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newsletter | report by Adanna Nwanguma issue 2 January 2015
The fight against Antimicrobial Resistance
Oga Chemist, mix Flagyl and tetracycline for me, I am purging”. This scenario is all too familiar to many people. In discussions of antimicrobial resistance, the daily activity of uninformed Nigerian patients with a patent medicine dealer comes to mind.
What causes Antimicrobial Resistance?
The misuse of antibiotics by way of over and under-use are the major factors in microbes are adapting and devising new ways to escape the effects of antibiotics. Should we be concerned? According to WHO, antimicrobial resistance has become a public health problem and a global concern; new resistance mechanisms emerge and spread globally threatening our ability to treat common infectious diseases, resulting in disability or death for individuals who until recently were able to live a normal life. The absence of effective anti-infective treatment, many standard medical treatments will fail or develop into high-risk procedures.
What are the risks of Antimicrobial Resistance?
Antimicrobial Resistance can kill:
Infections caused by resistant microorganisms often fail to respond to the standard treatment, resulting in prolonged illness, higher health care expenditures with a greater risk of death. It hampers the control of infectious disease: AMR reduces the effectiveness of treatment; thus patients remain infectious for a longer period, increasing the risk of transmitting resistant microorganisms to others.

It increases the costs of health care:
When infections become resistant to first-line drugs, more expensive therapies must be used. A longer duration of illness and treatment, often in hospitals, increases health care costs as well as the economic burden on families and societies.

It jeopardizes health care gains to society:
The achievements of modern medicine are put at risk by antimicrobial resistance. Without effective antimicrobials for prevention and treatment of infections, the success of organ transplantation, cancer chemotherapy and major surgery would be compromised.

It has the potential to threaten health security, and damage trade and economies:
The growth of global trade and travel allows resistant microorganisms to spread rapidly through human contact and food. Estimates show AMR may give rise to losses in Gross Domestic Product of more than 1% and that the indirect costs affecting society may be more than three times the direct health care expenditures, affecting developing economies proportionally more.
The way forward
Pharmacists are experts in the use of medicine, so the key to controlling resistance is to join the fight against this looming menace, by promoting smart use of antibiotics, educating patients the on the most effective course and advising prescribers on patient behaviours towards antibiotics. Patent medicine dealers on Nigerian streets and the extent to which they are monitored by the regulatory body and the effectiveness of this monitoring resemble a postcode lottery. Training the dealers and encouraging safe use of antibiotics, will substantially assist in the battle. The purveyors are the most accessible to those susceptible to follow the route of “mix flagyl and tetracycline for me”. The patent medicine stores are where the helpless majority or our target audience are likely to be found; therefore, to win this war against AMR, we cannot ignore this silent majority. The time to act is now!
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