Escalating Antimicrobial resistance in Kenya: Stewardship gaps and challenges?
Sunday Health Perspective
Antimicrobial drugs like antibiotics, antivirals, antifungals, and anti-parasitic, are the medicines used to prevent and treat infectious diseases in humans, animals, and plants.
Globally, the use of antimicrobials has significantly contributed to the control of infectious diseases and improved patients’ health outcomes. However, the overuse, misuse, and inappropriate prescription of antimicrobials has led to the development of antimicrobial resistance, where microorganisms evolve to withstand the effects of these drugs.
Antimicrobial resistance is a global health concern as it can render previously treatable infections more difficult to manage, leading to increased illness and death. When antimicrobials became widely available in the early years, they were hailed as lifesavers but are now quickly becoming killers themselves today. The more these drugs are used, the more the agents will develop resistance, rendering the medicine ineffective.
Antimicrobial misuse has created resistance and rapidly spreading far and wide. Each year, it is estimated that 700,000 people die as a result of antimicrobial-resistant illnesses. If current trends continue, the number of deaths each year will escalate to 10Million by the year 2050.
According to studies, the wrong use of antimicrobials is the primary cause of the escalating resistance, particularly in Sub-Saharan African countries that deviated significantly from the World Health Organization recommendations. Without intervention, these countries will be the most affected in the near future due to the existing high disease burden compared to the high-income countries.
Likewise, the emerging resistance of antimicrobials especially Malaria, tuberculosis, and HIV is a global concern that can impede the control of the pandemics and the achievement of sustainable development goals targets by 2030.
In Kenya, essential healthcare services has been commercialized and the purchase of antibiotics over the counter without prescription from a certified health care provider is on the rise due to health systems gaps especially in the areas of stewardship in the context of regulatory and monitoring.
In 2017, the Kenyan government launched a nationwide plan for antimicrobial resistance prevention and control. One of the strategies was to enhance the compliance to rationale use of antibiotics across all the tiers of health care service provision in the country.
It is now emerging that hospitals have established antibiotic stewardship desk with antimicrobial focal persons on board who are mandated to cut antibiotic consumption, reduce resistance prevalence, and result in considerable cost gains.
Ordinarily, antimicrobial resistance affects numerous sectors, including human, animal, and environmental health, and its control necessitates a consultative, comprehensive, and systemic strategy. This requires first fortifying the institutions, processes, and individuals in charge of the effort at all levels of the health system.
Reducing antimicrobial resistance is a complex and multifaceted challenge that need coordinated efforts at various levels, including individuals, healthcare professionals, policymakers, and key stakeholders. Here are some key strategies to help address and reduce antimicrobial resistance:
Public Awareness and Education: awareness about the responsible use of antibiotics and educate people about the importance of completing prescribed antibiotic courses and not sharing antibiotics.
Responsible Antibiotic Use in Healthcare: Encourage healthcare professionals to prescribe antibiotics only when necessary and based on accurate diagnoses. Promote adherence to guidelines and encourage the use of narrow-spectrum antibiotics when appropriate.
Surveillance and Monitoring: Implement robust surveillance systems to monitor the use of antibiotics and the emergence of resistant strains of bacteria. Regularly assess patterns of resistance and adjust treatment guidelines accordingly.
Infection Prevention and Control: Emphasize the importance of strict infection prevention and control measures in healthcare settings.
International Collaboration: This is to address the global nature of antimicrobial resistance. Share information, best practices, and resources to collectively combat antimicrobial resistance.
Research and Development: Research on new antibiotics together with pharmaceutical companies while ensuring responsible use to avoid quick resistance.
The writer is a Clinician/Health systems expert and researcher (PHD Candidate).
He is the immediate CEC Health Services (Medical Services, Public Health and Sanitation)-Wajir County.
