Why super-bugs are causing global jitters

The United Nations is concerned about antimicrobial resistance (AMR), with a recent study in Kiambu County revealing widespread use of antibiotics to enhance poultry production, and self-prescription — particularly a combination of antibiotics and those classified as important in human medicine.
The new study by scientists affiliated to the Nairobi-based International Livestock Research Institute (ILRI) showed that farmers extensively used antibiotics.
The study was to investigate the drivers and practices of antibiotic use in poultry farming in Kiambu. It reveals that antibiotic use was influenced by factors such as high disease burden, access to medicines and economic pressure.
“External factors driving the inappropriate use of antibiotics included easy access, influence by marketers such as sellers of day-old chicks, and branding,” the scientists said in the January 2023 study.
Further, use of antibiotics, according to the scientists, was driven by economic factors among the farmers, sellers of day-old chicks and agro-veterinary dispensers.
Authors of the study recommended that a multifaceted one health approach — focusing on regulatory frameworks, knowledge transfer and research — be applied for judicious use of antibiotics.
Researchers say AMR is a dire problem in Kenya, with high levels of resistance to common first-line drugs and rising infections from life-threatening pathogens, including those leading to pneumonia, salmonella, and gonorrhoea.
Initially AMR only alarmed health systems, but in the latest observations by the UN Environment Programme (Unep), the impacts could destroy other social and economic aspects of life.
While interpreting a new report on AMR, Unep Executive Director Inger Andersen said food systems are also not safe from its impact.
She urged the world to cut down pollution so as to reduce superbugs, a group of strains including bacteria; viruses, parasites and fungi that are resistant to most antibiotics and other medications.
“Pollution of air, soil, and waterways undermines the human right to a clean and healthy environment. The same drivers that cause environmental degradation are worsening the antimicrobial resistance problem,” said Andersen about the report: ‘Bracing for Superbugs: Strengthening Environmental Action in the One-Health Response to Antimicrobial Resistance’. The report was launched at the sixth meeting of the Global Leaders Group on AMR, in Barbados, Southeastern Caribbean Sea.
It calls for a multi-sectoral one-health response. This is in line with the work of the Quadripartite Alliance, including UNEP, the Food and Agriculture Organisation (FAO), the World Health Organisation (WHO), and the World Organisation for Animal Health (WOAH).
Sustainable mechanisms
Last November, the government through the ministries of Health, Agriculture and Livestock Development merged national efforts towards sustainable mechanisms to mitigate the effects of AMR.
Health Cabinet Secretary Susan Nakhumicha said AMR is posing a growing threat to treatment and control of epidemic-prone, endemic as well as pandemic diseases.
Through the one-health approach, the various Ministries have developed a National Action Plan (NAP) and an AMR Policy whose implementation is underway.
“The continuous emergence of resistance to antimicrobials restricts our ability to treat diseases, reversing the gains made in the fight against infectious diseases and curbing the efforts to achieve Universal Health Coverage and health-related sustainable development goals.
“To efficiently and effectively implement the interventions in the NAP, functional and integrated systems, with well-coordinated, suitably resourced governing structures, are required”, said Nakhumicha during the launch of World Antibiotics Awareness Week, 2022.
Examples of superbugs include resistant bacteria that can cause pneumonia, urinary tract infections and skin diseases.
Andersen said that curtailing pollution caused by pharmaceuticals, agricultural and healthcare sectors, is essential in reducing the emergence, transmission, and spread of superbugs.
AMR is taking a serious toll on humans, animals, and plants, as well as the global economy. According to Barbados Prime Minister Mia Amor Mottley, the current environmental crisis is also one of human rights and geopolitics.
“The AMR report published by UNEP today is yet another example of inequity, in that the AMR crisis is disproportionately affecting countries in the Global South,” Mottley, also chairperson of the One-Health Global Leaders Group on Antimicrobial Resistance, said.
“We must remain focused on turning the tide in this crisis by raising awareness and placing this matter on the agenda of the world’s nations,” she added.
According to the Kenya Medical Research Institute (Kemri) Acting Director General, Prof. Sam Kariuki, the bacterial infections that contribute most to human disease in Kenya are often those in which resistance is most evident.
Examples are multidrug-resistant enteric bacterial pathogens such as typhoid, diarrheagenic escherichia coli and invasive non-typhi salmonella, penicillin-resistant streptococcus pneumoniae, vancomycin-resistant enterococci, methicillin-resistant staphylococcus aureus and multidrug-resistant mycobacterium tuberculosis.
Resistance to medicines commonly used to treat malaria is of particular concern, as is the emerging resistance to anti-HIV drugs.
Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-poor settings.
The report highlights a comprehensive set of measures to address both the decline of the environment and the rise of AMR, especially addressing key pollution sources from poor sanitation, sewage, community and municipal wastes.
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