95% of Pakistanis may be resistant to life-saving antibiotics: experts

Speakers at a symposium stress need to take steps to better understand and address AMR

KARACHI: Antimicrobial resistance is a scary thought. Think superbug - a bacteria that is resistant to any antibiotic and will not respond to any treatment. Medical experts have been warning about superbugs for some time now, but the ease with which antibiotics can be obtained from pharmacies doesn't make matters any easier.

Medical experts at a symposium on Friday warned that up to 95% of Pakistan's population could be carrying bacteria that make them resistant to life-saving antibiotics. They were speaking at the annual National Health Sciences Research Symposium (NHSRS) of the Aga Khan University (AKU) in Karachi. This year, the theme of the symposium is 'Antimicrobial resistance: an opportunity to transform global health'.

Antimicrobial resistance (AMR) occurs when microorganisms, such as bacteria, fungi, viruses and parasites change when they are exposed to antimicrobial drugs. Microorganisms that develop AMR are sometimes referred to as 'superbugs'. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of their spread to others.

Global threat

A recent United Nations report warned that the threat of AMR can be a global health crisis that could lead to 10 million deaths every year by 2050. Pakistan is the sixth most populous country in the world, which is expected to rise to fourth place by 2050.

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If not managed timely, AMR may lead to a 'health emergency-like situation' that might have implications for the country's health system as well as the economy, they said.

Antibiotics have been a founding stone of modern medicine. The use of antimicrobials has enabled the implementation of novel treatment modalities such as cardiac bypass surgeries, joint replacements and bone marrow transplants. Management of infectious complications would not have been possible without antibiotics.

The spread of resistant bugs is now taking us back in the pre-antibiotic era where advanced medical interventions may become compromised, said Rumina Hasan, a professor of microbiology at the AKU and chair of the 22nd NHSRS organising committee.

"Antimicrobials have also been instrumental in the control of infections in farm animals and in crops, allowing an increase in agricultural output and providing food security. The emergence of antimicrobial resistance threatens this progress," she added.

Realising that AMR puts the gains of the Millennium Development Goals at risk and jeopardises achieving the Sustainable Development Goals, the WHO instituted a global action plan to tackle AMR in the 68th World Health Assembly in 2015, which was endorsed by all countries including Pakistan.

Zafar Mirza, the federal Minister of State for Health and the chief guest on the occasion, expressed his government's commitment to work with provinces and public and private key stakeholders on the implementation of the National Action Plan for AMR.

"The misuse and overuse of antimicrobial medicines is fueling resistance worldwide and the Eastern Mediterranean region is no exception. Drug-resistant infections are estimated to cause at least 700,000 deaths globally each year," said the keynote speaker Maha Talaat, who is also the WHO EMRO regional coordinator for infection prevention and control. "Implementation of AMR surveillance, hospital infection prevention and control, and antimicrobial stewardship are extremely important measures to curtail the spread of resistant bugs."

Certain life-saving drugs in short supply

The next speaker had an even starker message. "Although AMR is a global problem, estimates suggest that 89 per cent of deaths related to AMR in 2050 will occur in Africa and Asia," said Anthony Huszar, the South East Asia Regional Coordinator of the Fleming Fund - a special fund set up by the UK government to provide the much needed resources to better understand and address AMR.

AKU President Firoz Rasul, deans Adil Haider and David Arthur, and interim CEO of the Aga Khan University Hospital Shagufta Hassan also addressed the symposium and applauded the organisers and participants for highlighting the issue of AMR.

NHSRS is AKU's annual 'flagship' event that focuses on a health sciences topic relevant to Pakistan and the region. The second and third days of the symposium will cover discussions on animal AMR, antimicrobial use surveillance, food safety, control of antibiotics quality in Pakistan and several other sessions. 

Published in The Express Tribune, November 16^th, 2019.