Reducing pollution from the pharmaceutical, agricultural and healthcare sectors is needed to reduce the emergence, transmission and spread of superbugs
Higher temperatures have been linked to an increase in AMR infections and extreme weather patterns can contribute to the emergence and spread of AMR. Photo: Twitter@Inger Andersen._ Environment plays a key role in the development, transmission and spread of Antimicrobial resistance (AMR), a recent report by the United Nations Environment Programme (UNEP) pointed out.
AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat.
Also read: DTE Coverage: World Antimicrobial Awareness Week 2022
Bracing for Superbugs: strengthening environmental action in the One Health response to antimicrobial resistance report, released February 7, 2023, chalked out multiple routes to curb AMR in the environment.
The document was launched at the Sixth Meeting of the Global Leaders Group on AMR, held in Barbados.
It called for a multisectoral ‘One Health’ response in line with the efforts of the Quadripartite Alliance, including UNEP, the Food and Agriculture Organization, the World Health Organisation (WHO) and the World Organisation for Animal Health.
The report briefly described the environmental dimensions of AMR and presented management options for these specific dimensions, as well as the next steps to combat AMR in the environment at the national and global levels.
AMR has been listed by the WHO among the top 10 global threats to health. In 2019, 1.27 million deaths were directly attributed to drug-resistant infections worldwide, with bacterial AMR associated with 4.95 million deaths.
Also read: Lack of access to antibiotics is a key driver of antimicrobial resistance
By 2050, AMR is likely to cause 10 million additional deaths annually. This is on par with the number of cancer deaths worldwide in 2020. The economic cost of AMR is anticipated to be at around $3.4 trillion annually by 2030, pushing 24 million more people into extreme poverty.
Reducing pollution from the pharmaceutical, agricultural and healthcare sectors is critical to reducing the emergence, transmission and spread of superbugs, according to the report. Superbugs or AMR-resistant bacteria are already wreaking havoc on human, animal and plant health, as well as the economy.
In order to better understand the development, transmission and spread of AMR in the environment, we must consider numerous interconnected dimensions, the document emphasised. It is critical to view it through a multi-dimensional lens.
Also read: Rise of AMR could result in up to 10 million annual deaths by 2050: UN report
AMR is also linked to the triple planetary crisis of climate change, biodiversity and nature loss, as well as pollution and waste. These are exacerbated by human activity and unsustainable consumption and production patterns.
Higher temperatures have been linked to an increase in AMR infections and extreme weather patterns can contribute to the emergence and spread of AMR.
Biological and chemical pollution sources containing antimicrobials contribute to the development of resistance in the environment.
Because of nature’s complex interconnections, antimicrobial-resistant microorganisms can spread and be transmitted to humans, animals, plants, and wildlife within the same environment.
Human exposure to AMR from the environment can result from consuming food and/or water contaminated by resistant microorganisms. This calls for a concerted ‘One Health’ response to AMR.
The report highlighted three economic sector value chains that significantly impact the development and spread of AMR in the environment. These include pharmaceuticals and other chemicals manufacturing industries, agriculture and food production sector and healthcare facilities and pharmacies.
Some of the management options for the pharmaceutical sector to address effluent and waste from the pharmaceutical manufacturing sector include:
The report emphasised the importance of improving animal health through biosafety, biosecurity, vaccination and good animal husbandry programmes to reduce antimicrobial use in food animals.
It suggested considering targeted waste pre-treatment from farm to slaughterhouse to remove AMR microorganisms and reduce antimicrobials before discharge.
Disease prevention in aquaculture and animal husbandry through various interventions such as vaccination, nutritional interventions, immune stimulation and UV application for water systems will go a long way towards reducing the need for antimicrobials and parasiticides.
Creating market incentives can also encourage aquaculture producers to invest in and use alternative management practices that reduce the use of antimicrobials.
For the crop sector, it talks about optimising monitoring and evaluation system for antimicrobials used in plant protection at regional and country levels, including other options
For healthcare facilities, it is crucial to educate and train hospital personnel on hygiene, sanitation and safe medicine disposal practices.
Implementing high-quality hygiene and infection prevention in healthcare operations, including safe and sustainable disposal and treatment of antimicrobial medicines and hazardous waste, is critical. AMR-targeted, on-site treatment of hospital wastewater with vigorous treatment is also necessary to limit its spread into the environment.
“Pollution of air, soil, and waterways undermines the human right to a clean and healthy environment. The same drivers that cause environment degradation are worsening the antimicrobial resistance problem. The impacts of antimicrobial resistance could destroy our health and food systems,” said Inger Andersen, Executive Director of UNEP.
Cutting down pollution is a prerequisite for another century of progress towards zero hunger and good health, she added.
The report demonstrated that the environmental dimensions of AMR are multifaceted, necessitating action at the local, national, regional and global levels, as well as collaboration with a diverse range of stakeholders.
Country-level implementation is especially important in a successful AMR response because addressing AMR’s many challenges takes place at this level.
Improving reporting, surveillance and monitoring systems for future data needs is also necessary, as is prioritising financing, innovation and capacity development to support environmental action.
Furthermore, Quadripartite organisations must continue to leverage their resources to assist countries in scaling up national AMR responses using a ‘One Health’ approach.
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