KARACHI: Antimicrobial resistance (AMR) is the third leading cause of deaths in Pakistan that directly or indirectly results in 1 million deaths in the South Asian country annually, officials and public health experts said on Sunday.
They said this at a press conference in Karachi in connection with the National Antimicrobial Stewardship Summit 2024, organized by Getz Pharma drug manufacturer in collaboration with the National Health Services Ministry, Health Services Academy (HSA) and the National Institute of Health (NIH).
Around 300,000 people die annually due to drug-resistant bacteria, while AMR contributes to 700,000 deaths because of complications following treatment of diseases, according to the experts.
The deaths are linked with “irrational use” of antibiotics as Pakistan is the third largest consumer of antibiotics in the world, after China and India, and consumed antibiotics worth Rs126 billion in 2023 alone.
“Antimicrobial resistance is now the third leading cause of death after cardiovascular disease and maternal and neonatal disorders in Pakistan because we now have infections caused by bacteria that are not responding to third- and fourth-generation antibiotics,” said Prof. Shahzad Ali Khan, vice-chancellor of the Health Services Academy in Islamabad.
“Abuse of antibiotics by doctors, quacks, and people themselves is making these important medicines highly ineffective,” he said, urging people not to use antibiotics without the advice of trained and qualified physicians.
The summit was attended by over 1,400 health care professionals, including health secretaries and directors-general from federal and provincial governments, officials from the NIH, Drug Regulatory Authority of Pakistan, medical societies and health care regulatory authorities, senior physicians and policymakers.
Khan maintained that antibiotics were “wonder drugs” that saved millions of lives during world wars and pandemics, but their “irrational use or abuse” had led to AMR, which was now becoming a global public health concern.
“Self-medication, unjustified prescription of antibiotics by quacks and physicians, taking antibiotics for a shorter duration, and the production of substandard antibiotics by some companies are some of the major causes of antimicrobial resistance,” he said.
Prof. Javed Akram, former Punjab health minister and president of the Pakistan Society of Internal Medicine (PSIM), said AMR was the third major challenge facing Pakistan after population growth and non-communicable diseases (NCDs).
“People are now dying due to infections that are extremely hard to treat due to the resistance developed by bacteria against these medicines,” Akram said.
“On one hand, Pakistan has become the world capital of diabetes and other non-communicable diseases, and on the other, we have developed Extremely Drug-Resistant (XDR) typhoid, Multi-Drug Resistant (MDR) TB, and various other infections that are extremely hard to treat with most of the available antibiotics. This is because we have been using antibiotics like candies.”
He urged people not to consume antibiotics on their own, saying antibiotics have similar side effects as cancer treatment therapies.
Dr. Afreenish Amir, an NIH representative and senior microbiologist, said AMR had spread to almost all countries and regions, including Pakistan, owing to the “misuse and overuse” of antibiotics.
“This contributes to the increasing burden of infections due to resistant bacteria while limiting treatment options for managing such infections,” she said.
The experts also highlighted the “overuse and abuse” of antibiotics for livestock and said it was responsible for 80 percent of AMR in the veterinary sector. They called for creating awareness among the masses regarding the irrational use of antibiotics in humans, livestock and poultry.
In his keynote address, Prof. Zulfiqar Bhutta, a renowned pediatrician and public health scientist, urged people to get their children vaccinated against typhoid, saying Pakistan was the only country in the world where the Typhoid Conjugate Vaccine (TCV) was being administered to children to prevent the drug-resistant, water-borne disease.
Dr. Wajiha Javed, an associate director of public health at Getz Pharma, said over-the-counter availability of antibiotics, use of these medicines for a shorter duration, and unnecessary prescription of antibiotics by quacks and doctors should be looked into by the authorities.
She said substandard antibiotics containing less or low-grade raw materials were also responsible for AMR and announced that her firm was working work with the government to develop a national action plan on AMR.
On the occasion, a declaration was also signed between the Health Services Academy, NIH and Getz Pharma for the implementation of Antimicrobial Stewardship (AMS), while Memorandums of Understanding (MoUs) were also signed with 13 medical societies in this regard.
