When cure could become poison

The World Antimicrobial Awareness Week ended yesterday. In Thimphu, like many international day, it was marked with some few experts making presentations and concluded with a sumptuous meal.

The issue deserves much more respect than usual platitudes in that antimicrobial resistance is a growing global health threat.

Nearly 700,000 lives, the size of Bhutan’s population,  are lost globally every year as a result of antimicrobial resistance (AMR). Experts estimate the number to cross 10 million by 2050.

Many common infections are becoming resistant to antimicrobial medicines, resulting in higher morbidity and mortality every year.

Antimicrobials are drugs that destroy disease-causing pathogens. AMR occurs when pathogens undergo evolutionary changes that enable them to survive antimicrobials. People or animals infected with resistant pathogens could develop untreatable infections.

Often we stop taking antibiotics when we feel better; we don’t complete the course after we feel we no longer need them. Experts say that half-killed bacteria will infect again. That means that the same antibiotics won’t be effective.

The impact of AMR goes beyond human health, as it impacts animal health, agriculture, food security, and economic development, to name a few.

The use of antibiotics is mainly restricted to government hospitals and veterinary centres. In the 2019-2020 financial year, 16 million units of antibiotics were imported, including 55,256 units by retail pharmacies.

While the AMR occurs naturally over time, the process is accelerated by misuse and overuse of antimicrobials.

Tackling AMR might seem easy given the strict control over the import of medicines for use in hospitals and veterinary centres. But it is easier said than done.

At best the existing controls are inadequate. Many Bhutanese buy medicines of all sorts from neighbouring towns across the border.  Half of the medicines sold in India are antimicrobials.

Livestock farms are mushrooming across the country. Antimicrobials are used to help livestock grow bigger and faster. Without any deterrence measures in place, people will be tempted to use them as they please. And if the farms use them generously, the result, in the long run, would be devastating for the country.

The complexities in addressing the high existence of multi-drug resistant tuberculosis have been giving us a hard time for some years now.

Effective monitoring and surveillance in both human and animal health have to be established. If coordination among the many agencies is the problem, the time is now to fix it and streamline the whole approach.

More importantly, however, the responsibility comes down to the individual. We are what we eat.

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