The era where no effective antibiotics shall be available for most infections is upon us

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By Hon. Dr. Jane Ruth Aceng

As you are aware, the bulk of Uganda’s health problems are infectious. HIV, malaria, tuberculosis, respiratory tract infections, meningitis, neonatal sepsis and diarrhea account for 8 of the top 10 causes of premature death in Uganda.
Even for non-communicable conditions like cancer, trauma and cardiovascular disease, death is often due to infectious complications.
Sophisticated medical interventions such as complicated surgery, intensive care and anticancer chemotherapy that we take for granted today would not be possible without effective antimicrobial agent which prevent or treat the infections that would inevitably follow.

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Unfortunately, man has not used this precious resource judiciously and we are now rapidly descending into the post antibiotic era where no effective antibiotics shall be available for most infections.
With the current trajectory, global deaths attributable to antimicrobial resistance shall rise from the present 700,000 to about 10 million annually by the year 2050. Antimicrobial resistance therefore greatly concerns us as a nation.
In addition to causing death, antimicrobial resistance is threatening our economies especially those of developing countries.
The second line antimicrobial medicines needed to treat resistant infections are not only toxic but also prohibitively expensive.

Currently, Uganda spends an estimated USD 4,000 to treat a patient with resistant T.B as opposed to the cost of USD 250 for a patient with non-resistant T.B. The World Bank estimates that antimicrobial resistance could drive up global healthcare costs by between 300 billion and 1 trillion dollars.
Antibiotics are also crucial for animal production. The World Bank estimates that by 2050, antimicrobial resistance could lead to a decline in animal productions by up to 7.5% and increase extreme poverty by up to 28 million people by 2050.
Indeed, AMR isn’t just a public health problem but a problem of humanity that threatens to make the sustainable development goals unattainable.
We ought to look at these medicine as an exhaustible resource that should be accessible to those that need it but jealously protected against excessive use. In many of our heath care facilities, drug shops and homes, we continue to use antibiotics in an unregulated manner, offering a chance for resistant organisms to proliferate. The situation is probably worse in the animal production where antimicrobials are used as growth promoters, with the sector accounting for more than 80% of all antimicrobials used globally.

AMR is therefore a cross-cutting problem whose causes and consequences span beyond human health to involve the environment, agriculture as well as the economy. Its containment therefore requires a concerted multi-sectoral approach in the spirit of one health.
In response to the problem, the Ministry of Health in collaboration with partner Ministries on the One Health Platform including Ministry of Agriculture, Animal Industries and Fisheries, the Ministry of Water and Environment, the Uganda Wildlife Authority and with technical support from the National AMR Taskforce ,WHO and the Uganda National Academy of Science embarked on developing a National Action Plan against Antimicrobial Resistance. I am glad to note that the plan has been finalized and shall be launched.

The plan is a commitment by government towards mobilization of the resources necessary to combat the scourge of AMR. We should therefore look forward with courage and each play our part in this noble cause

Editor’s note: Speech by the Minister of Health, Hon. Dr. Jane Ruth Aceng, During the Official Opening of the 3RD National Antimicrobial Resistance Conference and Launch of the Uganda National Action Plan (NAP) for AMR.

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