Addressing antimicrobial resistance among Nigerians

Thu, Sep 19, 2024
By editor
6 MIN READ

Health

By Abujah Racheal

AS the world grows increasingly interconnected, a silent yet formidable health crisis threatens the globe: antimicrobial resistance (AMR).

Once a background issue in public health discussions, AMR has emerged as a pressing challenge with the potential to reverse decades of medical progress.

World Health Organsation (WHO) says AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines.

As a result of drug resistance, WHO says, antibiotics and other antimicrobial medicines become ineffective and infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability and death.

From Nigeria to the U.S.A, from rural villages to bustling cities, AMR affects everybody. Yet, it often remains acknowledged by the public.

According to experts, humans have co-evolved with microbes for millions of years, with their bodies providing a safe environment for thousands of microbial species to flourish.

In return, these microbes offer humans many benefits such as protection against harmful organisms and regulation of many physiological processes.

A healthy and balanced microbiome is essential to human well-being.

However, even with co-evolution, infectious diseases often remained fatal until the advent of modern antimicrobial drugs, such as antibiotics in the 19th century.

These drugs revolutionised human medicine, saving hundreds of millions of lives and accelerating economic development by reducing human suffering and illness.

The COVID-19 pandemic has taught humans not to ignore warnings about dire health threats. Scientists have warned about the dangers of antimicrobial resistance for decades.

In 2019, the World Health Organisation (WHO), declared AMR one of the top 10 global public health threats, while the United Nations estimated that by 2050, AMR could cause as many as 10 million deaths annually.

The WHO said that in 2019 alone, drug-resistant infections were responsible for nearly five million deaths worldwide.

The Nigeria Centre for Disease and Prevention Control (NCDC) said that AMR occurs when bacteria, viruses, fungi, and parasites evolve and no longer respond to the medicines—like antibiotics and antivirals—designed to kill them.

This resistance renders standard treatments ineffective, leading to persistent infections, longer hospital stays, and increased mortality.

According to Dr Tochi Okwor, NCDC lead on AMR, 64,500 deaths are attributable to AMR, while 263,400 deaths are associated with it.

Okwor said that these figures underscored the urgent need for enhanced surveillance, better hygiene practices, and stricter control over antibiotic use across human and animal health sectors.

“AMR, fuelled by the misuse of antibiotics in hospitals, farms, and communities, remains a critical issue.

“Taking antibiotics when they’re not needed, or buying them without a prescription, is driving resistance.

“We are losing ground in this fight, and the consequences are deadly,” she warned.

A mother, Mrs Abigal Mekaniki from Yamu Community in Kwali Area Council of  FCT, experienced, first-hand, how AMR could turn a routine infection into a life-threatening situation.

Mekaniki said after delivering her second child through caesarean section at the Kwali General Hospital, she developed a post-surgical infection.

She said that the standard antibiotics prescribed by her doctors failed to work.

“After weeks of suffering, multiple hospital transfers, and rising medical bills, I was finally put on a stronger, more expensive antibiotic that saved my life.

“I didn’t know much about antibiotic resistance before, but now I understand how serious it is. It almost cost me my life,” she recalled.

This scenario plays out across hospitals worldwide. The root of the problem often stems from the overuse and misuse of antibiotics, alongside poor infection control measures.

Dr Tedros Adhanom Ghebreyesus, Director-General, WHO, recently highlighted the growing global threat of AMR:

“We are facing future where simple surgeries, childbirth, and even minor infections could become life-threatening due to antimicrobial resistance.

“This is a fight we cannot afford to lose,” Ghebreyesus said.

Nigerian researchers are collaborating with international partners to explore alternative therapies.

These include bacteriophage treatments, which show promise in addressing bacterial infections that no longer respond to conventional antibiotics.

Dr Adeyemi Bakare, microbiologist, said, “Phage therapy is one potential solution, but much work remains before it can be widely adopted.”

Investigation by the News Agency of Nigeria (NAN) showed that In many communities, in the FCT, antibiotics are seen as a cure-all for every ailment.

From colds to minor fevers people often turn to antibiotics, even when they’re unnecessary.

The misuse is aggravated by easy over-the-counter access to these drugs in countries such as Nigeria.

Dr Ibrahim Musa, a pharmacist, explained: “Patients often demand antibiotics for viral infections like the flu, which do not respond to these drugs.

“Doctors sometimes prescribe them to appease patients, and in rural areas, people self-medicate without proper diagnoses.”

According to Musa, in bustling drug markets, counterfeit and substandard antibiotics are rampant, further fuelling resistance.

“Fake drugs not only fail to treat infections but also contribute to bacteria developing resistance’’, he said.

AMR does not affect all Nigerians equally. Rural communities often lack access to proper healthcare and rely heavily on over-the-counter drugs, making them the most vulnerable.

Dr Chioma Umeche, a public health advocate, said the intersection of poverty and poor access to healthcare exacerbates the AMR problem in Nigeria’s underserved communities.

Nigeria has made significant strides in addressing AMR through the development of a One Health National Action Plan (NAP). This plan involves collaboration across multiple sectors to reduce the spread of AMR.

However, there are still critical areas that need improvement. Financial limitation remains a significant challenge in Nigeria’s ability to fully implement its AMR NAP.

Dr Aminu Magashi, Coordinator, Africa Health Budget Network (AHBN), underlined the need for increased financial investment in AMR strategies.

“Nigeria must prioritise AMR by funding initiatives, enforcing regulations on antimicrobial use, and expanding public awareness campaigns,” he said.

Dr Gabriel Adakole, a Public Health expert, said without action, the country could face a future where even minor surgeries become high-risk, and diseases once controlled by antibiotics, like tuberculosis, spiral out of control.

“The window for preventing this crisis is closing fast, and the consequences could be devastating for public health,” Adakole said.

The public plays a crucial role in the fight against AMR. Simple actions, patience with doctors, completing prescribed antibiotic courses, and not purchasing antibiotics over the counter without prescriptions, can go a long way in curbing resistance.

Dr Olayinka Umar-Farouk, Deputy Project Director, Risk Communication at Breakthrough ACTION Nigeria, urges a move transition from awareness to action.

Umar-Farouk said that everyone, healthcare professionals, patients, and policymakers, should take responsibility for preventing antibiotics misuse. (NANFeatures

19th September, 2024.

C.E.

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