Understanding antimicrobial resistance: a call to action for South Africa

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The global health community has sounded the alarm on an invisible yet devastating threat during World Antimicrobial Awareness Week (WAAW), which is celebrated from 18-24 November, aims to raise awareness about this growing crisis.

This year’s theme, “Educate. Advocate. Act Now”, underscores the urgency for action across health sectors to mitigate the risk that antimicrobial resistance (AMR) poses to public health, food security and economic stability.

In South Africa, the situation is increasingly dire. AMR occurs when bacteria, viruses, fungi, and parasites evolve to resist the drugs designed to kill them, making once-treatable infections difficult or even impossible to manage.

According to the World Health Organization (WHO), AMR not only increases the risk of disease spread but also leads to severe illness and death.

AMR not only increases the risk of disease spread but also leads to severe illness and death. Picture:Pavel Danilyuk /pexels

As Elani van Zyl, sales and marketing manager for Pharma Dynamics’ Hospital Division, explained: “When common infections become difficult or even impossible to treat, it leads to prolonged illness and higher mortality rates.”

She stressed that without immediate intervention, the spread of drug-resistant infections will continue to strain South Africa's already challenged healthcare system.

The global AMR crisis

The numbers are alarming. A study by the Global Research on Antimicrobial Resistance (GRAM) Project, published in The Lancet, reveals that antibiotic resistance has been directly responsible for over one million deaths per year since 1990.

Experts predict that AMR could contribute to 39 million deaths globally—a staggering three lives lost every minute. Picture: Turek /Pexels

This figure is expected to rise significantly if action is not taken. By 2050, experts predict that AMR could contribute to 39 million deaths globally — a staggering three lives lost every minute.

South Africa is not immune to this crisis. The country is already grappling with high rates of infectious diseases, including tuberculosis (TB), which is increasingly showing resistance to standard treatments.

Van Zyl pointed out that South Africa, like many other low and middle income countries, bears a disproportionate burden of AMR due to factors such as antibiotic misuse and overuse, as well as the widespread use of antibiotics in agriculture.

Misuse and overuse: The root of the problem

One of the main drivers of AMR is the misuse and overuse of antibiotics. This includes taking antibiotics without a prescription, not completing the full course of treatment, and using antibiotics to treat viral infections like the flu, where they are ineffective.

In agriculture, the routine use of antibiotics to promote growth in livestock rather than treating specific infections also accelerates resistance.

According to WHO, the misuse of antibiotics in humans and animals is one of the biggest global health threats we face today.

In South Africa, this challenge is compounded by limited access to quality healthcare, which can lead to improper prescription practices by healthcare providers or patients self-medicating.

Educate, advocate and act now:

Educate: Education is the foundation of the fight against AMR. Every South African, from healthcare workers to farmers to ordinary citizens, must understand the role they play in reducing AMR risks, whether it’s through responsible antibiotic use or infection prevention practices.

Public awareness campaigns can help people understand when antibiotics are necessary and how to use them responsibly.

The public must also be educated about simple infection control practices such as regular hand washing and vaccination, which can reduce the need for antibiotics in the first place.

Advocate: Without concrete government support and policy change, the fight against AMR will falter. South Africa has already taken steps in this direction, with the National Department of Health working on a

National Action Plan to address AMR. This plan focuses on improving surveillance systems, enhancing diagnostic capabilities, and increasing public awareness of the dangers of antimicrobial resistance. However, more needs to be done to close the gaps.

Act now: Health professionals are urged to implement and strengthen Infection Prevention and Control (IPC) measures, which include developing new vaccines, improving access to clean water and sanitation, and making greater investments in diagnostics and healthcare training.

The impact of AMR on health and the economy

AMR doesn’t just threaten health — it has significant economic implications. The cost of treating drug-resistant infections is much higher than treating infections that respond to standard antibiotics.

This can lead to longer hospital stays, increased demand for diagnostic services, and higher operational costs for healthcare systems already under strain.

In agriculture, AMR can lower production yields and increase farmers' costs. Antibiotic resistance in livestock can also affect human health, as resistant bacteria can be transmitted from animals to people through direct contact or through the food chain.

Taking action at an individual level

Simple actions, like practising good hygiene can also help reduce the spread of infections. Picture: cottonbro studio /Pexels

Practise responsible antibiotic use

Only use antibiotics when prescribed by a healthcare professional.

Complete the full course of treatment to prevent resistant bacteria from developing.

Simple actions, like practising good hygiene and getting vaccinated, can also help reduce the spread of infections and the need for antibiotics.