Survival of the fittest, an oft-heard maxim is generally accepted as the way natural selection and evolution occurs. This holds true even for microbes.
Due to the increasing use of antibiotics or the misuse of them, the bacterial population which were previously susceptible to antibiotics and got killed, have found ways to persist by becoming resistant to the effects of antibiotics, a phenomenon that is commonly referred to as ‘antibiotic resistance’.
In May 2015, a global action plan to tackle the growing problem of resistance to antibiotics and other antimicrobial medicines was endorsed at the Sixty-eighth World Health Assembly at WHO. One of the key objectives of the plan was to improve awareness and understanding of antimicrobial resistance through effective communication, education and training. The World Antibiotic Awareness Week 2016 was celebrated worldwide from 14-20 November 2016 to meet these objectives.
In line with these recommendations, Singapore government is currently developing a national action plan to tackle the issue of antibiotic resistance.
Speaking to The Straits Times, the Ministry of Health (MOH) told that it is working in conjunction with the Agri-Food and Veterinary Authority (AVA), the National Environment Agency and the National University of Singapore (NUS) to develop a nationwide strategy for antimicrobial resistance in Singapore. It is likely that awareness campaigns, educating the masses about the illnesses which require antibiotics and regulating their usage, will be the key points.
Some experts like infectious Diseases specialist Dr Paul Tambyah feels that there are other issues which need consideration, apart from public education. “Public education can help, especially when it is targeted at those who may not need antibiotics. But the reality is that far more antibiotics are used in agriculture than in human clinics and hospitals,” he told The Straits Times.
It is true that approximately 50% of all antibiotics used worldwide are used in raising animals, including poultry, and fish.
Animals grown for food, as part of the livestock industry, are often treated with large doses of antibiotics to prevent infection/illnesses or to promote faster growth. Bacteria which have become resistant to antibiotics, especially those derived from livestock can pass their resistance genes to other bacteria in the gut once the meat is consumed, especially if it is not cooked properly.
The rearing of animals in high densities for food, as seen in the livestock industry is possible only through antibiotics and it provides substantial gains too. However, their health and societal consequences could be disastrous if proper measures are not taken to regulate their usage.
Another area where antibiotic usage is rampant is in human medicine. Sometimes, patients feel the necessity to “take antibiotics” for upper respiratory tract infections, which are more viral in origin. It cannot be stressed enough that – Antibiotics do not work on viruses and hence patient education is a key issue that needs to be addressed too.
Says Dr Hsu Li Yang, Associate professor and Programme leader of the antimicrobial resistance programme at the Saw Swee Hock School of Public Health in NUS, Singapore, “We are ‘addicted’ to antibiotics – it has become an integral part of human medicine and the livestock industry.”
He adds, “The more antibiotics a person takes, the more pressure there is for the bacteria to evolve and become resistant”.
The details of the action plan haven’t been released yet, but it is highly likely that it will be based on the World Health Organization recommendations to tackle antimicrobial resistance.
Source: The Straits Times