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Low- and middle-income countries face high levels of antimicrobial resistance amid global awareness week

  • 24 Nov 2023

In 2019, an estimated five million deaths were attributed to bacterial antimicrobial resistance (AMR). Alarming projections indicate that if current trends persist, deaths resulting from infections that were once treatable by antibiotics could escalate to 10 million per year — a figure on par with the 2020 global cancer death rate.

Antimicrobial Resistance (AMR) Awareness Week is an important opportunity to highlight this growing problem, which is particularly pertinent in low- and middle-income countries that face formidable challenges in combating this silent global threat.

"These countries grapple with alarmingly high levels of antimicrobial-resistant bacteria, a consequence of widespread and often inappropriate antibiotic use," said Burnet Fleming Fund Program Director Professor Robert Power AM.

"It's considered in the top ten global health issues as defined by the World Health Organization."

In many of these nations, individuals may use only a fraction of a prescribed antibiotic course, share it among family members, or discontinue use prematurely, contributing significantly to antimicrobial resistance.

Burnet Institute, alongside government and non-government partners, and in alignment with PNG national strategy, is leading the implementation of the Papua New Guinea (PNG) Country Grant component of the Fleming Fund, a £265 million UK Aid program helping to tackle AMR in low- and middle-income countries.

The project aims to strengthen One Health approaches in both the human and animal health sectors and brings together a unique collaboration of experts all working collaboratively to support PNG’s domestic responses to address AMR.

Phase One of the project, which involved establishing governance structures, launching surveillance systems, providing laboratory renovations and delivering essential equipment, will run until March 2024. The team is set to meet in Cairns next week to formulate a proposal to bid for Phase Two of the project.

"Phase Two is about developing and flowing through good quality data from our laboratory sites [to practitioners and policymakers]," Professor Power said.

"This involves providing both the equipment and skills necessary for bacterial culture, isolation and identification of drug-resistant testing, and ultimately generating data of value."

In countries like Papua New Guinea, antibiotics are obtainable over the counter without a prescription, adding to the challenge.

Many countries under the Fleming Fund also face competing health priorities, with issues like COVID-19, tuberculosis, and malaria taking precedence over tackling antimicrobial resistance.

The overuse and inappropriate use of growth hormones and antibiotics in the animal health sector also pose significant challenges.

"They'll often use antibiotics routinely in the feed and because of that, the certain bacteria that become resistant to the antibiotics multiply and evolve. And then we end up with infections that aren't able to be resolved by the use of current antibiotics," Professor Power said.

He underscores the importance of national action plans and policies to effectively combat antimicrobial resistance.

"To make this happen, you've got to get relevant policies in place that are implemented within a One Health paradigm," he said.

Upgrading the skills of laboratory and clinical staff in low- and middle-income countries is crucial to effectively address these challenges, he adds.

The Department of Health and Social Care (DHSC)’s Fleming Fund is a UK aid programme supporting up to 25 countries across Africa and Asia to tackle antimicrobial resistance (AMR), a leading contributor to deaths from infectious diseases worldwide.

The Fleming Fund invests in strengthening AMR surveillance systems through a portfolio of country grants, regional grants and fellowships managed by Mott MacDonald, and global projects managed by DHSC.