According to the World Health Organisation (WHO), antimicrobial resistance is defined as the ability of a microorganism (like bacteria, virus, and some other parasites) to stop antimicrobials (such as antibiotics, antivirals and anti-malarial) from working against it. Or simply, it is the ability of a microbe to resist the effects of medication that once could successfully treat the microbe. Today, more than ever, Antimicrobial resistance (AMR) is becoming a new epidemic on the horizons of the different health systems across the globe. It is now equating the attention of other global health problems such as HIV, to such an extent that experts have started thinking that the Antimicrobial Resistance, especially antibiotics, will take us back to the old times where people were unable to treat common infectious diseases including pneumonia, tuberculosis and gonorrhoea. Statistics and several researches show that by 2050, antimicrobial resistance will be responsible for 10 million deaths every year if nothing is done about it, and as a result, become the number one killer. As said above, they are many forms of antimicrobial resistance, but in this article I will limit my focus on antibiotic resistance and what role can be played by everyone to protect ourselves from this public health threat. Since their discovery, antibiotics have served as the cornerstone of modern medicine. However, the persistent overuse and misuse of antibiotics in human and animal health have accelerated the emergence and spread of antibiotic resistance, which occurs when bacteria become resistant to the drugs used to treat them. “Antibiotic” has become a familiar term, especially in our community, even to uneducated people, and not for good reasons like awareness or the know-how to use them, but mostly, for misuse and over-use — not to mention the uncontrolled use of antibiotics in animals and agriculture. To put this in context, just ask a person, parent, or a young adolescent coming from the hospital or a healthcare facility. “Bagufashije gute kwa Muganga? (Loosely translated as ‘what did the doctor say?’) The automatic response is “bampaye “twa antibiyotike” (‘I was given anti-biotics’). And after some time, you will hear from some patients, uyu muti ntago ukimvura (this medicine is no longer working), it would be better if you upgrade to something stronger. This alone shows how alarming the problem is. And as healthcare professionals, we need to do something about it. It is evident that antibiotics are effective drugs to infections but they are not meant for any condition. Antibiotics are not meant to treat viral infections such as flu and cold, they are not meant for pain relief, and the list goes on. A fellow pharmacist once told me that some patients believe that “amoxicillin” is the cure for almost all diseases such as back-pain, cough, flu, even malaria. It is so sad, the lack of awareness around antibiotics is huge. Other myths around antibiotics are; the most expensive antibiotics are the best, yet still, traditional and affordable medicines, such as penicillin, are still useful in compacting bacterial infection. Antibiotics have no side effects, mind you, they can cause side effects such diarrhoea, nausea, allergic reactions, and most of the other side effects go unnoticed. Healthcare professionals should take the blame for this, we have the ultimate responsibility to sensitise the general public o this public health problem and demystify all those myths about antibiotics. Other risk factors which contribute to the rapid spread of antimicrobial resistance include substandard or fake medicines, sharing medicines with friends or family members, lack of adherence to full antibiotic regimens, among others. The main puzzle remains, what is the role of everyone in the fight against this public health challenge? From an individual to a healthcare professional and a policy maker. As an individual, there are plenty of things you can do to prevent the risk of infection and reduce the spread of antimicrobial resistance, like using antibiotics when only prescribed, seeking advice from a pharmacist or any other healthcare professional, and preventing infections by regularly washing hands and avoiding sharing medicines with anyone, or using leftovers. Patients should also come out and ask their pharmacist or other healthcare professionals all necessary material about antibiotics, such as, why you need to use that medicine. For how long? What are the risks of getting resistance? Although the problem is alarming and escalating fast, the response from WHO, civil society such as the World Antimicrobial Week which runs from November 12 to 18 every year and ‘Fight the Fakes’ campaign, is a subject of appreciation and one would further advocate for more political will, strengthening of policies regarding the use of antimicrobials, and more support and engagement from the private sector through partnerships. The author is the CEO of Unitia Pharmaceuticals.
