‘700,000 die annually in Pakistan due to antimicrobial resistance’

Antimicrobial resistance (AMR) is the third leading cause of death in Pakistan, where it is estimated that around 300,000 people die annually due to drug-resistant bacteria, while AMR contributes to 700,000 deaths annually, health officials, public health experts, physicians and policymakers said on Sunday.

Deploring that Pakistan is the third largest consumer of antibiotics in the world after China and India, they noted that antibiotic medicines worth Rs126 billion were consumed in 2023 alone in Pakistan. They urged people not to purchase and use antibiotics without the advice of trained and qualified physicians.

“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 Islamabad’s Health Services Academy (HSA).

Speaking at a press conference at Astola, Getz Pharma’s dedicated and segregated manufacturing facility in Karachi, Prof Khan said abuse of antibiotics by doctors, quacks and people themselves is making these important medicines highly ineffective.

The press conference was held in connection with Pakistan’s first National Antimicrobial Stewardship Summit, organised by Getz Pharma in collaboration with the Federal Ministry of National Health Services, the HSA and Islamabad’s National Institute of Health (NIH).

The summit was attended by over 1,400 healthcare professionals, including health secretaries and directors general from the federal and provincial governments, officials from the NIH and the Drug Regulatory Authority of Pakistan, office-bearers of 13 medical societies, senior physicians, policymakers and students.

Prof Khan maintained that antibiotics are wonder drugs that saved millions of lives during world wars and pandemics, but their irrational use or abuse has led to AMR, which is 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.”

Pakistan Society of Internal Medicine President and former Punjab health minister Prof Javed Akram lauded Getz Pharma for organising the summit on this important issue, and termed AMR as the third major challenge facing Pakistan after population growth and non-communicable diseases.

“People are now dying due to infections that are extremely hard to treat due to the resistance developed by bacteria against these medicines,” said Prof Akram.

“On the 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 typhoid, multi-drug resistant 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.”

Urging people to consider antibiotics as poison, he said people should not consume antibiotics on their own like they do with cancer drugs, adding that antibiotics have similar side effects as cancer treatment therapies.

NIH representative and senior microbiologist Dr Afreenish Amir said AMR has spread to almost all countries and regions, including Pakistan, owing to the misuse and overuse of antibiotics, adding that this contributes to the increasing burden of infections due to resistant bacteria while limiting treatment options for managing such infections.

The health experts also highlighted the overuse and abuse of antibiotics in the livestock sector, claiming that the abuse of antibiotics in the veterinary sector was responsible for 80 per cent of AMR. They called for creating awareness among the masses regarding the irrational use of antibiotics in humans, and the livestock and poultry sectors.

In his keynote address, renowned paediatrician and public health scientist Prof Zulfiqar Bhutta urged people to get their children vaccinated against typhoid, saying that Pakistan is the only country in the world where the typhoid conjugate vaccine is being administered to children to prevent them from the drug-resistant water-borne disease.

Dr Wajiha Javed, associate director of public health at Getz Pharma, said that over-the-counter availability of antibiotics, using these medicines for a shorter duration, and unnecessary prescription of antibiotics by quacks and doctors should be looked into by the authorities.

She said that substandard antibiotics containing less or low-grade raw materials were also responsible for AMR, and announced that Getz Pharma was working work with the NIH and the government to develop a national action plan on AMR.

On the occasion a declaration was also signed between the HSA, the NIH and Getz Pharma for the implementation of antimicrobial stewardship, while memorandums of understanding were signed with 13 medical societies for antimicrobial stewardship.