Drug resistance wrecking havoc on health systems

Dar es Salaam. One of the world’s top ten public health threats facing humanity is now wreaking havoc on Tanzania’s health system, The Citizen can report.

The antimicrobial resistance (AMR), which was declared as one of the current global public health threats in 2019 by the World Health Organization (WHO) has already knocked in the country.

It continues to give sleepless nights to the health sector workers and those in the livestock and fisheries dockets.

Experts say that AMR occurs when microbes, such as bacteria, viruses, fungi, and parasites, undergo mutations over time and no longer respond to drugs to which they were initially sensitive.

This makes infections harder to treat, thus resulting in increased risks of diseases spreading, severe illness and death.

In Tanzania, experts say the use and misuse of antimicrobials among people, animals and plants, poor prescription and lack of patient adherence to medical prescriptions have accelerated the AMR threats.

The country’s health sector continues to improve laboratories for testing AMR among patients to enable proper use of drugs. However, statistics indicate an alarming state.

The use of antibiotics is at 92 percent in Tanzania, making the problem of antimicrobial resistance stand at an average of 59 percent, which varies from one bacteria to another for the drug in question.

Medical experts also note that the challenge is also observed in livestock, whereby livestock keepers use antibiotics to treat livestock instead of using vaccinations.

They say this has been increasing the resistance of parasites to human medicines after the consumption of meat or eggs.

But, the Chief Medical Officer (CMO), Prof Tumaini Nagu says if the misuse of antibiotics continues, “We will find ourselves at a point where we lack drug options for the patients due to the wide resistance.”

She called on the public to prevent and reverse the trend for the betterment of the present and future generation.

During the commemoration of the World Antimicrobial Week (WAAW) held on November 22, this year, WHO noted that the trend was at an alarming stage both globally and regionally.

In its statement ahead of the commemoration which takes place globally from 18-24 November every year, the global body says, the sub-Saharan African countries were the ones bearing the heaviest burden of resistant bacterial infections.

In 2019, over 4.95 million deaths that occurred globally were attributed to drug-resistant bacterial infections, with 1.27 million directly related to AMR which is more compared to HIV/AIDS and malaria deaths combined.

Compared to other regions, sub-Saharan Africa has the highest AMR-associated death rates, at 99 deaths per 100,000 population, far exceeding previous global projections of 700,000 annual deaths from AMR.

The 2022 WAAW event themed ‘Preventing antimicrobial resistance together’ called for cross-sectorial collaboration to preserve the efficacy of antibiotics and seeks to increase awareness of the global crisis of AMR.

Initiatives launched

The new public health scourge is also receiving great resistance from the government.

The latter has unveiled a new five-year action plan, which, among other strategic objectives, targets restructuring of policy, regulations and guidelines to reinforce conformity at individual, institutional and country-level in tackling the problem of antimicrobial resistance.

The National Action Plan on Antimicrobial Resistance (NAP-AMR 2023-2028) was launched recently in Dar es Salaam during the second National Antimicrobial Resistance Symposium.

The Ministries of Health, Livestock and Fisheries, and Agriculture through the National Multi-Coordinating Committee on Antimicrobial Resistance (AMR-MCC), organised this year’s major AMR two-day symposium in the city.

Other objectives of the new document are to create awareness and understanding of AMR for effective information, education and communication.

It also intends to strengthen the knowledge-evidence based through surveillance and research, reduce the incidence of infections through effective sanitation, hygiene and infection prevention measures as well as optimising the use of antimicrobial agents in human and animal health.

The health programme would be targeting both human and animal health and the environment, with consideration of AMR along the food value systems at sub-national level and fostering more private sector engagement.

This plan equally acknowledges the need to bridge the NAP-AMR implementation gaps between human and animal sectors, versus plant and environment sectors.

“This government plan can keep Tanzania more secure and help reach the goal of universal health coverage. But an education strategy for the public must be provided because many do not understand these effects,” says Dr Amos Mbunda from the Muhimbili National Hospital (MNH).

He says that at a rapid pace, they have been witnessing patients for whom some medicines do not work at all, which threatens the safety of people and the ability of existing medicines.

The CMO, however, advises that before using any medicine after falling sick, one should go to the hospital for diagnosis and get the right answers on the health complications they are facing.

It is from the effective medical examinations that health practitioners should provide appropriate prescriptions to patients visiting hospitals, which will be an efficient complimentary into the war against AMR, according to the CMO, Prof Nagu.

“Despite the fact that we have come up with this five-year work plan, we must fight to ensure that we defeat this enemy (AMR). This scourge requires each of us, citizens, pharmacists, doctors in general to do what is necessary,” said Dr Mbunda.

But, Ms Rose Shija from the WHO says the consequences of AMR on the health and healthcare systems are extraordinary.

“It has been estimated that multidrug resistant infections cause approximately 700,000 deaths worldwide each year. Unless action is taken, it is projected that the burden of deaths from AMR could reach 10 million each year across the world reaching 2050,” she exudes.