We need an agency to fight AMR, the region’s silent killer

Minsitry of Health/Saudi Arabia

Two weeks ago Saudi Arabia took centre stage in the global fight against antimicrobial resistance by hosting the 4th Global High-Level Ministerial Conference on AMR, culminating in the adoption of the Jeddah Commitments. 

This initiative highlights the kingdom’s leading role in offering actionable and cross-sectoral strategies to combat a looming global health crisis. Right now, decisive leadership in this arena is more critical than ever.

AMR is a phenomenon that threatens the effectiveness of antibiotics and other antimicrobial drugs. 

It occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat. AMR also increases the risk of disease spread, severe illness and death. 

The Arab region is one of the world’s AMR hotspots, thanks in part to laissez-faire use of antibiotics. Studies have shown that antibiotics are sold over the counter in many Arab countries, and often self-prescribed to try to avoid high medical bills.

The World Health Organization estimates that AMR will be responsible for at least 10 million deaths globally a year by 2050. AMR also plays a hand in more than $400 billion of additional health expenses and productivity losses a year globally.

Drugs in the food chain

In the Arab region, antibiotics are often liberally applied in veterinary medicine to livestock such as poultry, goats, sheep and cows as a growth booster. 

In a particularly concerning trend, the powerful antibiotic Colistin is frequently given to animals to treat bacterial infections, and sometimes to help with animal growth.

In human medicine, Colistin is an antibiotic used to treat severe infections caused by multidrug-resistant bacteria. It is used by doctors as a last resort treatment option, because it has the potential to cause severe side effects, such as kidney damage. 

Unfortunately, the liberal use of Colistin in agriculture means that it often ends up in the human food chain. This toxic substance has been found in Arab markets in goat and sheep milk and chicken eggs for human consumption. This could have grave consequences for those who consume such products. 

Targeted advice to farmers could be dispensed via AI-supported apps

The overuse of antibiotics represents a complex health issue. Lack of medical education for livestock farmers and squeezed finances are partly to blame.

Non-existent healthcare systems in many middle and low-income countries are another contributing factor.

Finally, a lack of government financial resources and little, if no, regulatory frameworks add to the problem. 

The Jeddah Commitments call for better awareness, training, monitoring, financing and regulation of antibiotic use in both human and veterinary medicine. As with the Covid pandemic, AMR can strike anyone anywhere, regardless of status.

The way forward

The World Bank says that reducing antibiotics use in agriculture by 30 percent could increase global GDP by US$14 billion, by minimising the negative impact of antibiotics on food security. This endeavour would require significant investments in health care systems, including regulatory agencies and the monitoring of prescriptions. 

Technologies such as AI can help to regulate the use of antibiotics in human medicine. However, regulating antibiotic use in agriculture will require the creation of a regional food safety agency to oversee traded products. 

Such a centre would look to regulate all inputs, such as herbicides, pesticides, hormones and antibiotics, through thorough testing.

It would also extend advice to farmers on how to reduce inputs or adjust inputs so they are less harmful. For example, farmers might be guided to use antibiotics such as Enroflaxacine, rather than Colistin, while promoting vaccinations could prove much more beneficial to animal and human health than antibiotics.

An agency of this sort would help with health outcomes and also help farmers save money by reducing the need for expensive, strong antibiotics.

Modern technology can do wonders for supply chain management. Targeted advice to farmers could be dispensed via AI-supported apps. Information could be made available online, allowing every farmer to transparently learn best practices. 

Effective regional food chain management has the potential to enhance both regional and global trade, ultimately increasing farmers’ incomes. The GCC could position itself as a leader in this area by establishing an inter-regional food safety agency. Such an organisation would collaborate with national ministries to advance agricultural practices and set new standards for the region.

Apart from a tangible effect on food quality, a new food chain quality agency would also help bolster fragile, structurally impaired rural economies and their livelihoods. Such a move would provide a clever regional soft power option for GCC countries.

Martin Keulertz is a lecturer in environmental management at the University of the West of England, Bristol