Can One Health Approach eliminate the threat of Antimicrobial Resistance to Global Health Agenda?

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This article was exclusively written for The European Sting by Ms. Shirazum Munira, a third year medical student currently studying in Shaheed Suhrawardy Medical College,Dhaka,Bangladesh. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

While biting on the crispiest chicken legs or popping antimicrobial pills for little sneezing, did it ever occur to you that your food or medicine might make your body unresponsive to antibiotics one day?If this isn’t making sense then let me tell you a story of the era of Antimicrobial Resistance we are heading.Say,Robert is a farmer who takes antibiotics even at the slightest sign of physical distress, he injects his poultry with high antimicrobials and sells them to a overcrowded city.

Analysing the chain of actions,it is evident that unsupervised use of antimicrobials instigates pressure on the microbes for which organisms create adaptive solutions to antimicrobials.Residuals of these resistant pathogen in food supply is transmitted to people.

With globalization and urbanisation, antimicrobial resistant pathogens are mobilised globally proliferating more in hosts leaving antimicrobials: Antibiotics, Antivirals, AntiFungals and drugs alike ineffective ultimately resulting in implementation of less effective resorts to fight infectious diseases burdening the healthcare system which is against everything the Global Health Agenda is established for.Global Health Agenda aims to achieve SDGs addressing health emergencies  by enhancing preparedness,early detection,prevention,surveillance and intersectional collaboration across countries.

This is where One Health Approach comes into play. The US Centers for Disease Control and Prevention and the One Health Commission says: ‘One Health is defined as a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment’.

The classes of antimicrobials like cephalosporins,tetracyclines used to treat bacterial infections in humans are also used in animals.Industrial-chemical-domestic-farm wastes are making microbes resistant of heavy metals,UV rays aiding to high adaptive modules.So the human-animal-environmental interface related to antimicrobial resistance makes multifaceted one health approach  a perfect fit to curve this menace.

WHO has launched new guidelines stopping routine use of medically important antimicrobials in food-producing animals by farmers and the food industry.It has developed Antimicrobial stewardship in hospital antibiotic policy and treatment policy.

One health provides a multidisciplinary network following bottom to top approach of veterinarians, wildlife experts, environmental experts, community health workers, community-based animal health workers, NGOs, clinics, hospitals, farmers trained to act collaboratively on the surveillance  by combining inter professional exchanges,upgraded communication, research, innovation, student engagement,public awareness, policy  development on food safety, tackling corporate campaign on antimicrobials which helps limiting current antimicrobial use, reducing use of antimicrobials on animals and dissolve environmental threats because integrated multi sectoral efforts from stakeholders happen parallelly removing all causal factors simultaneously.

According to the 2017 report  ‘Drug-Resistant Infections: A Threat to Our Economic Future’,each year 700,000 people die of AMR and if unintervened it will rise to 10 million annually with gross loss of 3.8% GDP.But we can save these precious lives as one health approach will be our biggest weapon to take down Antimicrobial Resistance now and in the days to come.

About the author

Shirazum Munira is a third year medical student currently studying in Shaheed Suhrawardy Medical College,Dhaka,Bangladesh.She is also the Liaison officer of Standing Committee on Public Health in Bangladesh Medical Students’ Society.She is a public health enthusiast and an advocate of Gender Equality.She loves reading and writes poems and sketches conceptual art.

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