Wejuli Mike: Will our efforts to tackle Antimicrobial Resistance outpace their evolving tactics

Imagine you fall ill, seek medical help, and start a cure to cure your ailment. You put your trust in modern medicine and hope that the prescribed drugs will do their work and restore your health. This was the case with me when I recently came down with malaria. After a series of medical interventions failed to bring relief, I questioned the effectiveness of the drugs and the resilience of the microbes that had caused the disease.

My story began when I fell ill with the common but debilitating disease malaria. I immediately went to see a doctor and was prescribed a number of medicines commonly used to treat malaria in Uganda. To my horror, however, none of these drugs seemed to have any effect on my condition. It was as if the parasites causing the disease had erected an impregnable fortress against the drugs that were supposed to defeat them.

Despite the discouraging results of conventional medicine, my determination to regain my health led me to explore alternative treatments. I turned to herbal medicines and a mixture of different drugs, hoping that this concoction could be the key to my recovery. Slowly, my health began to improve, but the question remained: Were the medicines ineffective or had the microbes evolved to outsmart the drugs?

My experience reflects a global problem known as antimicrobial resistance (AMR). Antimicrobial resistance is the phenomenon whereby microorganisms such as bacteria, viruses, parasites, and fungi evolve to resist the action of drugs that were once effective against them. This resistance results from the overuse and misuse of antimicrobial drugs in humans and animals. When microbes develop resistance, common infections become more difficult to treat, leading to longer illnesses, higher healthcare costs, and even death.

According to the World Health Organization (WHO, 2023), antibiotic resistance is currently one of the top 10 public health threats facing humanity. It is responsible for over 1.27 million deaths per year directly caused by bacterial AMR, while 4.95 million deaths per year are associated with bacterial AMR. AMR develops through a variety of pathways.

In bacteria, for example, the misuse of antibiotics allows resistant strains to survive and multiply, passing on their resistance genes to subsequent generations. This can happen in healthcare, agriculture, and communities and contributes to the widespread spread of drug-resistant infections. The ease of international travel and trade further accelerates the global spread of resistant microbes.

Regions with limited access to quality health care, such as parts of sub-Saharan Africa and Southeast Asia, are particularly vulnerable to the impact of AMR. In these areas, infectious diseases are more prevalent due to factors such as poor sanitation, inadequate healthcare infrastructure, and limited resources for effective treatment. The misuse of antibiotics, often without proper prescription, exacerbates the development of drug resistance.

Our missteps in combating antimicrobial resistance include the over-prescription of antibiotics, failure to follow prescribed treatments, and the use of antibiotics in agriculture to promote animal growth. These actions have created a breeding ground for drug-resistant microbes to emerge and thrive, and the urgency of tackling antibiotic resistance cannot be overstated. Tackling this growing crisis requires a multi-faceted approach involving governments, healthcare providers, researchers, and the general public.

• Improved Antibiotic Stewardship: Healthcare professionals must exercise caution in prescribing antibiotics, reserving them for situations where they are truly necessary.
• Public Awareness and Education: Educating the public about the appropriate use of antibiotics, the importance of completing prescribed courses, and the dangers of self-medication is crucial.
• Investment in Research: Research into new antibiotics and alternative treatments is essential to stay ahead of evolving resistance.
• One Health Approach: Recognizing the interconnectedness of human, animal, and environmental health, and implementing measures to reduce AMR across all these domains.
• Global Collaboration: International cooperation is key to limiting the spread of drug-resistant microbes across borders.

Amidst all these strategies, we want to understand whether governments and all different key players are willing to commit to the cause are the medical workers ready to abide by treatment procedures by not selling drugs without a diagnosis for money gains or is the ministry ready to fund projects or improve the health systems to prevent all practices that lead to AMR or is the education institutions ready to frontier AMR stewardship in all levels and or are Ugandan ready to abide with the prescription. Trust me, we all have a role and unless we play our parts, we will lose the game to the microbes which are becoming better day by day.

My personal battle with malaria and the subsequent exploration of alternative treatments underscore the need for a comprehensive and collective effort to combat AMR. As the line between effective treatments and drug-resistant microbes blurs, the urgency to address this global challenge becomes increasingly evident. By understanding the underlying causes, and pathways to resistance, and taking concerted action, we can hope to preserve the efficacy of our precious antimicrobial arsenal.

The question remains: Will our efforts to tackle AMR outpace the evolving tactics of the microbes, or are we destined to engage in a constant battle of wits with the tiny adversaries that threaten our well-being?

The answer to this lies in our collective determination and strategic actions to secure a healthier future for all.