SARChI Chair at UKZN Raises Awareness of Antibiotic Resistance

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UKZN commemorated the world’s first Antibiotic Awareness Week on two Health Sciences campuses under the auspices of the newly appointed South African Research Chair (SARChI) in Antibiotic Resistance and One Health, Professor Sabiha Essack.

Antibiotics – the drugs used for fighting infections caused by bacteria – reduce illnesses and even death from infectious diseases, however, although they have many beneficial effects, their overuse has resulted in the problem of antibiotic resistance: a global pandemic that needs global solutions.

Essack, who established UKZN’s Antimicrobial Research Unit, said antibiotic resistance occurs when bacteria are unaffected by the antibiotics used to treat the infections they cause. The bacteria survive and continue to increase in number, causing complications.

Antibiotics were first mass-produced in the 1940s and their ability to fight and kill bacteria revolutionised medicine and profoundly impacted everything from agriculture to war, Essack said.  'But after less than 80 years, these miracle drugs are failing. Infections caused by resistant bacteria kill several people around the world each year and there are now a large number of so-called Superbugs each with its own challenges and costs,’ she said.

The World Health Organization (WHO) launched a campaign themed “Antibiotics: Handle with Care” reflecting the overarching message that antibiotics are a precious resource and should be preserved. ‘Antibiotics should be used to treat bacterial infections only when prescribed by a certified health professional,’ the WHO declared:  ‘they should never be shared and the full course of treatment should be completed – not saved for the future.’

Essack sensitised the University community to the global pandemic by screening the award-winning film “Resistance: Not All Germs Are Equal” in addition to her inaugural public lecture as SARChI Chair entitled: Antibiotic Resistance and Conservation “No Action Today, No Cure Tomorrow”.

She explained that the epidemiology of antimicrobial resistance was attributed to the indiscriminate use in human health and agriculture. Statistics revealed that by the year 2015, 10 million deaths will have been caused by this silent killer if urgent interventions are not implemented on a global scale.

Essack presented the following key messages:

•   ‘Antibiotic resistance is a tragedy of the commons that happens when individuals act independently and in self-interest to the detriment of the best interests of a whole group by depleting a common resource.’

•   ‘Antibiotic conservation requires co-ordinated, multi-pronged, multi-stakeholder, multi-disciplinary partnerships underpinned by national and international policies that suspend sectorial interests for public good.’

•   ‘Antimicrobial stewardship promotes the safe, rational, correct, and effective use of antimicrobial agents to promote positive patient outcomes, such as  rapid recovery from illness or infection, the prevention and containment of  antimicrobial resistance; and reduction of health care costs.’

‘Global solutions needed to be geared towards the principles of whole-of-society engagement, prevention first, access not excess, sustainability and incremental targets for implementation, as advocated by the WHO.’

Essack further highlighted the One Health concept – a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of healthcare for humans, animals and the environment – because it envisages that the synergism achieved will advance health care for the 21st century and beyond by accelerating biomedical research discoveries, enhancing public health efficacy, expeditiously expanding the scientific knowledge base, and improving medical education and clinical care.

She lauded South Africa and Ethiopia – the only African countries with national plans to combat antibiotic resistance.  She also strongly endorsed the WHO’s Global Action Plan developed in partnership with the Food and Agriculture Organisation of the United Nations, the World Organization for Animal Health and the World Bank.

The objectives of the plan are to improve awareness and understanding of antibiotic resistance through effective communication, education and training;  strengthen the knowledge and evidence base through surveillance research; reduce the incidence of infection through effective sanitation, hygiene and infection prevention methods; optimise the use of antimicrobial methods in human and animal health; develop the economic case for sustainable investment that takes account of the needs of all countries; and increase investment in development of new medicines, diagnostics and other interventions.

Essack, the Dean of Health Sciences Teaching and Learning at UKZN, is an expert consultant to the WHO Africa Office on antimicrobial resistance; founder and co-chair of the South African Chapter of the Alliance for the Prudent Use of Antibiotics (APUA); and  the country representative on the Global Respiratory Infections Partnership (GRIP).  She serves on the South African Chapter of the Global Antibiotic Resistance Partnership (GARP), the South African Antibiotic Stewardship Programme, WHO’s Technical Working Group on Health Workforce Education Assessment Tools, and is co-founder of the South African Committee of Health Sciences Deans.

Lunga Memela