‘One Health’ approach needed to address Antimicrobial Resistance rising threat – Experts

Health experts have said that the “One Health” approach, a holistic and multisectoral approach, is needed to address Antimicrobial Resistance (AMR) rising threat.

They pointed out that it was important to adopt the Antimicrobial Stewardship (AMS) programme to fight resistance and protect global health.

These experts spoke during a virtual media roundtable organised by an American pharmaceutical giant- Pfizer, to raise awareness about AMR and ensure ongoing patient safety efforts “so as to maintain the future effectiveness of antibiotics.”

Speaking at the roundtable, Oyinlola Oduyebo, a professor of clinical microbiology at the College of Medicine of the University of Lagos (CMUL), Idi-Araba, said that Antimicrobial Stewardship is a system-wide healthcare strategy, designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health.

“AMS has been very successful in promoting antimicrobials’ appropriate use by implementing evidence-based interventions. AMS practices, principles, and interventions are critical steps towards containing and mitigating AMR. Evidence-based policies must guide the “One Health” approach, vaccination protocols, health professionals’ education, and the public’s awareness about AMR,” she said.

Oduyebo noted that antimicrobial resistance is a serious threat to global public health adding that it increases morbidity and mortality and is associated with high economic costs due to its healthcare burden. “Infections with multidrug-resistant (MDR) bacteria also have substantial implications on clinical and economic outcomes.”

Kennedy Tamunoimiegbam Wariso, head of the Department, of Medical Microbiology and Parasitology, University of Port Harcourt, who also spoke at the event, said that antimicrobial stewardship programmes optimise the use of antimicrobials, improve patient outcomes, reduce AMR and health-care-associated infections, and save health-care costs, amongst others.

Wariso said with rates of AMR increasing worldwide, and very few new antibiotics being developed, existing antibiotics are becoming a limited resource.

“It is, therefore, essential that antibiotics only be prescribed – and those last-resort antibiotics be reserved – for patients who truly need them. Hence, AMS and its defined set of actions for optimizing antibiotic use are of paramount importance.

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“Over 46 percent of Nigerians abuse antibiotics, thereby leading to AMR, about 62 to 71 percent of under-five children in Nigeria have been exposed to antibiotics in various ways. Yet, there are no concerted efforts to tackle AMR, Wariso said, while calling on Nigerians to reduce self-prescription, self-indulgence and across-the-counter purchase of antibiotics.

“Rather, Nigerians should ensure they take the right prescription of antibiotics by doctors and at the right time. If we follow this step, we would reduce to the barest minimum, AMR in Nigeria,” he said.

According to him, “AMR occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness, and death. Antimicrobials – including antibiotics, antivirals, antifungals, and antiparasitics – are medicines used to prevent and treat infections in humans, animals, and plants.”

Kodjo Soroh, medical director, of West Africa Pfizer, said at least 700,000 people die each year due to drug-resistant diseases.

“More common diseases, including respiratory tract infections, sexually transmitted infections, and urinary tract infections, are untreatable; lifesaving medical procedures are becoming much riskier, and our food systems are increasingly precarious.

“Without action by governments, industry, and society, AMR is expected to cause 10 million deaths each year by 2050 as overuse of antibiotics is creating stronger germs. governments and the public health community must work together with industry to take further action and support measures that will enable continued innovation in the development of new antibiotics and vaccines to help curb the spread of AMR.

“A robust pipeline of new antimicrobials is essential to restoring the balance against increasing rates of AMR,” Soroh said, adding:

“However, significant economic hurdles have made research and development in this area a challenge. No novel class of antibiotics has been launched for almost 40 years, and even when newly approved treatments come to market, they may be used sparingly to support good antimicrobial stewardship practices, making it difficult to recover the high cost associated with development. New reimbursement models that more fully reflect the complete value of antimicrobials are critical.”