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Combating the Antimicrobial Resistance Crisis

Antimicrobial resistanceAntimicrobial resistance, or AMR, is a growing trend among newly discovered viruses. The World Health Organization (WHO) identifies 30 new diseases that threaten half the world’s population, which are particularly prevalent in developing nations.

Background of Antimicrobial Resistance

Drug-resistant diseases (AMR) have grown in prevalence over the past 40 years. Many of the medicines used to treat common infections like the flu and pneumonia have been around for decades. Eventually, viruses and bacteria develop their own microbial methods of fighting back against these drugs and inevitably become fully resistant to treatments.

Perhaps the most well-known example is the virus known as pneumococcus, or streptococcus pneumoniae. Penicillin has been used to treat pneumococcus since the early 1950s, giving it plenty of time to develop a strong resistance to the drug. Now, pneumococcus is practically untreatable, killing over 300,000 children below the age of 5 annually.

The CDC explains that germs that grow resistant to medications can be almost impossible to treat, often resulting in severe illness or death. This problem is only getting worse, as the U.N. finds that while 700,000 people die every year due to AMR diseases now, by 2050 that number will skyrocket to 10 million people.

The AMR crisis has severe economic implications as well. Antimicrobial diseases affect livestock as well as humans, leaving our international agricultural sector to collapse if not dealt with. All in all, the AMR crisis is projected to cause $100 trillion worth of global economic damage by 2050, only pushing people further into poverty.

Three organizations have stepped up to address the issue of antimicrobial resistance.

The AMR Action Fund

The AMR Action Fund is a financial project created by an international group of pharmaceutical companies. It aims to bring four new antibiotics that combat AMR to the consumer market by 2030. The fund expects to invest over $1 billion into late-stage antibiotic research by the end of 2025.

The AMR Alliance

The AMR Alliance is a massive coalition of more than 100 of the most powerful pharmaceutical companies, dedicated to fighting AMR. In 2016, the AMR Alliance signed the Industry Declaration, an agreement promising the development of anti-AMR medicines.

In 2018, the AMR Alliance spent a record $1.8 billion in the war against AMR. In 2020, the  AMR Alliance released its second progress report, detailing the progress made so far. The results are promising: 84% of relevant biotechnology companies are in the late stages of research and development for AMR cures and more than 80% of them have strategies in place for releasing the drugs.

UN Food and Agriculture Organization (FAO)

The FAO is taking serious steps to battle antimicrobial resistance. These dangerous antimicrobial superbugs threaten livestock in farms throughout the world. The FAO explains that two-thirds of future antimicrobial usage will be in livestock. These AMR superbugs will only increase in danger over time, as they develop stronger resistance to medicines.

The FAO has worked to improve agricultural practices across the world, specifically in developing nations. The FAO is raising awareness about this issue with rural farmers and is providing millions of dollars in funds to combat AMR.

World Antimicrobial Awareness Week (WAAW) is an annual campaign designed to increase awareness of the issue and encourage best practices among the general public, health workers, and policymakers to avoid the further emergence and spread of drug-resistant diseases. Over the week of November 18, millions of posts are made around the globe in support of antimicrobial resistance awareness. Expanding awareness is key, as the WAAW campaign website explains that less general use of antibiotics could help to mitigate the effects of this issue.

– Abhay Acharya
Photo: Flickr

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Poverty and Antibiotic Resistance in Southeast Asia

Antibiotic Resistance in Southeast Asia
In September 2016, the United Nations General Assembly (UNGA) declared antimicrobial resistance (AMR) a major health threat for nations in every part of the world. AMR comes about when bacteria evolve to resist antibiotics used for the treatment of many infectious diseases such as pneumonia, tuberculosis and salmonellosis. According to the Center for Disease Control and Prevention (CDC), AMR can bring harm to people of all types and agriculture, health care and veterinary industries. Antibiotic resistance in Southeast Asia is of particular concern. 

Antibiotics have been essential to curing infections ever since Alexander Fleming discovered the first form of antibiotics, penicillin, in 1928. In the developing countries of Southeast Asia, antibiotics often do not have regulation and are available for purchase without a prescription from a physician, which exacerbates the phenomenon of AMR and causes major concern. This is an example of how poverty in Southeast Asia contributes to the antibiotic resistance crisis.

Contributions to Antimicrobial Resistance

AMR is a natural process. With or without the use of antibiotics, bacteria will always evolve to fight for survival by strengthening their resistance or by multiplying. Despite this, humans make AMR worse. A plethora of unnatural issues exaggerates AMR, but there are two that are cause for the greatest concern: unregulated sale of antibiotics and the use of antibiotics not as medicine for humans but as growth promoters and disease treatments in livestock. 

Unregulated Antibiotics and Self Medication in Southeast Asia

The World Health Organization Southeast Asia Region (WHO SEAR) includes the countries of Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste. These countries are notorious for selling antibiotics as an unregulated product to the public, a reality of many developing countries around the world. In developing countries, the prevalence of infectious deadly diseases is higher than in more developed nations, making the likelihood of death from these issues higher.

Many consider the countries in Southeast Asia listed above to be hotspots for the spread of AMR. Here, the cost of antibiotics bought over the counter is lower than the cost to visit a physician or health professional. As a result, many self-medicate, making it the leading cause of AMR. Self-medication refers to the use of medication to treat ailments, diseases or infections without the guidance of a medical professional. Without curbing this habit practiced in WHO SEAR, bacteria quickly mutate to resist treatment, leading to more intense illnesses, increased medication prices and death. 

The Use of Antibiotics for Livestock in Southeast Asia

In this region, the use of antibiotics in livestock outweighs the use of antibiotics in humans. To keep livestock in countries around the world healthy, farmers commonly use antimicrobials to treat and prevent diseases and decrease mortality in livestock. Though people widely practice this, the countries of WHO SEAR use this technique excessively due to poverty. With weak regulatory laws to govern or survey the effects this has on the AMR crisis, AMR is aggressively growing. 

Where previously people ignored it when considering the causes of AMR, livestock antibiotic use has recently become a growing concern across the globe. With recognition came complication: in developing countries, farmers rely on the use of antibiotics to prevent illness or death of their animals so they can continue to make a profit. In Southeast Asia especially, the hard reality is that these issues layer and mix with other issues, such as poverty and food security. Policies regarding antimicrobial consumption in livestock that work for developed nations often do not work in underdeveloped nations, due to the complex differences of cultural differences and locations. It is for these reasons that poverty contributes to antibiotic resistance in Southeast Asia.

Efforts to Slow Antibiotic Resistance in Southeast Asia

Given that this crisis is on a global scale and affecting every nation, some are making efforts to control AMR. Unfortunately, there is no way to stop it completely. There are, however, the WHO’s action plans that can bring light to this topic. WHO has laid out five strategic goals: to increase recognition and understanding of AMR, to increase global monitoring and research, to decrease the prevalence of infectious diseases requiring antibiotic treatment, to improve the use of antibiotic treatment and to create a case for sustainable investment that includes all nations, no matter location or level of development

An example of raising awareness is World Antibiotic Awareness Week. Every year brings the annual World Antibiotic Awareness Week, created by the WHO in 2015. This week in November sets goals to increase awareness and encourage health care providers, policymakers and the public to practice healthy and sustainable techniques to slow the spread of antibiotic resistance in Southeast Asia.

– Anna Giffels
Photo: Flickr