'Antimicrobial resistance causing 300,000 deaths annually in Pakistan'

AMR is the third leading cause of death in the country, say experts

KARACHI:

Antimicrobial Resistance (AMR) is the third leading cause of death in Pakistan, where it is estimated that around 300,000 people die annually due to drug-resistant bacteria, health officials, public health experts, physicians, and policymakers stated on Sunday,

Deploring that Pakistan is the third-largest consumer of antibiotics in the world after China and India, they noted that antibiotic medicines worth Rs126 billion were consumed in the country in 2023 alone. They urged people not to purchase and use antibiotics without the advice of trained and qualified physicians.

“Antimicrobial resistance is now the third leading cause of death after cardiovascular diseases and maternal and neonatal disorders in Pakistan because we now have infections caused by bacteria that are not responding to third- and fourth-generation antibiotics. Abuse of antibiotics by doctors, quacks, and people themselves is making these important medicines highly ineffective,” Professor Shahzad Ali Khan, Vice Chancellor of Health Services Academy (HSA) Islamabad, told a news conference in Karachi.

Prof. Shahzad Ali Khan maintained that antibiotics are ‘wonder drugs’ that saved millions of lives during world wars and pandemics, but their irrational use or abuse has led to Antimicrobial Resistance, which is now becoming a global public health concern.

Read more: How bad is AMR?

“Self-medication, unjustified prescription of antibiotics by quacks and physicians, taking antibiotics for a shorter duration, and the production of substandard antibiotics by some companies are some of the major causes of antimicrobial resistance,” he added.

“People are now dying due to infections that are extremely hard to treat due to the resistance developed by bacteria against these medicines,” Former Punjab Health Minister and President of the Pakistan Society of Internal Medicine (PSIM) Professor Javed Akram deplored.

“On one hand, Pakistan has become the world capital of diabetes and other non-communicable diseases, and on the other, we have developed Extremely Drug-Resistant (XDR) typhoid, Multi-Drug Resistant (MDR) TB, and various other infections that are extremely hard to treat with most of the available antibiotics. This is because we have been using antibiotics like candies,” he opined.

Urging people to consider antibiotics as “poison,” he said people should not consume antibiotics on their own like they do with cancer drugs, saying antibiotics have similar side effects as cancer treatment therapies.

Also read: Antimicrobial resistance: Health ministry drafts a ‘national action plan’

NIH representative and senior microbiologist Dr Afreenish Amir said AMR has spread to almost all countries and regions, including Pakistan, owing to the “misuse and overuse” of antibiotics. This contributes to the increasing burden of infections due to resistant bacteria while limiting treatment options for managing such infections.

Health experts also highlighted the overuse and abuse of antibiotics in the livestock sector and claimed that the abuse of antibiotics in the veterinary sector was responsible for 80 per cent of AMR. They called for creating awareness among the masses regarding the irrational use of antibiotics in humans, livestock, and poultry sectors.

Renowned paediatrician and public health scientist Professor Zulfiqar Bhutta, in his keynote address, urged people to get their children vaccinated against typhoid, saying Pakistan is the only country in the world where the Typhoid Conjugate Vaccine (TCV) is being administered to children to prevent them from the drug-resistant water-borne disease.

Dr Wajiha Javed, Associate Director of Public Health at Getz Pharma, said over-the-counter availability of antibiotics, use of these medicines for a shorter duration, and unnecessary prescription of antibiotics by quacks and doctors should be looked into by the authorities.

She added that substandard antibiotics containing less or low-grade raw materials were also responsible for AMR and announced that Getz Pharma was working with NIH and the government to develop a national action plan on AMR.