Antimicrobial resistance is when a germ thrives in the presence of a medicine that previously inactivates or kills it. Generally, medicines that kill germs are called antimicrobials. Antimicrobials have played and continue to play a great role in the promotion of global health, socio-economic development, and advancement of nations and civilization. The discovery of penicillin is a case in point. So, it is of huge concern when antimicrobials begin to lose their efficacy as a result drug resistance development. There are several reasons why germs do develop resistance to medicines. One reason could be that a strain of the microbe that was naturally resistant multiplies and becomes the majority strain. A second reason is when, over time, a microbe develops ways to avoid the medicine. Antimicrobial resistance is a big problem all over the world. This is because it makes cheap available medicines useless. As a result there is much suffering from infectious diseases and deaths. However, individuals have a vital role to play in the control of antimicrobial resistance. This can be done by taking only the medicines prescribed by an authorized health care personnel, for the duration prescribed, and by purchasing medicines only from authorized vendors. It can be difficult for some people to practice these, for example, when one cannot access a health care facility for prescriptions or when counterfeit medicines find their way into legitimate supply chain processes.
Communities of low socio-economic status suffer the most from antimicrobial resistance. This is mainly because individuals from these communities cannot afford the expensive alternative antimicrobials. This can make people die from a germ causing illness because the medicines they are given do not kill the germ and there are no affordable options. This can happen for viral, bacterial, fungal or parasitic infections. As we noted in another post HIV infection and HIV drug resistance, resistance to HIV drugs is a threat to the treatment and elimination of HIV infections. The objective of global health research and education is to improve access and equity to healthcare. However, it is very important for the perspective and voice of communities, particularly communities of low socio-economic status to be heard. This is because the strategies or interventions developed to support communities would have a higher chance of success and sustainability in a partnership between science and communities.
Antimicrobial resistance is a global problem. In 2015, the World Health Assembly described efforts to reduce antimicrobial resistance as a global priority. It threatens the usefulness of available medicines, and the health and socio-economic development of communities. It takes years and a lot of resources for a new antimicrobial to be developed, so it is very important that available antimicrobials remain effect and accessible to all. A study which I lead, showed that even in young children, who are not sick and have never received antibiotics, you can find gut bacteria that have genes coding for a variety of antibiotic resistance http://www.samj.org.za/index.php/samj/article/view/11819/0. It is very important to find out how these young children acquired antibiotic resistant bacteria so early in their life. The answers may lead to the design of appropriate measures to prevent its occurrence. Dr Richard Guerrant, University of Virginia, USA https://globalhealth.virginia.edu/Guerrant, and myself have advocated, through a guest editorial for the South African Medical Journal, for surveillance of antibiotic resistance to be carried out at the population http://www.samj.org.za/index.php/samj/article/view/11827. If we do this, we can better understand the burden and dynamics of the problem. Sustained efforts from different angles are needed to curb the rise of antimicrobial resistance. This is because there are different causes of the development of antimicrobial resistance: the unnecessary prescription or under prescription of antimicrobials, the use of antibiotics in livestock, self-medication, and the use of counterfeit substandard medicines. It will be interesting to know your views about antimicrobial resistance, and what you think individuals and the lay leadership in communities, such as non-governmental organization, can do to control and prevent antimicrobial resistance development and spread in communities.
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