Fighting antimicrobial resistance does not involve miracle drugs

Antibiotic sensitivity test. [iStockphoto]

Africa, like other continents, has a problem with antimicrobial resistance (AMR). But Africa stands out because it has not invested in the capacity and resources to determine the extent of the problem, or how to solve it.

To start, consider Staphylococcus aureus, which is the source of a skin infection that can become fatal if combated with medication.

Estimates of the most common resistant variation, methicillin-resistant Staphylococcus aureus (MRSA), exceed 100,000 deaths worldwide in 2019.

But until recently, we didn’t have a good idea of ​​the scale of the problem of MRSA – or any other antimicrobial resistant pathogen – in Africa.

It turns out that after testing 187,000 samples from 14 countries for antibiotic resistance, scientists found that 40% of all staph infections were MRSA, but we still don’t know what causes the bacteria. becomes resistant, nor the extent of the problem. .

We don’t take RAM seriously, perhaps because it’s not glamorous or relevant.

There is nothing fancy or futuristic about the technology we currently use to identify resistant pathogens. The fight against AMR doesn’t involve miracle drugs, expensive treatments, or fancy diagnostic tests. Instead, we have bacteria and other pathogens that are commonplace and we’ve learned to ignore the good old drugs that used to work.

The global health and pharmaceutical industries do not appear to view solving this problem as cost-effective compared to the speed with which vaccines for Covid-19 have been found with government-funded diagnostics to end the disease. pandemic.

Why can’t the same be done for antimicrobial resistance, when the World Health Organization (WHO) has repeatedly declared antimicrobial resistance to be a global health priority – one of the top threats for 21st century public health?

A recent study estimated that in 2019 nearly 1.3 million people died from antimicrobial resistant bacterial infections, with Africa bearing the highest burden of deaths. A high prevalence of AMR has also been identified in foodborne pathogens isolated from animals and animal products in Africa.

Collectively, these numbers suggest that the burden of AMR could be on par with – or greater than – that of HIV or Covid-19. The growing threat of antimicrobial resistance will likely weigh heavily on African health systems, but the lack of accurate information on antimicrobial resistance limits our ability to understand how commonly used antimicrobials actually work.

It also means that we cannot determine the drivers of RAM infections and design effective interventions in response.

Data from our recent project on many of the scariest pathogens across 14 countries has provided insight into the underdetected and underreported depth of Africa’s AMR crisis. Less than two percent of medical laboratories in the 14 countries surveyed can perform bacteriological testing, even with conventional methods developed more than 30 years ago.

While strengthened staffing is essential, many health facilities in Africa face interrupted access to electricity, poor connectivity and persistent severe labor shortages.

Containing AMR means we need to fix African health systems. The work begins now.

-Dr Pascale Ondoa is the Director of Science and New Initiatives of the African Society for Laboratory Medicine and Dr Yewande Alimi is the AMR Program Coordinator of the African Center for Disease Control.

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