The top global public health issues facing humanity
So these resistance traits can be passed on from one generation to the next and also spread between organisms through various genetic elements.
What is it why is it a problem what are the main drivers and how do prevent what antimicrobials are agents that kill microorganisms or inhibit their growth? while they've been used in various forms such as herbal treatments for thousands of years the modern era of antimicrobials began in the early 1900s with the creation of a compound called salver son and the discovery of penicillin since then many different types of antimicrobials were developed revolutionizing medical practice they are a key tool in our fight against infectious diseases how do they work.
Antimicrobials typically work by entering an organism binding to specific target sites and blocking important
processes in the organism that either kill them or stop them from multiplying but organisms have developed several ways to resist antimicrobials this is called antimicrobial resistance.
There are several mechanisms by which they become resistant they include preventing access of the antimicrobial into the organism removing the antimicrobial using pumps in the cell wall destroying or inactivating the antimicrobial with enzymes changing the antimicrobial target so that it cannot latch onto it or developing new processes that avoid using the target of the antimicrobial cross-resistance can also occur where an organism that is resistant to one antibiotic can show some resistance to other types as well as can occur in bacteria such as staphylococcus aureus and mycobacterium tuberculosis viruses such as influenza
and parasites such as plasmodium falciprum that causes malaria and leash mania species that cause leishmaniasis and fungi such as candida oris and aspergillus note that antibiotic resistance is a type of antimicrobial resistance that is used to describe resistance to antibiotics that are used to treat bacteria resistant organisms are sometimes called superbugs of particular concern are organisms that are multi-resistant showing resistance to more than one antimicrobial or those that are pain resistant showing resistance to all known types of antimicrobials the consequence is that antimicrobials become ineffective and therefore infections are harder to treat diseases.
What were once treatable may require treatment with alternative drugs which may be more expensive require treatment for longer periods of time or not have any effective treatment at all procedures such as surgery chemotherapy or transplantation can be very risky
without the protection offered by antimicrobials can lead to adverse clinical outcomes including death.
in addition to this can also have a significant economic cost at an individual level it can reduce productivity and increase health care costs at a health systems level there can be high costs associated with treating patients with severe or prolonged illness. let's have a look at the drivers behind the increase in is a natural evolutionary process that microorganisms use to avoid destruction and survive however there are several drivers that have accelerated this process the main driver for the unrestrained use of antimicrobials in humans and animals antimicrobials are one of the most commonly prescribed drugs for people but unnecessary and inappropriate use is common for example using antibiotics for viral infections or not completing the full course of the medication antimicrobials are widely used in animal husbandry not only to treat disease but prophylactic ally to prevent infections and as a growth promoter other drivers is include poor water quality sanitation and hygiene inadequate infection control practices and inappropriate food handling these provide conditions in which resistant organisms can emerge multiply and spread to add to this issue is the fact that there are few new classes of antimicrobials being developed so how do we prevent is a complex problem and preventing it requires a multi sectoral approach the world health organization's global action plan provides a good framework to tackle and it outlines five strategic objectives these are improving awareness and understanding of antimicrobial resistance through effective communication education and training
strengthening the knowledge and evidence base through surveillance and research this includes research to develop new treatments diagnostic tools and vaccines.
Clinical studies on effective antimicrobials or alternatives to antimicrobials reducing the incidence of infection
through effective sanitation hygiene and infection prevention measures, this is particularly important in health care facilities it also involves promoting hand hygiene food and water safety developing new vaccines or promoting the use of existing vaccines optimizing the use of antimicrobial agents in humans and animal health these include at an industry level stopping the inappropriate use of antimicrobials in agriculture having antimicrobial stewardship programs which are organizational or system-wide healthcare strategies to promote the appropriate use of antimicrobials through the
implementation of evidence-based interventions.
A national-level having a strong legal and regulatory
Framework to ensure the rational use of antimicrobials in animals and humans ensuring sustainable investment and
Increasing
investment in new medicines vaccines and diagnostic tools these actions require a whole of society
approach with everybody in all sectors and disciplines working together it includes taking a one health approach
incorporating human health animal health and environmental factors into consideration and that's an overview and we've had a quick look at what it is why it's a problem the main drivers and how we can prevent it.
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