Could antimicrobial resistance be East Africa’s new pandemic?Could antimicrobial resistance be East Africa’s new pandemic?

A stealthy pandemic that threatens to upset the delicate balance of food security, economic stability, and public health is taking place in the heart of East Africa.  It might not be out of place to say that antimicrobial resistance (AMR) is likely spreading faster than COVID-19 and posing a danger to decades of effort put into strengthening healthcare systems and economic growth and development.

Considering the widespread abuse of antibiotics and the dearth of newly developed drugs, what innovative approaches can industry players, policymakers, and leaders in the healthcare sector implement to halt the spread of antibiotic resistance? Let us break it down.

Who is affected by antimicrobial resistance (AMR)?

The AMR crisis affects everyone, from patients and healthcare workers to farmers and business leaders. Key stakeholders include governments, healthcare providers, veterinarians, farmers, the pharmaceutical industry, and as well as businesses. Each has a vital role to play in mitigating the spread of AMR.

Economic and health costs of AMR

The statistics are stark, but AMR is projected to claim 10 million lives annually by 2050, eclipsing the mortality rates of cancer and diabetes combined. In East Africa, the situation is particularly dire, with inadequate healthcare systems, poor sanitation, and excessive antibiotic use in agriculture creating a perfect storm of AMR proliferation. The economic toll is equally alarming, with estimates suggesting that AMR could shave off 3.8 per cent of global GDP by 2050.

Barriers to addressing AMR

Many East African countries struggle with limited resources, making it difficult to implement robust AMR control measures. Inadequate funding, insufficient healthcare infrastructure, and a lack of trained personnel are also significant barriers. Cultural practices and misconceptions about antibiotic use contribute to the misuse of these drugs. In many communities, antibiotics are easily accessible without prescriptions, leading to overuse.

Other strong barriers include weak enforcement of regulations regarding antibiotic use in both human and veterinary medicine further accelerates the spread of AMR. Inconsistent policies and lack of coordination across sectors also hinder effective management.

Developing a multisectoral response to AMR

East Africa needs to address AMR with a multisectoral strategy that prioritises improving infection prevention, encouraging prudent antimicrobial use, strengthening surveillance, and raising public awareness. Important tactics include instituting antimicrobial stewardship initiatives, enforcing antibiotic use regulations, and forming regional collaborations for surveillance. To lower infections, industry players, policymakers, and leaders in the healthcare sector need to ensure that healthcare workers and the public receive the right education, while enhancing sanitation, hygiene, and vaccination rates.

Amidst all of this, there is some hope despite this bleak background. All health stakeholders can contribute to the solution. We can slow the spread of AMR by implementing ethical behaviour, funding research and development, and endorsing public awareness initiatives.

Case Study: Kenya’s National Action Plan on AMR

Kenya's National Action Plan on AMR, an extensive programme that has united government, business, and civil society to combat this multifaceted threat, is one source of inspiration. Kenya's National Action Plan (NAP) on antimicrobial resistance, launched in 2017, is a strategic framework aimed at combating AMR through a coordinated, multi-sectoral approach. The plan aligns with the WHO's Global Action Plan and focuses on five key objectives: raising awareness of AMR, strengthening surveillance and research, reducing infection incidence, optimising antimicrobial use, and ensuring sustainable investment in AMR activities. The NAP also prioritises capacity building, policy enhancement, and public-private partnerships to support its implementation. The goal is to safeguard the effectiveness of antimicrobials for future generations by addressing the growing threat of resistance.

East Africa may successfully combat the escalating threat of AMR by taking note of Kenya's experience and putting comparable strategies into practice throughout the region. This should be done with the understanding that a coordinated, multisectoral approach is needed to maintain public health, economic stability, and the effectiveness of antibiotics.

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