AMR poses threat to public health and sustainable food production

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Anti-microbial resistance (AMR) poses an increasingly serious threat to public health and sustainable food production, necessitating an effective response involving all sectors of government and society, stakeholders attending the World AMR Awareness Week in Zimbabwe have said.

Addressing delegates during the official opening ceremony of the 5th Continental World Antimicrobial Awareness Week for Africa in Harare today, Mr. Abebe Haile-Gabriel, Assistant Director-General and Regional Representative for Africa of the Food and Agriculture Organization (FAO) said his organization covers antimicrobial stewardship over a variety of disciplines such as aquatic and terrestrial animal health, animal welfare and production, food and feed safety, crop production and protection, water, land, and along agrifood system.

He revealed that in 2015, FAO’s member countries adopted a resolution on antimicrobial resistance that recognized that antimicrobial resistance, or AMR, poses an increasingly serious threat to public health and sustainable food production and that an effective response should involve all sectors of government and society.

“Drivers of AMR in the food and agriculture sector include unregulated antimicrobial sales in veterinary pharmacies, misuse of antimicrobials as growth promoters in the unsustainable intensification of livestock production, or as preventative medicine for diseases, unintended uses of medicated feed by farmers, the proliferation of poor-quality veterinary medicines, and poor farm biosecurity and disease prevention measures.

“Antimicrobials used anywhere in the world impact Africa because of the continent’s high dependence on food imports. If left unaddressed, AMR may force tens of millions more people into extreme poverty, hunger, and malnutrition, and could cripple livelihoods. Therefore, it is crucial to implement measures, from farm to fork, to reduce the spread of drug-resistant microbes and use antimicrobial drugs more responsibly and only when needed,” Mr. Haile-Gabriel said.

Addressing the same gathering, Dr Ahmed Ouma Ogwell, the Deputy Director General of Africa Centres for Disease Control and Prevention (Africa CDC) said antimicrobial Resistance is a “silent pandemic” and it is a global public health threat.

“For Africa, it is a critical threat to health security and economic growth. It is projected that millions of Africans could succumb to antimicrobial resistance by 2050 if important steps are not taken. In Africa, AMR has already been documented to be a bigger problem than HIV, malaria, and tuberculosis combined. AMR stands as one of the leading public health challenges of the 21st century, with Africa having the world’s highest mortality rate from AMR infections, resulting in over 27 deaths per 100,000.

“The problem of AMR is very complex and there is no single solution for it, it requires a very strong coordinated multi-sectoral and multidisciplinary approach to tackle it. Africa CDC continues to leverage its institutional and political influence to promote continent-wide policy, legislation, and advocacy across all sectors of government and society,” he said.

Africa CDC played a continental and leadership role in establishing a continental framework on AMR control. This Framework recommends key strategic activities that various stakeholders at the national, regional, and continental levels should undertake to control AMR in Africa.

Dr. Ogwell said within the next 5 years, Africa CDC will lead high-level advocacy and work with technical partners working on AMR in Member states to improve surveillance of AMR organisms among humans, animals, and plants; delay the emergence of AMR; limit transmission of AMR; and mitigate harm among patients infected with AMR organisms.

The representatives of relevant African Union agencies formed the Africa Union Task Force on Antimicrobial Resistance Control and developed the AU Framework on AMR 2020-2025. Through the leadership of the African Union Task Force on Antimicrobial Resistance led by Africa CDC and AU-IBAR, the African Union Heads of State and Government made a strong political commitment to control antimicrobial resistance in Africa.

The “African Common Position on AMR” was officially adopted at the 33rd African Union Summit in February 2020. The Assembly Declaration Assembly/AU/Decl.3(XXXIII) Declaration On African Common Position On Antimicrobial Resistance signifies the highest level of political commitment of the African leaders to combat AMR.

Ms Francesca Erdelmann, the Acting UN Resident Coordinator for Zimbabwe emphasised the need to raise awareness and take action against the growing threat of antimicrobial resistance.

She said during the United Nations General Assembly in September 2016, world leaders demonstrated their commitment to tackling AMR by declaring it a global crisis with significant implications for global health and food security.

The World Health Organization has even identified AMR as one of the top 10 global public health threats facing humanity.

“Why is antimicrobial resistance the biggest threat we face? Because drug-resistant infections pose a grave risk to our health, as well as the progress we’ve made in healthcare, food production, and life expectancy itself. Antibiotic-resistant pathogens have been found in all corners of the globe, and with the ease of modern travel, they can easily cross borders and continents.

“It is crucial for us to take urgent multisectoral action to address this global health and development threat. Misuse and overuse of antimicrobials are major drivers in the development of drug-resistant pathogens. Inadequate access to clean water, lack of sanitation, and insufficient infection prevention and control measures further contribute to the spread of antimicrobial-resistant microbes,” Ms Erdelmann said.

She highlighted that the economic cost of AMR is significant, with health complications resulting in longer hospital stays, increased expenses for medicines, and financial hardships for those affected. Without effective antimicrobials, the success of modern medicine in treating infections, including during major surgeries and cancer chemotherapy, would be at risk.

In sub-Saharan Africa, the threat of AMR primarily arises from unregulated and inappropriate use of antimicrobials across various sectors, including human, animal, and plant use. The lack of policies guiding the procurement and use of medicines has led to the proliferation of substandard and falsified drugs. These factors not only jeopardize health but also endanger several key sustainable development goals related to health, agriculture, animals, the environment, and food security.

“This year’s theme, “Preventing Antimicrobial Resistance Together,” underscores the need for urgent multisectoral action under the One Health Approach to safeguard the effectiveness of antimicrobial medicines. In 2019 alone, antimicrobial-resistant infections claimed 4.9 million lives globally, surpassing the combined death toll from HIV/AIDS and malaria. Sub-Saharan African countries, with 99 deaths per 100,000 people, bear the heaviest burden of AMR-associated mortality.

“The upcoming UNGA 2024 High-level Meeting on AMR will provide an opportunity to set new targets and practical steps to address AMR. Heads of Government, Government Ministers, and political leaders will gather to discuss effective approaches to combating AMR at local, national, and global levels, considering aspects such as funding, policy development, and international collaboration,” she added.