Infection

Shooting Our Own Foot: Misuse Of Medicines Is Making Infections Difficult To Treat

Posted on November 21, 2023November 21, 2023 by yun

21
Nov

Antimicrobials
should be regarded as global public goods

There are
several issues of access and equity affecting AMR.
“Research and development of new treatment options,
including new antibiotics, is not prioritized due to a
sector-wide market failure. As a result, we are running out
of treatment options and new drugs are not coming into the
market. Even when new medicines finally reach the market,
low- and middle-income countries are not able to access
these due to intellectual property and pricing constraints.
Antimicrobials should be regarded as global public goods.
Governments should strengthen their health systems and push
for universal health coverage, so that all have access to
the needed antimicrobials prescribed by registered
healthcare providers,” said Thomas.

Be the change:
Sharing personal experience of surviving AMR

Vanessa
Carter, an AMR patient survivor, One Health advocate,
Chairperson of the WHO Taskforce of AMR Survivors, and
founder of The AMR Narrative was one of the speakers at the
3rd Annual Global Media Forum on AMR, hosted by Global AMR
Media Alliance in lead up to WAAW 2023.

She shared her
eye-opening personal experience of her battle with
AMR.

“In 2004, I was 25 years old. I had a severe
car accident in Johannesburg, South Africa, and ended up in
a hospital with a lot of massive injuries. I had been
resuscitated on the side of the road, I was put on life
support, I had multiple fractures in my face- a broken jaw
and a broken nose- and also lost one eye. I also had a head
injury, major abdominal injury, fractured pelvis, neck, and
back injury. But the most complicated injuries were to my
face, and it took me 10 years to recover from them, during
which time I have had 4 different facial prosthetic
implants,” said Vanessa.

But the worst was yet to
come. Six years into the accident and after her fourth
implant, one day, while getting into her car, Vanessa saw
moisture seeping all over her face. It was pus oozing out
from her 4th implanted prosthetic. She underwent emergency
surgery, and the doctors did “debridement” and
reconstructive surgery to fix up the damaged tissue. Two
weeks later, the infection returned. She got more of tissue
reconstruction done. But the infection kept on returning and
it worsened over time. This went on for the next 11 months
during which she was kept under the care of several
specialist surgeons.

Vanessa was eventually diagnosed
with highly antibiotic resistant form of MRSA
(Methicillin-resistant Staphylococcus aureus) infection. She
could not undergo any more surgeries for one year, as the
doctors had to wait for tissue to recover. “I had to cover
my face as I looked terrible. My face was very red, full of
fluid and swollen. I could not wear my artificial eye. I
could not go to fetch my child from school because the kids
would get scared looking at me”, she recalls.

“I
lost ten valuable years of my life between 25-35 years of
age, being in and out of hospital, and not being able to
look in the mirror without seeing a changed face. I nearly
got a bloodstream infection and sepsis and almost died. But
I am also living with a severe disability now- facial
disfiguration which was partially caused by the accident but
exacerbated by the fact that we could not treat this
infection. When I learned about antibiotic resistance, it
came as a surprise that why was it not a common knowledge
even though it is such a widespread global threat,” she
shared in the forum.

Political commitment on
AMR

World leaders at next year’s UN General Assembly
will be convening a United Nations High Level Meeting on
AMR. “We are at a critical point in time to act against
AMR. The attention to AMR is growing and it is rightly so.
The UN High Level Meeting on AMR next year is a critical
opportunity to further accelerate the response to AMR,”
said Beatrice Atim Odwong Anywar, Uganda’s Minister of
State for Environment, and Member of Global Leaders Group on
Antimicrobial Resistance (AMR).

“Out of the 5
million AMR related human deaths that occur every year, most
of them are happening in low- and middle-income countries.
These are the countries where the burden of diseases is also
higher. That is why Uganda is spearheading action against
AMR across sectors such as human health, animal health, food
and agriculture, and the environment,” added Minister
Beatrice.

One Health Approach

The health of
humans, animals, (domestic and wild), plants and our
environment are closely interlinked and interdependent.
“This means that whatever happens to one of them, the
others will be inevitably affected and impacted for better
or for worse”, says Javier Yugueros-Marcos, Head of
Department Antimicrobial Resistance & Veterinary
Products at World Organisation for Animal Health (WOAH). We
cannot ignore one at the cost of another.

Agrees
Emmanuel Kabali, AMR Project Coordination Consultant at Food
and Agriculture Organization (FAO), that “AMR is a complex
issue that impacts human, animal, plant and environmental
health. Antimicrobials are used extensively in humans, and
in animal and plant production”.

“The drivers of
AMR are in several sectors. Misuse or overuse of
antimicrobials happen in human health, animal health, food
and agriculture, and several other sectors”, adds Dr
Philip Mathew, Technical Officer, World Health Organisation
(WHO).

As per WHO, One Health is an integrated
unifying approach to sustainably balance and optimize the
health of people, animals and our environment. By linking
humans, animals and the environment, One Health can help to
address the full spectrum of disease control and contribute
to global health security.

Information, knowledge,
action gap?

“When it comes to addressing AMR, mere
information is not enough. Information has to be translated
into knowledge and action. We need to bridge that
knowledge-action gap. In context of sustainability, we often
say – think global, act local. What we do at the local level
or what we do in our house, community, school, or
organisation, also makes a huge difference. Key message is
grounded in promoting appropriate use of antimicrobials, and
to stop misappropriate or inappropriate use of
antimicrobials in human health, animal health and livestock,
food and agriculture, and environment. That is why
quadripartite agencies of Food and Agriculture Organization
of the United Nations (FAO) United Nations Environment
Programme (UNEP), World Health Organization (WHO) and World
Organisation for Animal Health (WOAH) have united to advance
progress on One Health approach in addressing challenges
such as AMR,” said Wondwosen Asnake Kibret, Policy and
Partnerships Coordinator, UNEP.

“Calling AMR a
‘silent pandemic’ might convey a wrong message that
‘it is a very distant issue which may affect us sometime
in the future’. AMR is not a distant issue as it is
killing millions right now – even one death is a death too
many when it comes to preventable threats like AMR. AMR can
happen to anybody at any time”, cautions
Philip.

That is why all sectors across the One Health
spectrum spanning human, animal, plant, and the environment
must work together to ensure the responsible use of
antimicrobials while taking preventive measures to decrease
the incidence of infections. The medicines which we have
today to combat diseases have to be handled with care and
used responsibly.

Shobha Shukla, Bobby Ramakant –
CNS (Citizen News Service)

(Shobha Shukla and Bobby
Ramakant lead the editorial team of CNS (Citizen News
Service) and are on the Board of Global AMR Media Alliance
(GAMA) and Asia Pacific Media Alliance for Health and
Development (APCAT Media). Follow them on Twitter:
@shobha1shukla, @bobbyramakant)

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