BY DR TONY MICHEL MONDA
Zimbabwe is facing significant and growing resistance in common infections such as TB, malaria, HIV, respiratory infections, sexually transmitted infections (STIs), urinary tract infections (UTIs), meningitis and diarrheal diseases, as well as a host of veterinary diseases, affecting livestock production as a consequence of AMR.
One of the major drivers of resistance is increased antimicrobial consumption in both humans and animals.
However, data on antimicrobial use and patterns of AMR in humans and animals in Zimbabwe are limited due to lack of scientific research and informed AMR surveillance and reportage.
In Zimbabwe there is lack of meaningful surveillance data to help understand resistance patterns, prevalent organisms and guide policy development, due to constraints in the laboratory testing systems.
Only 25 percent of human public health laboratories have the necessary qualified professionals, equipment and reagents to perform culture and susceptibility testing on human samples, which limits the diagnostic capabilities of health care professionals.
The result is a lack of accessible antimicrobial resistance data to guide clinical practice, prognostic evaluation and policymaking.
In the agricultural sector of Zimbabwe, the use of antimicrobials in crop production is less well acknowledged publicly due to lack of research. Infectious diseases caused by microbiological agents including bacteria, fungi, protozoa and viruses in animals inflict significantly important economic and public health impact on animal production systems.
The unregulated use of antimicrobial agents is another important topic in livestock rearing and animal healthcare and has to be closely monitored to be effective for disease control.
However, due to the constant recurrence of vector borne diseases and other associated infections in the livestock sector in Zimbabwe, the overdependence and abuse of the same antimicrobials have contributed to the development of AMR in recent years.
In the communal livestock sector, the lack of stewardship of the environment, unsanitary feed lots, unkempt pastures and lack of proper waste and manure management and disposal, have also intensified the occurrence of AMR on rural farms.
The controlled use of antimicrobial agents is therefore an important aspect of animal healthcare for Zimbabwe.
The medicines control legislation authorities need to promote the rational and safe use of medicines through concerted outreach programmes between farmers, livestock producers and veterinary professionals.
Although alternatives to antimicrobial use (AMU) are being promoted, some important diseases such as vector-borne rickettsial (Erlichia of ruminants and dogs) and protozoan (Babesiases,
Theileria spp Trypanosomiasis), diseases can be prevented by the development of effective alternative non-resistant vaccines and the organic, hygienic stewardship of the environment.
While vector-borne and other diseases still rely on chemical vector control or frequent use of antibiotics with their environmental implications, – the adoption of good animal husbandry and
hygienic practices will reduce the occurrence of infections in the livestock sector, however, only after vigorous agricultural training and public health awareness.
Environmental monitoring and surveillance for AMR needs to be mainstreamed within a general national strategy to scale down the rate of emergence and occurrence of AMR. To do this, a clear understanding is required of leaders in each sub-sector in relation to the safety measures on the lists of essential veterinary and medical antimicrobials.
Today the entire African Continent faces the serious threat of AMR. How do we prevent this encumbrance from affecting disease control programmes in Zimbabwe and Africa as a whole?
Having worked in animal disease control sectors and public health communication in various US states and in some Pacific Ocean countries, one of the weakest links I notice in Zimbabwe and Africa in general, is the inherited detachment and professional gap between medical practitioners, researchers, pathologists, pharmacologists, medical lawyers, public health experts and the media and public.
Too often medical research findings and disease control implementation programmes in Africa and Zimbabwe are the reserve of universities and research institutions and are only communicated to the public when a crisis occurs. Constitutionally medical practitioners, health workers and veterinarians are professionally answerable to their communities and have an added role to safeguard human or and animal health.
An important sector of our community is the rural communal community of Zimbabwe which constitutes 65% of the total population and the larger voters’ base. This is the sector most in need of education on the causes and effects of AMR. However, most often local communities are the last to be informed about important public health issues.
Antimicrobial resistance had already been foreseen by the same scientists, who discovered and
developed the antimicrobial vaccines and other pharmaceuticals. Africa should not be the last to know about this global concern.
Information, research, inquiry, education and public health communication are essential tools of epidemiology and medical intervention in a public health crisis. The government of Zimbabwe needs to bolster these important symbioses to effectively tackle issues such as AMR Antimicrobial resistance.
Dr Tony Michel Monda is a Public health correspondent veterinary epidemiologist and medical researcher. E-mail: tonym.MONDA@gmail.com
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