Rising threat of resistance to drugs


Drug-resistant infections are on the rise in the country, adversely affecting human and animal health and also compromising the effective treatment of infections caused by bacteria, parasites, viruses and fungi. The failure or reduced efficacy of antimicrobial drugs (antibiotics, antivirals and antimalarials) to effectively combat infections certainly will make treatment of infections expensive, difficult or even impossible and ultimately leading to death. The economy is also not spared in this Anti-Microbial Resistance (AMR) menace bedeviling humanity thereby creating a source of worry and concern for all.

Anti-Microbial Resistance (AMR) is the ability of microbes to grow or resist the effect of drugs. When micro-organisms or some diseases become resistant to a drug that was originally effective for the treatment of infections caused by the micro-organisms, it is termed AMR. This has become a global threat as countries world over have been responding to this health challenge by deploying various AMR action plans.

A press release by the National Agency for Food and Drug Administration and Control (NAFDAC) on antimicrobial resistance reads: “The incidence of AMR leads to treatment failure or infections that cannot be easily treated, death and economic loss. This is a real problem in Nigeria because we tend to not finish antibiotic medication or buy only what can be afforded. In a local hospital in Nigeria, it was reported that many neonates or newborn acquire AMR from the mothers during childbirth. The child’s infection ended up not responding to treatment with the usual antibiotics. Many children have died as a result. This is not unique to the hospital; the situation at the particular hospital was just documented through scientific evidence.” This confirms possibility of mother-to-child transmission of AMR, just as we have animal-to-man transmission.

Gene mutation, replication of resistant microbes, genetic transfer from microbes and prolonged use of antibiotics are the main causes of AMR. Our actions as humans increase the development and spread of AMR. For instance, antibiotics are only indicated for treating infections caused by bacteria but we take antibiotics for most infectious diseases, and this causes AMR.

An Australian government AMR website puts it this way: “The main cause of antimicrobial resistance is antibiotic use. When we use antibiotics, some bacteria die but resistant bacteria can survive and even multiply. The overuse of antibiotics makes resistant bacteria more common. The more we use antibiotics, the more chances bacteria have to become resistant to them. This means that antibiotics won’t work when we need them in the future. If we decrease antibiotic use, the antibiotics may again become effective at killing bacteria.” Other causes of AMR may include self-medication, use of substandard drugs, consumption of animal products with high residues of antimicrobial agents and the administration of antibiotics in animal feeds.

AMR leads to a situation where infections and illnesses become untreatable in humans, animals and plants. Costs and length of time of treatments increase with attendant suffering. AMR also results in inability or reduced ability of antimalarial drugs to cure malaria, and failure of penicillin to cure some skin infections caused by bacteria.

It is a sad reality that AMR may not be totally eliminated but can be beaten down to large extent with improved technology and continued research on microbial reactions in different environments. An American public servant, Tom Frieden nailed it when he said, “Vaccines and antibiotics have made many infectious diseases a thing of the past; we’ve come to expect that public health and modern science can conquer all microbes. But nature is a formidable adversary!”

For Nigeria to make a quantum leap in the fight against AMR, the following are required; increased awareness and mass education on AMR, reduction in the excessive use of antimicrobial drugs, surveillance of AMR, placing a ban on the sale of antimicrobial prescription medicines as Over-The-Counter (OTC) drugs, proper legislation by putting agricultural laws in place for farmers and animal feeds producers to stop the use of antibiotics as feed additives except on recommendation by veterinary doctors followed by close monitoring, regulations that limit the discharge of antimicrobial residues into the environment, increased research and development in drugs, reduction of availability and ease of access to antibiotics.The federal ministries of Health, Environment and Agriculture, Nigeria Centre for Disease Control (NCDC) and NAFDAC all have huge roles to play in ensuring compliance to these requirements.

We as the citizens must not fold our arms and remain frozen in the ice of the moment forgetting the coming heat. Rather we should lead the fight against this AMR scourge in our body and food. This way, we can boast of a healthy society and bolstered economy. Let’s all take action today so we can have a guaranteed cure tomorrow.
• Ojewale wrote from Idimu, Lagos via
kayodeojewale@gmail.com

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