|Year : 2021 | Volume
| Issue : 3 | Page : 209-210
What COVID-19 pandemic can teach about antimicrobial resistance
Department of Surgery, Macerata Hospital, Macerata, Italy
|Date of Submission||13-Jul-2021|
|Date of Acceptance||14-Jul-2021|
|Date of Web Publication||04-Sep-2021|
Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sartelli M. What COVID-19 pandemic can teach about antimicrobial resistance. Adv Hum Biol 2021;11:209-10
COVID-19 pandemic has proved to be a severe moment of truth for health systems worldwide. We believe that all health systems should learn a lot from this pandemic about the way to fight any disease and manage the overall health of their citizens. Since globalisation has contributed to the quick spread of the COVID-19 pandemic worldwide, countries have been tempted to retreat into narrow national strategies for fighting it. What COVID-19 pandemic has taught is the need for an equivalent globalisation of scientific, medical and public health efforts linked by shared purposes and goals, as well as wider co-operation to counter this and future pandemics. The world needs to create a shared global health system to identify and spread innovative approaches for combating pandemics. In many cases, the practices that have been proved most effective in the fight against COVID-19 are the same ones that should be used to treat any major health condition. This may be particularly true for the silent pandemic of antimicrobial resistance (AMR).
Like COVID-19 pandemic, AMR is also a global threat — potentially a still greater one. Based on broad estimates, deaths from AMR infections are projected to increase from the current toll of 700,000 to 10 million every year by 2050. This scenario will not occur if we respond adequately to this emergency.
Like COVID-19 pandemic, AMR can affect us all. It does not care who we are, or where we are: everyone is at risk. AMR has emerged as one of the principal public health problems of the 21st century that threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi no longer susceptible to the common antimicrobial agents. The burden of AMR is especially urgent regarding antibiotic resistance in bacteria. Antibiotic resistance is a phenomenon resulting from the natural evolution of bacteria. Nonetheless, human activities accelerate the pace at which bacteria develop and spread resistance. The success of modernised medicine, namely organ transplantation, cancer therapy, management of preterm babies or major surgeries, might not have been possible without effective antibiotic treatment to control for bacterial infections.
The aetiology of AMR is multifaceted, and its consequences pose an impact across the globe. To adequately address AMR, it is necessary to take a 'One Health' approach with integrated actions across human, animal and environmental health sectors. AMR develops across the animal, human and environment triangle or niche and there is interlinked sharing of pathogens in this triad. The plausible causes of AMR include overuse and misuse the use of antibiotics in animals (food, pets and aquatic) and humans, antibiotics sold over-the-counter, increased international travel, poor sanitation/hygiene and release of non-metabolised antibiotics or their residues into the environment through manure/faeces. These factors contribute to a selection pressure for the emergence of AMR in the community.
AMR is a complex and multidimensional problem, threatening not only human and animal health but also regional, national and global security and the economy.
<TX After Space >AMR shows no signs of decline, though it may perhaps shift direction. The World Health Organization (WHO) is now leading a global effort to address AMR. At the 68th World Health Assembly in May 2015, the World Health Assembly endorsed a global action plan to tackle AMR. It sets out five strategic objectives:</TX After Space >
- To improve awareness and understanding of AMR;
- To strengthen knowledge through surveillance and research;
- To reduce the incidence of infection;
- To optimise the use of antimicrobial agents; and
- To develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
Actions against AMR should focus firstly on local needs and national plans because each country is different. However, resistance is everyone's problem and all countries have a role in solving the problem.
The countries that have crafted inclusive national plans have been successful in controlling AMR. These approaches include cautious use of antibiotics, surveillance of antibiotics by employing the 'One Health Approach', advancement of health care setup, restricted drug promotion, consistent disease control strategies and stewardship plans. On the other hand, these strategies demand patience and time to be organised. Furthermore, these require a comprehensive endorsement from the government authorities with ample funds. However, AMR poses a global challenge. No single country, however effective it is at containing resistance within its boundaries, can protect itself from the importation of AMR through travel and trade. Working alone is not sufficient and international partnerships to seek global solutions to tackle AMR are mandatory. By collaborating, there are opportunities for disseminating the best approaches for prevention and management. The global nature of AMR calls for a global response, both in the geographic sense and across the whole range of sectors involved. Nobody is exempt from the problem. This means wider engagement of the wider, healthcare workers, vets, farmers worldwide. AMR is universal, affecting anyone and everyone, at any age and in any country and misuse of antibiotics is worsening the situation globally. Urgent action is needed. Public health education and changes in behaviour are critical as the risk is to enter a 'post-antibiotic era' in which the simplest of infections may have the potential to kill. The current COVID-19 pandemic shows that despite all of our medical advances, we remain incredibly vulnerable to infections for which we have no therapies. However, it shows that if sufficiently motivated, we can make huge changes in short time frames.
The lesson learned from the COVID-19 pandemic has been that the world was woefully under-prepared for effectively managing emerging public health threats. AMR should be recognised as one of them – an ongoing, insidious pandemic that develops rapidly but more silently compared to COVID-19.
We hope that COVID-19 is a learning experience. We hope that the global response to the COVID-19 pandemic provides the perfect opportunity to strengthen health systems in a way that can both tackle the current pandemic and limit the spread of AMR over the long term.
| References|| |
Global Alliance for Infections in Surgery. A global declaration on appropriate use of antimicrobial agents across the surgical pathway. Surg Infect (Larchmt) 2017;18:846-53.