 |
| Published in IDN Bangladesh: 18 September 2024 |
Bangladesh has taken strong positions to prevent antimicrobial resistance (AMR) in the past. We urge the new leadership in Bangladesh to take stronger positions at the upcoming UN meeting of world leaders on 26th September 2024 on AMR and advance more concrete actions on the ground against AMR – one of the top-10 global health threats today.
AMR survivor Vanessa Carter called for engaging survivors of AMR in building a stronger and people-centred response. “Patient stories are crucial and should be acknowledged in how we communicate, shape policies, foster innovation, improve medical education, and implement strategies to address Antimicrobial Resistance (AMR), including improving access to quality-assured treatments, diagnostics and enhancing Water, Sanitation, and Hygiene (WASH) in low- and middle-income countries,” said Vanessa Carter who is also the Chairperson of WHO Task Force of AMR Survivors.
“AMR has been an issue that has been documented since the first antibiotic was developed back in 1940. In 2016 we had our first-ever United Nations General Assembly High Level Meeting on AMR (UNHLM on AMR). 2016 UNHLM on AMR drove much of the key results that we can see today in AMR response. Quadripartite organisations too united to address AMR using One Health approach (these include: the Food and Agriculture Organization of the United Nations – FAO, United Nations Environment Programme – UNEP, World Health Organization – WHO, and World Organisation for Animal Health – WOAH),” said Dr Jean Pierre Nyemazi of WHO.
The second High-Level Meeting on AMR will be organised at the upcoming United Nations General Assembly on 26th September 2024 in New York. Let us hope Bangladesh and leaders from other countries worldwide rise up to adapt a stronger political declaration to prevent AMR.
We need to save the medicines that protect us.
The second High-Level Meeting on AMR for all world leaders will be held at the upcoming United Nations General Assembly later this month in New York.
Antimicrobial Resistance (AMR) is a problem driven by misuse and overuse of antimicrobial medicines, including antibiotics and antivirals, and results in critical medicines losing effectiveness to treat infections. AMR occurs when bacteria, viruses, fungi and parasites change over time and become resistant to (or no longer respond to) medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. That is why AMR ranks among the top ten global health threats worldwide.
Misuse and overuse of antimicrobial medicines happen in human health, animal health and livestock, food and agriculture sectors and our environment. That is why One Health approach is required for well-coordinated inter-sectoral response to prevent AMR. AMR is a cross-sectoral challenge as it affects more than one sector, so, the response too must come from all the sectors jointly, said Dr Jean Pierre Nyemazi, Acting Director of Global Coordination and Partnership for AMR and Quadripartite Joint Secretariat on AMR at the World Health Organization (WHO). He was speaking at the special Global Media Briefing hosted by Global AMR Media Alliance (GAMA) last week.
Right and timely diagnosis along with right and timely treatment (no delay) and care and support is so vital if we are to prevent AMR.
Unless early and accurate diagnosis for a range of diseases becomes a reality in Bangladesh, especially for those who are likely to be left behind (or struggle to access standard quality healthcare services), it will be difficult to control misuse and overuse of medicines.
Early and accurate diagnosis is an entry-gate to treatment, care and support pathways. Early and accurate diagnosis helps stop the spread of infectious diseases in the population. It also reduces human suffering and risk of untimely death.
Cardiovascular diseases (heart diseases and stroke), cancers, diabetes, chronic respiratory diseases, or infectious diseases like tuberculosis (TB), sexually transmitted infections including HIV, hepatitis, among others – early and accurate diagnosis remains a critical entry-point if we are to save lives.
Let us look at a disease which is preventable and curable: TB. As per the latest Global TB Report of the WHO, there were 379,000 people newly infected with TB in 2022, out of which only 262,000 were diagnosed and linked to public programme (and 42,000 died of TB) in the same year. Each of these TB infections and TB deaths could have been averted if TB services to prevent TB transmission, early and accurately diagnose TB, treat TB and support people to cure – were available and accessible to everyone – in a rights-based, people-centred and gender transformative manner.
Accurate diagnosis was also available for 20% of those who were diagnosed of TB in 2022 in Bangladesh (WHO recommended molecular test TB diagnosis upfront). Sputum microscopy underperforms in diagnosing TB (may miss more than half of TB patients – that is why Bangladesh leaders along with others who met at UN High Level Meeting on TB in September 2023 promised to completely replace microscopy with WHO recommended upfront molecular tests by 2027.
Bangladesh has deployed important pilots to make TB diagnosis accessible to those unreached in recent past. For example, a special van equipped with Prognosys’ battery-operated, ultraportable and handheld x-rays to screen people with TB and offer them confirmatory test and linkage to care goes to remote areas. WHO recommended only point-of-care, battery operated, laboratory independent and decentralised molecular test for TB (Molbio’s Truenat) has been increasingly being deployed in remote settings – making quality TB diagnosis accessible to those who were earlier unreached. Bangladesh’s national TB programme should scale these important pilots rapidly to ensure early and accurate diagnosis and linkage to best of treatment, care and support becomes a reality for everyone.
Same needs to happen for every other disease – as far as possible. One good news is that Bangladesh’s deployment of molecular tests across the country has increased diagnostic infrastructure considerably – as these same machines can offer highly accurate tests for 40 or more diseases. Battery operated and laboratory independent Truenat can test for TB, HIV, HIV viral load, hepatitis, sexually transmitted infections, malaria, chikungunya, dengue, COVID-19, Mpox, Nipah virus, HPV (human papilloma virus which causes cervical cancer) among others.
Bangladesh needs to ensure drug sensitivity testing facilities are accessible to everyone so that healthcare providers can quickly know if the disease-causing microbe (that is making a person ill) is resistant or sensitive to an antimicrobial medicine. For example, people with TB disease must be treated with latest TB medicines to which TB bacteria is not resistant to.
Irrational use of medicines must be stopped. Regulating the use of medicines is critically important as we cannot afford to lose them and make easier-to-treat diseases – difficult to treat or incurable.
Responsibility to prevent every transmission of infectious disease is a government responsibility – and not just an individual one. We cannot blame people to live in poor and dehumanising conditions that puts them at risk of a range of diseases, exploitations and abuses.
Water, sanitation and hygiene along with evidence-based infection prevention and control measures should be accessible and available for everyone – rich or poor alike.
Antimicrobial Resistance (AMR) is a problem driven by misuse and overuse of antimicrobial medicines, including antibiotics and antivirals, and results in critical medicines losing effectiveness to treat infections. AMR occurs when bacteria, viruses, fungi and parasites change over time and become resistant to (or no longer respond to) medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. That is why AMR ranks among the top ten global health threats worldwide.
Misuse and overuse of antimicrobial medicines happen in human health, animal health and livestock, food and agriculture sectors and our environment. That is why One Health approach is required for well-coordinated inter-sectoral response to prevent AMR. AMR is a cross-sectoral challenge as it affects more than one sector, so, the response too must come from all the sectors jointly, said Dr Jean Pierre Nyemazi, Acting Director of Global Coordination and Partnership for AMR and Quadripartite Joint Secretariat on AMR at the World Health Organization (WHO). He was speaking at the special Global Media Briefing hosted by Global AMR Media Alliance (GAMA) last week.
Bangladesh must make early and accurate diagnosis accessible to all
Right and timely diagnosis along with right and timely treatment (no delay) and care and support is so vital if we are to prevent AMR.
Unless early and accurate diagnosis for a range of diseases becomes a reality in Bangladesh, especially for those who are likely to be left behind (or struggle to access standard quality healthcare services), it will be difficult to control misuse and overuse of medicines.
Early and accurate diagnosis is an entry-gate to treatment, care and support pathways. Early and accurate diagnosis helps stop the spread of infectious diseases in the population. It also reduces human suffering and risk of untimely death.
Cardiovascular diseases (heart diseases and stroke), cancers, diabetes, chronic respiratory diseases, or infectious diseases like tuberculosis (TB), sexually transmitted infections including HIV, hepatitis, among others – early and accurate diagnosis remains a critical entry-point if we are to save lives.
Let us look at a disease which is preventable and curable: TB. As per the latest Global TB Report of the WHO, there were 379,000 people newly infected with TB in 2022, out of which only 262,000 were diagnosed and linked to public programme (and 42,000 died of TB) in the same year. Each of these TB infections and TB deaths could have been averted if TB services to prevent TB transmission, early and accurately diagnose TB, treat TB and support people to cure – were available and accessible to everyone – in a rights-based, people-centred and gender transformative manner.
Accurate diagnosis was also available for 20% of those who were diagnosed of TB in 2022 in Bangladesh (WHO recommended molecular test TB diagnosis upfront). Sputum microscopy underperforms in diagnosing TB (may miss more than half of TB patients – that is why Bangladesh leaders along with others who met at UN High Level Meeting on TB in September 2023 promised to completely replace microscopy with WHO recommended upfront molecular tests by 2027.
Bangladesh has deployed important pilots to make TB diagnosis accessible to those unreached in recent past. For example, a special van equipped with Prognosys’ battery-operated, ultraportable and handheld x-rays to screen people with TB and offer them confirmatory test and linkage to care goes to remote areas. WHO recommended only point-of-care, battery operated, laboratory independent and decentralised molecular test for TB (Molbio’s Truenat) has been increasingly being deployed in remote settings – making quality TB diagnosis accessible to those who were earlier unreached. Bangladesh’s national TB programme should scale these important pilots rapidly to ensure early and accurate diagnosis and linkage to best of treatment, care and support becomes a reality for everyone.
Same needs to happen for every other disease – as far as possible. One good news is that Bangladesh’s deployment of molecular tests across the country has increased diagnostic infrastructure considerably – as these same machines can offer highly accurate tests for 40 or more diseases. Battery operated and laboratory independent Truenat can test for TB, HIV, HIV viral load, hepatitis, sexually transmitted infections, malaria, chikungunya, dengue, COVID-19, Mpox, Nipah virus, HPV (human papilloma virus which causes cervical cancer) among others.
Right treatment must become the mainstay
Bangladesh needs to ensure drug sensitivity testing facilities are accessible to everyone so that healthcare providers can quickly know if the disease-causing microbe (that is making a person ill) is resistant or sensitive to an antimicrobial medicine. For example, people with TB disease must be treated with latest TB medicines to which TB bacteria is not resistant to.
Irrational use of medicines must be stopped. Regulating the use of medicines is critically important as we cannot afford to lose them and make easier-to-treat diseases – difficult to treat or incurable.
Infection prevention and control
Responsibility to prevent every transmission of infectious disease is a government responsibility – and not just an individual one. We cannot blame people to live in poor and dehumanising conditions that puts them at risk of a range of diseases, exploitations and abuses.
Water, sanitation and hygiene along with evidence-based infection prevention and control measures should be accessible and available for everyone – rich or poor alike.
Engage AMR survivors at all levels of AMR response
AMR survivor Vanessa Carter called for engaging survivors of AMR in building a stronger and people-centred response. “Patient stories are crucial and should be acknowledged in how we communicate, shape policies, foster innovation, improve medical education, and implement strategies to address Antimicrobial Resistance (AMR), including improving access to quality-assured treatments, diagnostics and enhancing Water, Sanitation, and Hygiene (WASH) in low- and middle-income countries,” said Vanessa Carter who is also the Chairperson of WHO Task Force of AMR Survivors.
“AMR has been an issue that has been documented since the first antibiotic was developed back in 1940. In 2016 we had our first-ever United Nations General Assembly High Level Meeting on AMR (UNHLM on AMR). 2016 UNHLM on AMR drove much of the key results that we can see today in AMR response. Quadripartite organisations too united to address AMR using One Health approach (these include: the Food and Agriculture Organization of the United Nations – FAO, United Nations Environment Programme – UNEP, World Health Organization – WHO, and World Organisation for Animal Health – WOAH),” said Dr Jean Pierre Nyemazi of WHO.
The second High-Level Meeting on AMR will be organised at the upcoming United Nations General Assembly on 26th September 2024 in New York. Let us hope Bangladesh and leaders from other countries worldwide rise up to adapt a stronger political declaration to prevent AMR.
We need to save the medicines that protect us.
Shobha Shukla - CNS
18 September 2024
(Shobha Shukla serves as Managing Editor of CNS (Citizen News Service) in India/ UK and as Chairperson of Global AMR Media Alliance (GAMA) and Asia Pacific Media Alliance for Health and Development (APCAT Media). Follow her on Twitter: @Shobha1Shukla and @GlobalAMRmedia).