one-health-global-leaders-group-on-antimicrobial-resistance-summary

Context: Recently, a global group called ‘One Health Global Leaders Group on Antimicrobial Resistance’ was launched in the wake of rising antimicrobial resistance (AMR). 

About the group: 

  • Background:  
    • The group was created in response to a recommendation from the Interagency Coordination Group on Antimicrobial Resistance (IACG) that submitted its report to the Secretary-General of the United Nations in 2019. 
    • The IACG was convened by the Secretary-General of the United Nations after the UN high-level meeting on AMR in 2017.
  • Launched by the three global organisations: Food and Agriculture Organization (FAO), World Organisation for Animal Health (OIE) and the World Health Organization (WHO).
  • Members: 
    • This 20-member group comprises heads of states, current and former ministers of different countries, leaders from the private sector and civil society.  
    • Ex-officio members - Heads of FAO, OIE and WHO. 
  • Chaired by: 
    • It is co-chaired by the prime ministers of Barbados and Bangladesh, respectively.  
    • The group will meet twice a year.   
  • Objective: 
    • The group will harness the leadership and influence of these world-renowned figures to catalyze global attention and action to preserve antimicrobial medicines. 
    • This will help in averting the disastrous consequences of antimicrobial resistance. 
    • The group has to 
      • Monitor the global response to antimicrobial resistance; 
      • Maintain public momentum
      • Provide regular reports on the science and evidence related to AMR to the UN member states;
      • Advocate for the inclusion of AMR in investments on agriculture, health, development, food and feed production; and 
      • Push for multi-stakeholder engagement on the issue. 

Antimicrobial resistance (AMR):

  • AMR is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintic) that are used to treat infections.
  • As a result, standard treatments become ineffective, infections persist and may spread to others.
  • Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
  • AMR is considered one of the most significant challenges the world faces today. Globally, thousands succumb to untreatable superbug infections on a daily basis and is now regarded as a major threat to public health across the globe.

Reasons for Spread of AMR:

  • Excessive usage of antibiotics: Irrational antibiotic usage is a major reason behind this. For example, consumption in poultry and cattle, consumption in humans. 
  • Social factors:
    • Include self-medication.
    • Access to antibiotics without prescription.
    • Lack of knowledge about when to use antibiotics.
  • Cultural activities: Mass bathing in rivers as part of religious mass gathering occasions.
  • Pharmaceutical industry pollution: It also contributes to the resistance.
  • Environmental sanitation: Untreated disposal of sewage water bodies - leading to contamination of rivers with antibiotic residues and antibiotic-resistant organisms.
  • Poor infection control practices in healthcare settings: A report on hand-washing practices of nurses and doctors found that only 31.8% of them washed hands after contact with patients.

Impacts:

  1. A threat to prevention and treatment of infections: Medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery become very risky.
  2. Increases the cost of healthcare: With lengthier stays in hospitals, additional tests and use of more expensive drugs.
  3. Achievements of modern medicine are put at a risk: Without effective antibiotics for prevention and treatment of infections.
  4. The world is heading towards antibiotic apocalypse: A future without antibiotics, with bacteria becoming completely resistant to treatment and when common infections and minor injuries could once again kill.
  5. Putting the gains of the Millennium Development Goals (MDGs) at risk: And endangers achievement of the Sustainable Development Goals (SDGs).

Challenges in fighting AMR:

  • Lack of infrastructure and inadequate diagnostic facilities in our health-care sector.
  • A cross-cutting programme dealing with antimicrobial resistance across multiple microbes has been lacking.
  • The absence of stringently framed and implemented regulatory frameworks to limit the use of antimicrobials in livestock and food animals.
  • In India, current effluent standards do not include antibiotic residues, and thus they are not monitored in the pharmaceutical industry effluents.
  • Antimalaria drug resistance: According to a WHO report, the fight against malaria is becoming difficult due to the growing resistance against malarial drugs. Malaria killed 405,000 people in 2018 and affected 218 million people. 

Steps to fight against AMR:

  • Antibiotic stewardship among doctors: To rationalise antibiotic use is considered to be the most important intervention to tackle superbug crisis. 
  • World Antimicrobial Awareness week: To raise awareness of the superbug problem among the medical community and common people. 

The Chennai Declaration: It is a document, prepared by representatives of various stakeholders and eminent experts in India, to tackle the challenge of antimicrobial resistance from an Indian perspective. 

  • Lessons learnt during the ongoing COVID-19 pandemic: The most important linkage between COVID-19 and AMR was that both were pandemics. There is the need of 
    • Increasing investments, 
    • developing robust surveillance frameworks, 
    • Making better treatment available, 
    • Development of new diagnostics, medicines and vaccines.

Way forward: 

  • One Health Approach: To contain AMR, there is need for a One Health Approach through coherent, integrated, multi sectoral cooperation and actions, as human, animal and environmental health are integrated.
  • Development of antibiotic resistance breakers (ARBs): To restore effectiveness of older classes of antibiotics.

 Source: DTE