Here’s the rub

“People make the world go round.” Listening intently and indulging in the serenity that keeps one company into the late night hours, I could not help but marvel at how this song, originally by The Stylistics in the ‘70s, remains relevant to this day. Curious to see if there was one person who had written down their thoughts, I came across an article by Sean Clapis, a musician who wrote: “This song isn’t about love, nor is it simply a statement about the political woes of the day. It’s full of subtlety, addressing social, economic, and environmental upheaval as a nuanced result of human nature, without foisting a viewpoint or claiming a solution.” I could not agree more. In a large part, the world as it is now is a result of human actions.

People make things happen. It was a Friday night and having waded through traffic and experienced the side effects of physical and mental depletion from a full work week, it was a comforting sight to see attendance be near perfect. We were part of a group of initially identified stakeholders who were invited to discuss the issue on hand: how best to explore and, if possible, provide solutions to antimicrobial resistance (AMR) in the community. As a group, having zeroed in on the lack of public awareness as one of the contributory factors, this piece is a shot at helping to reboot the campaign against AMR, to assist in the work that has already been initiated and is being done on a national scale.

Let me start by defining the enormity of the problem. Antimicrobial resistance is one and remains to be, a top global threat of public health concern. Identified to be the main drivers are the use and misuse of antibiotics that lead to the emergence of drug-resistant pathogens.

If this does not resonate, maybe this will. If we do not take the necessary steps now, there might come a time when antimicrobials may not work, not only for “superbugs” (bacteria that are resistant to all currently available antibiotics) but for commonly occurring bacterial infections such as those that cause urinary tract infections, bloodstream infections, sexually transmitted diseases, tuberculosis, including those that are used to treat viral, parasitic, and fungal infections.

Into the workshop. The ensuing discussion mostly centered on identifying gaps, some interspersed with solutions and practices that contribute to AMR in the country. For the gaps, the importance of surveillance and diagnostics was shared together with the need to look into cultural factors that influence health behavior. As a majority of prescriptions emanate from outpatient consultations, a baseline assessment of antibiotic use in the community, from the providers to the end users, would be of value. Currently, there is no system to monitor this, as opposed to health facilities with antimicrobial stewardship programs in place. On the part of diagnostics, what was pointed out was the lack of point-of-care tests that would enable the clinician to decide if an antimicrobial is warranted and, looking into the future, with the ready availability of possibly integrating these into the system to encourage wider usage. On noted practices, self-medication and antibiotic sharing amongst family members are rampant. What further contributes to the problem is the ready access in sari-sari stores and the occasional presentation of false prescriptions, which are all reflective of the need for more stringent dispensing measures.

What to do? Combing through these pieces of information, it is a foregone conclusion that not only is there a need to strengthen intersectoral collaboration to combat antimicrobial resistance as its use is not only limited to human medicine but involves both the agricultural and the animal raising industries, but more importantly, raise the level of public awareness to a high pitch, enough to make people realize the gravity of the problem and the danger of inaction.

Antimicrobials may be part of medical treatment, but such a decision is best left to the health care professional. Self-prescription is never beneficial; it is dangerous and may involve consequences that can lead to complications. You and I can make this world go round. Hopefully, always for the better.

[email protected]