Catastrophic pandemics such as COVID- 19 often lead to conspiracy theories as to why some people are more easily prone to infections than others. While individual immune systems do determine a person’s capacity to overcome an infection, the discovery of antimicrobials greatly improves the capacity to fight infectious agents. However there is a natural phenomenon of antimicrobial resistance which exists. This is the fact that microorganisms such as bacteria mutate over time and, they develop resistance to medications which previously could worked against them. This resistance is what is known as antimicrobial resistance (AMR).
Antimicrobial resistance is broad to include all pathogens such as bacteria, viruses, fungi and parasites while antibiotic resistance is specific to medicines which are used against bacteria.
While antimicrobial resistance is a natural process, over use and misuse of drugs can accelerate the rate at which microorganisms develop resistance. This entails that when the human being or animal falls sick, they may not respond accordingly to the antibiotic treatment because the bacteria has developed resistance. Thus abuse of antibiotics such as self-prescription; not finishing a course of antibiotics; sharing a course of antibiotics are some of the leading ways in which human beings are causing antimicrobial resistance in humans or livestock.
AMR is a serious public health threat because this resistance affects our ability to treat common and more serious infections. AMR can be transmitted from microorganisms in food-producing livestock and plants, to human beings through the consumption. Resistant microorganisms can also be spread from humans, animals and plants to the environment. Thus the issue of AMR needs to be dealt with from all these sectors.
Dr. Ntombi Mudenda, a veterinary doctor in the Department of Clinical Studies at the University of Zambia and President of the Veterinary Association of Zambia, explained that Zambia has been engaged in research to assess the extent of AMR and the results so far have revealed a need for concern.
“We are seeing drugs, especially those that are critically important in treating people - probably the last line of drug that can be used to treat a condition when everything else is resistant – is now in animal products…that we are supposed to be consuming,” Dr. Mudenda said.
With specific regard to livestock products, she said one way AMR develops in human beings is when the withdrawal period is not strictly observed.
“The withdrawal period is the period’ from the time when the last dose of the antibiotic is given until the meat or animal product is safe for consumption. That is the time when the body works the medicine out of its system and then the animal becomes free of the antibiotic. So that’s the period of time we say, for instance, meat should not be consumed, eggs should not be eaten, milk should not be consumed from animals that are being treated [or recently treated] with antibiotics,” Dr. Mudenda explained.
She added that this withdrawal period differs from antibiotic to antibiotic and can be days to weeks long.
The increased demand for livestock products has been cited as one motivating factor behind the misuse of antimicrobials in the livestock sector. There is also lack of sufficient knowledge on the correct use of antimicrobials by some prescribers and lack of enforcement of medicine control laws with a tendency of purchasing of antimicrobials without a prescription. There is also a tendency by livestock farmers of stocking drugs and engaging unskilled people to treat their animals.
How is Zambia Playing its Part?
In response to this threat, The World Antibiotic Awareness Week (WAAW) campaign was launched by FAO, WHO and OIE to raise awareness on the importance of antibiotics. The aim is to highlights the steps everyone can take to improve antibiotic prescribing and use. The week has been commemorated every November and starting this year the week is now fixed from 18th to the 24th of November.
Dr. Fusya Goma the Principal Epidermio- Surveillance and Information Officer from the National Livestock Epidemiology and Information Centre (NALEC) under the Ministry of Fisheries and Livestock said that Zambia has responded to the global call for countries to get involved in the fight against Antimicrobials Resistance. A national level multi-sectoral AMR Coordinating Committee was formed to spearhead the country’s efforts in addressing AMR, with the Ministry of Health and the Ministry of Fisheries and Livestock being the key players. The AMRCC has formulated the AMR National Action Plan which guides what Zambia needs to do to tackle this problem. Some of the key strategic areas are raising awareness on the problem, undertaking surveillance to quantify the problem and formulated effective preventive measures, promoting infection prevention and conducting research.
She further said that the country has been actively participating in this WAAW annually spearheaded by the AMRCC. A number of activities have been done to create awareness on AMR and promote the prudent use of antimicrobials. Some of these activities are development of awareness materials (which have been distributed to different target groups), conducting of Radio and TV programs, media sensitization workshop, agro-vet shop sensitization, seminars for poultry farmers and engagements with veterinary professionals where a Continuous Professional Development (CPD) was conducted in collaboration with the Veterinary Association of Zambia..
“Antimicrobial resistance affects all of us in that regard all of us have a role to play…when we look at the wholesalers and distributers of medicines, they should sell antibiotics by prescription, …when we look at the farmers they need to go and get advice from a veterinary professional before treating their animals, …when we look at the veterinarians, they need to adhere to standard treatment guidelines and principals of prudent use, when we look at the policy makers they need to create an enabling environment through the legal framework to ensure that there is effective control and use of medicines” Dr. Goma urged.
Dr. Geoffrey Mainda - a Veterinary Public Health SpecialistOfficer in the Veterinary Services Public Health Unit under the Ministry of Fisheries and Livestock - disclosed that Zambia has been making strides towards establishing an antimicrobial surveillance framework aimed at better examining the context and extent of AMR.
Dr. Mainda who is also AMR Focal Point Person and sits on AMR Coordinating Committee (AMRCC) said that research that has been conducted so far has revealed trends of increasing AMR in microorganisms that cause infections in both humans and animals.
“Coming back home, the studies have not been too comprehensive, as they have been limited in terms of the number of micro-organisms and the geographic location. But we have an indication that, like most countries in the world, we are also affected with antimicrobial resistance. …We want to narrow down and have a more comprehensive picture and as a country we are implementing a surveillance system where we are collecting data from humans, from animals in a very structured way and then we wi’ll keep on expanding surveillance sites and at some point we anticipating to have a more concrete and clear picture representing the country,” Dr. Mainda explained.
In the Antimicrobial Coordinating Committee, key line ministries such as the Ministries, of Health, Environment, Agriculture and; Fisheries and Livestock, respectively, are represented together with other stakeholders like the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) among others, to raise awareness and strengthen surveillance on AMR in the country.
The slogan for the 2020 Antimicrobial Awareness Week is: Antimicrobials: handle with care to encourage best practices among both the general public and health workers so as to prevent the further spread of drug-resistant infections.
As a key take home message for the animal keepers Dr. Goma said “Remember that misuse and overuse of antimicrobials endangers both animal and human health. For Food animal producers: we need you! Handle antimicrobials with care. Use them ONLY when prescribed by a veterinarian or other authorized person. Remember that not every infection needs to be treated with an antimicrobial. Vaccination, good hygiene and good animal husbandry are essential to reduce the use of antimicrobials.”
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