Health - There has been an emerging resistance to antimicrobial agents that are used to treat infections caused by micro-organisms that include bacteria, fungi, parasites and viruses. Bacterial diseases include among others Tuberculosis (TB), Typhoid, Gonorrhea, Dysentery and Syphilis among others. In the rank and file of viral infections are influenza (flu), common Rota diarrhea (in children) and the HIV/AIDS. On the other hand, bilharzias, worm infestations, malaria are representatives of parasitic infections, while some common skin rashes, Cryptococcus meningitis, ringworms stand in for fungal infections. In general medical jargon, agents used to combat the germs or microbes that cause these infections are called anti-microbial agents. Those that deal with bacterial infections are called anti-bacterial agents, and those against fungal infections are called anti-fungals while anti-parasitic agents are those that work against parasitic infections.

Antimicrobial resistances occur when microorganisms such as bacteria, viruses, fungi and parasites change in such a way that the usual medications such as antibiotics (Brufen, amoxicillin, penicillin, and septrin among others) used to cure the infections they cause become ineffective.

This infectiveness of microorganisms to most antimicrobials is often referred to as superbugs (germs or bacterial).

Infections caused by resistant micro organisms often fail to respond to the usual treatment resulting in prolonged illness, suffering and greater risk of death.

According to scientific research, antimicrobials alleviate suffering from infectious diseases and have saved billions of lives over the past 70 years.

However their impact is under threat with the advent in the rise of antimicrobial resistance and the slow pace of research and development for new antimicrobial medicines.

This year's world health day which was commemorates on the 7th of April under the theme "Antimicrobial Resistance: No action today, No cure Tomorrow" was coined as a result of observed resistance to antimicrobial agents.

Multidrug-resistant Tuberculosis (MDR-TB) and extensively drug-resistant Tuberculosis (XDT-TB) are examples of new cases recorded by the World Health Organization (WHO) as having been caused by antimicrobial resistance leading to deaths.

WHO documents that about 4,400 new cases of MDR-TB emerge annually causing at least 1,500 deaths and XDT-TB has been reported in 64 countries to date

In the recent past resistance patterns had been observed in anti malarial medicines such as chloroquine and sulfadoxine-pyrimethamine (Fansidar) which become widespread in most malaria-endemic countries and resulted in discontinuation of use chloroquine for treating malaria.

Minister of Health Kapembwa Simbao in a speech read for him by Permanent Secretary Peter Mwaba during the commemoration of the WHD notes that the most important causes of antimicrobial resistance are inappropriate use and over-prescribing of antibiotics in clinical practice.

Mr Simbao adds that the abuse of antibiotics in communities, inadequate infections controls and prevention in health facilities due to high disease burden and excessive use of antimicrobial agents in animal husbandly were also causes of antimicrobial resistance.

"The abuse and misuse of antimicrobials in human medicine and animal husbandly over the past 70 years has increased the number and type of microorganisms resistant to the readily available and affordable medicines resulting in increased costs of providing health care services to our people," he said.

There are no actual static's on the suffering that abuse and misuse of antimicrobials in humans may have caused but MoH have observed treatment failures in many instances.

The effects of antimicrobial resistance are felt at the family level as costs are incurred by the family in treating a prolonged illness.

According World Health Organization (WHO), antimicrobial resistance has both financial and health implications.

WHO representative, Doctor Olusegun Babaniyi said in a speech that when infections become resistant to first choice, or "first-line" drugs, treatment has to be switched to second or third line drugs which are often more expensive and may not be available in some settings.

Dr Babaniyi said in addition to cost patients infected with the resistance microbes often remain sick longer, which increase the costs of health care and was an added burden to the family and society.

"WHO calls upon government and stakeholders to implement the policies and practices needed to prevent and counter the emergence of highly resistant superbugs and to also provide appropriate care to those seriously affected by these microbes," he said.

The World Health Organisation has also advised countries to develop capacity for the prevention and management of drug resistance, strengthen national and sub-national laboratory networks and establish networks for monitoring the resistance of antibiotics.

In response to this, MoH has put up initiative to combat antimicrobial resistance among them, the promotion of rational use of antimicrobials by the health care workers and the general public.

It would also ensure that the essential medicines of the required standard of quality drugs are available and rationally used and promotion of public education regarding appropriate antibiotic use and consequences of their abuse.

Other initiatives include support and promotion of strategies for disease prevention and control programmes and provide policy guidance and technical support for systematic surveillance and documentation of antimicrobial resistance nationwide and promote infection prevention and control strategies in health facilities.

To avoid transmission of infectious diseases, harmful practices such as over-crowding, inadequate dosage, poor adherence, use of poor drugs, purchasing of drugs without prescription should be discouraged.

Deliberate efforts should be taken to avoid transmission of resistant organisms in homes, communities, healthcare settings, food chains, water supplies and international trade routes.

Other factors that contribute to the spread of resistant organisms include overcrowding, poor sanitation, pollution, environmental degradation and changing weather patterns which can affect the incident and distribution of infectious diseases which should at all costs avoided.

The AIDS epidemic has greatly enlarged the population of immune compromised patients at risk of opportunistic infections and that diseases such as tuberculosis cause millions to infections each year.

The enormous growth of global trade and travel means that a resistant microbe can spread from its place of origin to almost anywhere else in the country within 24 hours.

As many infectious diseases risk become uncontrollable, progress made towards reaching the targets of the health related United Nations Development Goals set for 2015 might be derailed.

Steps should be taken to combat antimicrobial resistance as among other things, the health care delivery systems depend on the antibiotics to mitigate the impact of infectious diseases in communities including HIV/AIDS.

It is however a responsibility of all to be committed to safeguarding of these medicines not only for use today but also for a cure tomorrow because antimicrobial resistance and its global spread is a serious threat to public health.

This can only be done if partners with the MoH, stakeholders and the nation at large support the initiatives being undertaken by the ministry to combat antimicrobial resistance such as promoting rational use of antimicrobials by the health care workers and the general public and ensuring that the essential medicines of the required standard of quality drugs are available and rationally used.

Let us all take proactive steps to prevent and counter the emergence of highly resistant micro organisms through the use of prescribed, quality and appropriate antibiotics as well good adherence to drugs.

Ketra Kalunga

Times of Zambia/08/08/2011