The problem of AMR is seen as either not urgent or too difficult to solve. Neither is true. The tools to solve it are widely available, says co-author Prof Ramanan Laxminarayan.
Antibiotics, if used as indicated, can avert many deaths from bacterial infections, and access to second-line antibiotics can even prevent deaths from some drug-resistant infections.Antibiotics, if used as indicated, can avert many deaths from bacterial infections, and access to second-line antibiotics can even prevent deaths from some drug-resistant infections.
Every year, almost five million people die globally because of
anti-microbial resistant (AMR) bacteria, according to a latest Lancet study. In
fact, they make up a major part of the estimated 7.7 million deaths globally
due to bacterial infections, which are becoming the second largest cause of
mortality.
“In India, in 2019, approximately 10,43,500 deaths were associated with AMR. For too long, AMR has been seen as either not urgent or too difficult to solve. Neither is true. We need immediate action and the tools to do so are widely available. We hope that this September the UN high-level meeting will ensure that there is a global will to act,” says Prof Ramanan Laxminarayan, senior research scholar at Princeton University and co-author of a new Lancet series on the subject.
According to an analysis by The Lancet series of papers, administrators suggest improving and expanding existing methods to prevent infections, such as hand hygiene, regular cleaning and sterilisation of equipment in healthcare facilities, availability of safe drinking water, effective sanitation and use of paediatric vaccines. These could prevent over 750,000 deaths associated with AMR every year in low- and middle-income countries (LMICs), say researchers.
This occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines, which include antibiotics, antivirals, antifungals and antiparasitics. “AMR is the failure of antibiotics to work because the bacteria have evolved to be resistant to drugs that have been widely used or misused,” says Prof Laxminarayan. As a result, infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability and death.
The challenge of Antimicrobial Resistance (AMR), and how to confront it effectively
What are the reasons for antimicrobial resistance?
The misuse and overuse of antimicrobials in humans, animals and
plants are the main drivers in the development of drug-resistant pathogens. AMR
puts many of the gains of modern medicine at risk. It makes infections harder
to treat and makes other medical procedures and treatments – such as surgery,
caesarean sections and cancer chemotherapy – much riskier, according to WHO.
According to study authors, in parts of Asia and sub-Saharan Africa, the burden is aggravated by scarcity of access to effective antibiotics, inadequate laboratory testing and poor surveillance.
Antibiotics, if used as indicated, can avert many deaths from bacterial infections, and access to second-line antibiotics can even prevent deaths from some drug-resistant infections.
WHO updates Bacterial Pathogens Priority List: What is it, and should you be worried?
How can AMR impact you?
Bhakti Chavan, patient advocate and member of the WHO task force
of AMR survivors, was 23 and completing her last project for a master’s degree
in biotechnology in 2017 when she was diagnosed with Extensively Drug Resistant
(XDR)TB. “I required daily painful injections and medicines,” she says. Even
with newer medicines, she had to take a break, not to forget the repeated
hospital admissions, to manage adverse side effects. Now, as a champion for
patients with drug-resistant TB, she says, “We must handle novel therapies
judiciously to avoid a situation in which no drugs are available to treat the
disease or the evolution of drug-resistant bacteria,” she says.
Can newer drugs be used to counter AMR?
For starters, these are too expensive and as Prof Laxminarayan
says, “It’s not simply a matter of developing new antibiotics. Unless access
and affordability are guaranteed, the vast number of deaths from resistant
bacterial infections will continue unabated. Reducing the cost of drug
development would help keep antibiotics affordable, as shown by the public-private
partnerships for medications to treat malaria and neglected tropical diseases.
It’s time for similar tactics in antibiotic development.”
The Lancet analysis actually quantified prevention rates. Better hand hygiene and more regular cleaning and sterilisation of equipment could save up to 337,000 lives a year. Universal access to safe drinking water and effective sanitation in community settings could prevent approximately 247,800 deaths annually. Expanding the rollout of some paediatric vaccines, such as pneumococcal vaccines, which help protect against pneumonia and meningitis, and introducing new ones, such as RSV vaccines for pregnant mothers, could save 1,81,500 lives a year.
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