Antimicrobial resistance (AMR) and public health: Part One
…is Zim on course?
ANTIMICROBIALS have been hailed as one of the most important discoveries in medical history; successfully treating many diseases in both animals and humans promoting good health and well-being.
However, today, antimicrobial resistance (AMR) has become an increasingly serious threat to national and global public health.
This requires prioritised action across all Government sectors and society in Zimbabwe.
The health of a nation is of utmost priority. According to the Institute of Medicine (IOM) public health deals with: “epidemiology, health promotion and education, public health administration, international health, maternal and child health, biostatistics, environmental health, and nutrition”
Public health centres on preventing disease, prolonging life, and promoting physical and mental wellbeing through organised community efforts and effective communication.
On Saturday November 18 2023, I attended the inaugural session of the World AMR Awareness Week medical conference held at the HICC in the capital Harare, to focus on the prevention of antimicrobial resistance (AMR) in Africa.
In attendance were medical students, physicians, microbiologists, pathologists, epidemiologists, veterinary surgeons, journalists, medical sociologists, nutrition scientists and a few policy makers from the African continent.
With Zimbabwe as the host country, the core of the conference was to advocate for the prudent and responsible use of anti-microbial medicines to combat the prevalence of Antimicrobial Resistance (AMR), in the country and the rest of Africa.
Jointly hosted by the African Union (AU), the Food and Agriculture Organisation of the United Nations (FAO), the World Health Organisation (WHO), United Nations Environment Programme (UNEP) World Organisation For Animal Health (OIE), Medicine Control Authority of Zimbabwe (MCAZ), Ministry of Health and Child Care (MoHCC), the Zimbabwe Department of Livestock and Veterinary Services and the Animal Health Industry Committee of Zimbabwe (AHICZ),the debates and discussion centred on a current public health threat to the African continent - the advent and prevalence of antimicrobial resistance (AMR).
Antimicrobial resistance (AMR), occurs when germs that cause disease or infection in humans and animals mutate and become resistant to antimicrobial medicines that are used for treatment of infectious diseases.
It develops from changes at genetic levels through mutations or as acquired resistant traits in the microorganism.
As a naturally occurring phenomenon, AMR is accelerated by selection pressure in the environment of the microorganism. Due to the fact that microorganisms are present in the natural environment, when AMR develops, it can also escalate and spread in the environment with implications on the well-being of all forms of life.
Events precipitating AMR in microorganisms can therefore have implications on the pathogenicity and genetic structure of plant, animal and human health.
In veterinary circles in Zimbabwe, AMR was already reported to be prevalent in 1997, when a large number of livestock were not responding the usual antibiotic treatment.
In September 2017, the National Action Plan on AMR was designed to prevent the occurrence of antimicrobial resistance following the adoption of the Global Action Plan (GAP) on Antimicrobial Resistance by the 68th World Health Assembly in May 2015 the Zimbabwe One Health Antimicrobial Resistance National Action Plan (2017-2021), was published by the government of Zimbabwe as a strategic framework, operational plan, and monitoring and evaluation plan under the auspices of the Ministry of Health and Child Care, the Ministry of Agriculture Mechanisation and Irrigation Development and the Ministry of Environment, Water and Climate.
The AMR governance structure was formed and endorsed in August 2016 by the Secretary for Health and Child Care to allow for coordination, management and monitoring of AMR activities in the country.
The AMR focal point is the AMR Coordinator who works under the Department of Epidemiology and Disease Control (EDC), the Directorate Laboratory Services (DLS) in the Ministry of Health and Child Care (MoHCC) and the Division of Livestock and Veterinary Services (DLVS).
The findings of the AMR situation analysis carried out showed that AMR in Zimbabwe would grow if not addressed holistically and timeously.
As a result an inter-ministerial group of the relevant ministries and stakeholders proposed to increase investment in new medicines, diagnostic tools, vaccines and other interventions in order to combat antimicrobial resistance in Zimbabwe.
Additionally, the three governmental departments and other relevant stakeholders whose responsibilities converge on human, animal and environmental health committed themselves to invest resources and design sound strategies and interventions to preserve the effectiveness of our antimicrobial agents and slow down the emergence and spread of AMR in the country.
The same ministries were responsible for implementing the ‘One Health’ approach in Zimbabwe, which is still in its nascent stage compared to other African countries.
Dr. Tony Michel Monda is a Public health correspondent veterinary epidemiologist and medical researcher. E-mail: tonym.MONDA@gmail.com