobial medication only if it is really necessary, and only after getting an advice from a qualified healthcare practitioner • Always completing the full prescription you are given, even if you feel better - stopping treatment early promotes the growth of drug-resistant organisms • Taking the right dose of your medication at the right time as prescribed • Not sharing your prescription with someone else • Not purchasing antibiotics without a prescription (self-medication is a significant contributor of antimicrobial resistance) • Taking preventative measures such as regular, thorough hand washing and hygienic food preparation to avoid infections, and maintaining these practices to prevent any spreading of resistant organisms and reducing any potential need for antimicrobials • Observe the expiry date of the medicine, which is generally found on the label. Antimicrobial resistance may occur with sub-potent medications as they may not be able to completely kill or stop the growth of microbes, but the exposure can cause them to start adapting to (and ultimately resisting) the drugs • Receiving vaccinations as per government recommendations • Myth-busting - spreading the awareness that antibiotics cannot treat colds and flu because they are caused by viruses • Not consuming leftover medication for other illnesses - remember that the antimicrobial you take for one condition may not work for another
If you work with animals, you can also help by:
• Not using antimicrobials for growth, or to prevent diseases in healthy animals • Only giving antimicrobials to animals under veterinary supervision • Ensuring you vaccinate animals in the first instance to reduce the need for antimicrobials in the future, and using alternatives to antimicrobials when available • Preventing infections through improved hygiene and animal welfare
Health professionals can also help by:
• Ensuring your hands, instruments and environments are clean to prevent infections • Only prescribing antimicrobials when they are needed and in line with health guidelines • Reporting antimicrobial resistance to surveillance teams • Educating your patients on how to take antimicrobials correctly • Talking to your patients about preventing infections in the first instance e.g. through vaccinations, hand washing and good hygiene
It has never been more important to spread awareness of antimicrobial resistance and the actions we can all take to help. Please help us to share these vital messages during World Antimicrobial Awareness Week 2020.
More about Erick:
“I started advocating for antimicrobial resistance and rational use of antimicrobials while I was an undergraduate student studying pharmacy. I have always had a burning desire to become part of the solution to different public health challenges. Whilst still a student, I led a nationwide campaign that successfully brought attention to antimicrobial resistance in schools all over Tanzania. In total, we educated over 49,000 students in 114 secondary schools, across 23 administrative regions. The campaign also empowered student ambassadors to spread the message about antimicrobial resistance within their own communities. To sustain these efforts and build on what we achieved in university, I founded non-governmental organization RBA Initiative with a dedicated focus to curb antimicrobial resistance.”
Article published: November 2020
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