Viruses resistance to drugs worrying

Antimicrobial resistance (AMR) is currently a global threat and over the past decades, the global scientists are puzzled by the rate at which many infections are no longer responding to treatment.

What is antimicrobial resistance? In a layman’s understanding, this means a situation where the disease causing microorganisms such as bacteria, fungi, parasites and viruses are no longer killed or inhibited by the drugs (Antimicrobials)  that previously used to kill or inhibit them. The ability of bacteria, virus, fungi or parasites to fail to be killed or inhibited by a specific antimicrobial is called Resistance. 

AMR is currently claiming millions of lives globally every year and it is estimated to be killing about 10 million people worldwide  per year by 2050. It is further estimated to cost the world about $100 trillion by 2050. AMR has been confirmed from several scientific studies to be on the rise globally.

Many infections are becoming problematic since they cannot be easily treated. These include Tuberculosis commonly known as TB, which has been in some cases, reported to be resistant to more than one of the essential drugs in the treatment of TB a condition termed as Multidrug resistant TB. 

Human Immune deficiency Virus (HIV) has over the years been showing resistance to various regimens of antiretroviral drugs. Malaria parasite resistance to Artemisinin-based Combination therapies (ACTs) have been reported in some countries across the world and this is worrisome.

Antimicrobial resistance is a natural process but it is accelerated based on how people use these antimicrobial drugs in treatment of infections. The major contributors to the rise of AMR include limited diagnostic services, misuse of medicines/drugs (overuse or use of sub-optimal doses), limited access to quality medicines, self-medication, lack of awareness and knowledge about AMR and lack of enforcement of legislation, among others.

Why must we worry? 

The biggest problem arises as resistance to existing antimicrobials is increasingly becoming high while the discovery of new drugs has greatly decreased in the 20th Century.  Therefore, if no fast action is taken to combat AMR, the world will go back to pre-antibiotic era, where there will be no drugs to treat the used-to-be treatable infections.

Antimicrobial resistance give rise to hard to treat infections with increased risk of severe illness and death, disease spread, longer hospital stays, increased hospital costs hence high economic burden to the victims and the government.

AMR will stretch the health system, making it close to impossible to carry out major surgeries and cancer chemotherapies, which requires antibiotics to prevent other infections.  The answer to combating AMR is multidisciplinary and requires joint and coordinated commitment from policy makers, government, and healthcare providers in both human and animal sectors and other stakeholders. 

The medical laboratory is the core for detecting and monitoring Antimicrobial resistance through performing Drug sensitivity tests on specific recommended patient samples such as urine, blood, stool, cerebral spinal fluid (CSF), HVS, Pus etc. This is achieved through carrying out a laboratory technique called culture and sensitivity. Therefore, there is dire need for government to establish and expand well-equipped laboratories with microbiology sections to carry out culture and sensitivity at Regional referral and General hospitals to increase accessibility and affordability of this service.  

Further need for well-established and functional systems for monitoring the trends of resistance to antimicrobials through real time surveillance.

In Uganda, there are national referral hospitals, regional referral hospitals and general hospitals, 186 H/CIV, 1300 H/CIII and 32 accredited laboratories. Few facilities have well-equipped laboratories with the ability to carry out sensitivity yet very crucial in guiding prescription of antibiotics by clinicians. 

Mr Isaac ogwal works at a medical laboratory society of Uganda.