The insidious ascendance of antimicrobial resistance: A looming national, continental, and global pandemic
By Oladoja M.O
…and if we begin to face a threat of setbacks in our supposed success against diseases induced by pathogenic microorganisms, are we not seemingly sent back to the dark ages even as we claim to have advanced? When recounting the history of medicine, few triumphs can compare to the emergence and widespread use of antimicrobials, for indeed, it was a win for the world.
Without mincing words, Alexander Fleming’s serendipitous discovery of penicillin on his petri dish ushered in a new era in biomedicine. For just before our eyes, pathogens that had wreaked havoc for generations, perpetuating morbidity and mortality in their wake, were suddenly at the mercy of the new chemical arsenal deployed in the fight; and just like that, infectious diseases receded before the ever-rising tide of antimicrobials. Everyone felt optimistic and, in fact, predicted a swift and righteous victory over the scourge of infection.
For over a decade now, the world’s leading figures have consistently voiced concerns about the threat to global health posed by microorganisms’ resistance. It appears that humanity’s arsenal, which once assured victory over these microorganisms and their harmful effects, is now inadequate. Can we suggest that the drugs being produced are ineffective? Can we assert that our research is flawed? Or that humanity has developed a different genetic makeup? Or that these microorganisms are now clever enough to evade destruction?
Well, many questions like these are very relevant. But as we consider these questions, it is more reasonable to retrace our steps to identify the real causes and understand what has positioned the world, particularly Africa and Nigeria, toward this path of looming global, continental, and national health breakdown.
Nationally, for example, this issue is moving very rapidly. Diseases that should be treated in a short time are becoming difficult to manage, with treatment becoming elusive. Many blame the serious organized crime surrounding “fake drug production ” in Nigeria, which floods the market day and night, and yes, this is a reasonable claim. What greater factor could contribute to a drug’s ineffectiveness than poor or flawed production? However, if this were the only cause, it would be a unique issue to Nigeria; instead, it transcends even beyond that.
The individual practice can be directly linked to this whole issue without prejudice. Simply put, the consistent intake of drugs renders the individual impotent over time. The Department of Health of the Australian Government, in one of their submissions, noted that “using a drug regularly can lead to tolerance (resistance); your body becomes accustomed to the drug and needs increasingly larger doses to achieve the same effect or, even, becomes less potent.” This attitude, unfortunately, is almost a daily occurrence for many individuals, stemming from the persistent issue of self-prescription, however minor it may appear.
The US National Library, in one of its publications in 2013, stated that “Self-medication is a global phenomenon and a potential contributor to human pathogen resistance to antibiotics. The adverse consequences of such practices should always be emphasized to the community, along with steps to curb them.” I think we can all agree that many people are guilty of this act; at the first sign of discomfort, almost everyone becomes a medical expert in their own home, concluding which drug works best for them, diagnosing their own ailments, and taking antibacterial drugs for fungal issues.
A user on X @the_beardedsina narrated his experience: “A patient comes to the hospital. He has been sick for a week, having had a fever for days. A blood culture is done, and the result shows that he’s resistant to the following drugs (antibiotics): Ceftriaxone, Ampicillin, Cipro, Levofloxacin, Metronidazole, Cefepime, Meropenem, Piperacillin, Gentamicin, Amikacin, Nitrofurantoin, Vancomycin, and Chloramphenicol.” How can we survive this??
The issue of how antimicrobials are used in agriculture is another concern. The rise of industrial farming has fully embraced the prophylactic use of antimicrobials in livestock, not primarily to treat diseases, but to enhance growth rates. However, unlike clinical settings, the agricultural use of antimicrobials lacks the same oversight and prescribing guidelines.
The inconsistency in regulation allows for significant variation in the classes and concentrations of antimicrobials used in agriculture. In 2021, approximately 54% of the 11 million kilograms of antimicrobials sold for use in domestic agriculture in the United States were categorised as “medically important. “
In conclusion, this issue requires significant awareness and sensitisation of the general public regarding the dangers of antimicrobial resistance. Conservative preventive care should be promoted, and individuals should seek care from qualified professionals.
The commercial use of antimicrobial drugs must be approached with caution, and all relevant agencies responsible for this oversight at national, continental, and global levels should act swiftly before the situation escalates and threatens global health, reverting us to the dark ages of high mortality and the economic toll of microbial threats.
The world faces numerous challenges, and we should focus on celebrating our victories rather than becoming overwhelmed by this struggle.
Oladoja M.O writes from Abuja and can be reached at mayokunmark@gmail.com.
