Rumbidzayi Zinyuke — The winter season is well upon us.
And with it, comes a rise in cases of flu and common colds.
When these common infections strike, we all have a great need for relief, so many of us often look for the fast acting medicines to quickly get rid of it.
Antibiotics often do the trick.
Even when the doctor has not prescribed it, we somehow find a way to get our hands on them. Of course, they will work to kill the bacteria, causing the infection to die quickly. But a more silent threat that most are not aware of looms.
The more we use these antibiotics for common infections, the more the bacteria that cause them gain resistance and fail to do the work they are supposed to do.
This is just the beginning of Antimicrobial Resistance (AMR).
AMR is among the top 10 global health threats, killing more than 1 million people each year.
One in five of these deaths occur among children under the age of five years.
In Zimbabwe, there were 3 900 deaths attributable to AMR and 15 800 deaths associated with AMR in 2019 alone.
These are alarming figures.
Sadly, this phenomenon is not only confined to the common infections like flu.
Antimicrobial resistance is happening with many other serious infections like Malaria, HIV and Tuberculosis to name just a few.
AMR occurs when bacteria and other microbes evolve to become resistant to the drugs designed to kill them. This silent threat undermines the effectiveness of antibiotics, rendering them useless against even minor infections.
According to the World Bank, the global gross domestic product (GDP) could fall by up to US$3,4 trillion annually after 2030 due to AMR. The Bank estimates that an additional 24 million people would be forced into extreme poverty by 2030 if no action is taken on AMR today.
It is against this background that a strategic roundtable on "charting a new path forward for global action against Antimicrobial Resistance (AMR)" was organised at the 77th World Health Assembly last week.
Dr Peter Piot, Professor of Global Health at the London School of Hygiene & Tropical Medicine, who chaired the WHA roundtable said: "AMR is a gathering storm that threatens a century of progress in medicine. Each year, drug-resistant bacteria claim more than a million lives globally, especially in low and middle-income countries. Yet this crisis is still a silent one. We take for granted that infections that once spelt death are routinely cured with antibiotics. In the age of ever more advanced and personalised medicine, we have grown complacent about these marvels that allowed us to bring infections under control."
Of course, low and middle income countries are most disproportionately affected by this public health threat and this calls for more concerted efforts on their part.
For many African countries, a unique challenge exists.
Overcrowded living conditions, limited access to clean water and sanitation, coupled with the overuse and misuse of antibiotics in both human and animal health all contribute to a breeding ground for resistant microbes.
For Zimbabwe, we are faced with a high burden of infectious diseases and the widespread use of counterfeit or substandard antibiotics only exacerbates the problem.
Zimbabwe is among the top 30 countries highly burdened with multi-drug resistant TB. This means MDR TB patients continue to face catastrophic costs associated with accessing treatment. For the country, the cost of second and third line treatment becomes substantially high, posing another challenge in ensuring availability of drugs at all times.
Without a concerted effort, AMR could cripple the country's already fragile healthcare system.
The Government has made commitments to fight the threat posed by AMR.
During last year's World AMR Awareness Week (WAAW) commemorations held in Harare, it was agreed that a multi-stakeholder approach was the way to go.
Minister of Lands, Agriculture, Water and Rural Development Dr Anxious Masuka said the One Health approach in combating AMR resonated with the whole of Government approach, which had been adopted by Zimbabwe, where every arm of Government was involved in the national socio-economic developmental agenda.
"We will continue to promote responsible antibiotic use in agriculture, strengthen surveillance systems to monitor AMR in animals, and encourage the adoption of sustainable farming practices that reduce the need for antibiotics. Together with our partners in the health and environmental sectors, we will strive to create a future where antibiotics remain effective tools in treating diseases, both in humans and animals," he said.
On his part, Health and Child Care Minister Dr Douglas Mombeshora said it was critical to encourage best practices among the general public, health workers and policymakers to minimise the emerging, re-emerging and spread of drug-resistant infections.
Zimbabwe finalised the second review of the AMR One Health national action plan (NAP), which is expected to be launched soon.
The use of NAPs, which have well-defined goals, strategies and policies as well as frameworks, is essential in the fight against AMR.
This commitment within African governments is commendable and should also be complemented by commitment by the general public to stop the misuse and abuse of antimicrobials.
But the responsibility for tackling this global threat does not fall solely on them. Everyone has a moral and strategic imperative to act.
Increased funding for research and development of new antibiotics is crucial.
Sharing knowledge and expertise in areas like antimicrobial stewardship, which promotes the responsible use of antibiotics, is equally important.
Investing in strengthening African healthcare systems is also essential.
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This includes building robust surveillance systems to track the emergence and spread of resistant pathogens, as well as educating healthcare professionals on proper antibiotic use.
Furthermore, addressing the underlying factors that contribute to AMR -- like access to clean water and sanitation -- is vital for long-term success.
There is hope for accelerated action at the upcoming United Nations General Assembly High Level Meeting (UNHLM) on AMR to be held in September this year.
Stakeholders at the roundtable expressed hope that the UNHLM on AMR would prioritise prevention, access, governance, and accountability.
They said it should truly address the needs of the most vulnerable communities and called for fair and equitable access to antibiotics and diagnostics, embedded in a better system of WASH (water, sanitation and hygiene), infection prevention and control, vaccines, and prevention with responsible stewardship.
And for this to happen, the One Health approach will be the cornerstone of all actions to be taken and the successes thereafter.
AMR is a silent killer, but it does not have to be our future.
By taking decisive action, the world can work together to ensure that antibiotics remain effective tools for generations to come.
This is not just about protecting Africa; it is about protecting all of us from a threat that recognises no borders. The time to act is now!
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