PHYLLIS MBANJE
ZIMBABWE is experiencing a high burden of drug resistance to common antibiotics, a situation which has made disease control difficult and too expensive for the poorly resourced country.
Also known as antimicrobial resistance (AMR), this public health crisis has the potential to undo gains made in containing diseases like cholera, typhoid and even COVID-19.
Addressing the media during a virtual meeting on “AMR in Africa”, the director of epidemiology and disease control in the Health ministry, Portia Manangazira, said the country was witnessing an emergence of resistance to common antibiotics.
“There is an urgent need to preserve the remaining antibiotics so that they continue being effective against pathogens,” she said.
According to the World Health Organisation, AMR occurs when bacteria, viruses, fungi, and parasites resist the effects of medications, making common infections harder to treat and increasing the risk of the spread of the disease, severe illness and death.
As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.
Some of the antibiotics which are facing resistance include amoxicillin, penicillin, augmentin, ciprofloxacin and cotrimoxazole.
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Data from a private laboratory in Harare revealed increasing resistance rates to common antibiotics like ampicillin (ie, from 73,9% in 2011 to 74,6% in 2015). The increasing resistance rates indicate that Zimbabwe is affected by AMR.
A situational analysis carried out in 2017-2018 showed that the 2018 cholera outbreak in Harare’s Glen View and Budiriro high-density suburbs reported a high resistance to antibiotics.
“Resistance to the first line antibiotics by the cholera antigen meant patients had to be switched to a stronger antibiotic,” Manangazira said.
This became more expensive, making the disease difficult to control. The cholera pathogen vibrio cholerae has been resistant to ciproflaxin as far back as 2009.
Manangazira added that ampicillin and tetracycline were readily available and, hence their overuse could lead to high resistance.
While the implementation of AMR surveillance in Zimbabwe is limited, stakeholders have called for infection prevention as the best strategy for curbing the condition as well as use of vaccination for diseases like typhoid where the remedies are available.
“The government has set up a national AMR programme. There is need for stewardship programmes to be implemented in all sectors,” said Manangazira.
Speaking during the same meeting, Tracy Mubambi from the Environmental Management Agency (EMA), said there was needed to understand the link between environment and AMR.
She said poor waste management gave rise to disease outbreaks.
“Recurrence of diseases like cholera, typhoid exposes people to overuse of antibiotics,” she said.
Mubambi said EMA was facing challenges in aligning AMR with existing environmental laws.
Meanwhile globally, about 700 000 people die due to AMR related illnesses every year. It is estimated that by 2050, these deaths will reach 10 million, costing the world US$100 trillion.
