Indonesian Health Ministry offers new strategy to curb antimicrobial resistance

Russia’s Health Ministry has recently unveiled a new national AMR action plan to counter the growing global problem called by some experts a ‘quiet pandemic’. 
 
AMR is the ability of a microorganism to withstand a substance meant to prevent its growth or kill it, Including antibiotics that are used for bacteria and viruses such as antiviral medication. Consequently, disease treatment and control measures lose efficacy, and infections linger; they can then spread to other people. 
 
The new plan is dedicated for the length of five years to 2029 in order to enhance the capacity of laboratories throughout the country with a better coordinated system that tracks the cases of AMR and promptly identify them. 
 
It also includes expanding and protecting the rational utilization of antibiotics within the healthcare facilities including the restriction of the usage and avoiding improper prescription and utilization by the healthcare profession and the general public on the threats of AMR. 
 
Health Services Director General Azhar Jaya said that academics, private sector and people’s support are important in implementing the policy intended for the defeat of AMR. 
 
In an interview last week, Azhar said that to fiancé the new policy, one needs a hearty commitment from the central government, regional administrations and hospital heads. 
 
In a Kompas investigative report on March, many doctors were found to have wrongly prescribed antibiotics to patients including in conditions which do not require the use of an antimicrobial agent for instance dengue fever, vertigo, the flu and constipation. 
 
In addition, antimicrobials in the Watch class of the WHO’s Access, Watch, and Reserve tool are also often prescribed by doctors and are more likely to enter the environment and amplify use-based antibiotic resistance. 
 
That being the case, all currently available antimicrobials can be classified into one of three groups within the WHO’s AWaRe tool. 
 
Access category drugs are specific active substances and are not likely to add to the burden of AMR to a huge extent. The antibiotics of the Watch category are more likely to cause AMR so their prophylactic prescription is possible only for certain categories of patients with severe diseases. Carriage antibiotics are to be used only when necessary, that is in severe infections, which point to resistance to several antibiotics. 
 
As for the lack of the monitoring from the health authorities, the Indonesian Pharmacists Association (IAI) recently admitted that, many of drugstores across the country sold the antibiotics to the consumers without any prescription from the doctors. 
 
Growing issue 
 
Thus, as it was stated by the WHO, AMR was a cause of 4. 2019; 95 million people died across the globe and one was. Nor even nearly five million;’ an over- ‘conservative’ estimate of twenty-seven million deaths that were caused directly by drug-resistant infections. 
 
World Health Organization stated that AMR is one of the top 10 threats to humanity in the global level according to the United Nations health agency. Annual deaths being attributed to AMR itself are forecast to reach 10 million by 2050 if things currently are not changed. 
 
A study conducted by the Institute for health Metrics and Evaluation at the University of Washington indicated that in year 2019, in Indonesia, 34500 deaths were due to AMR and 133800 deaths were related to AMR. 
 
The study also stated: Self-explanatory The AMR death rate in Indonesia is higher than the diease causing deaths of digestive diseases, respiratory infections and TB, chronic respiratory diseases, enteric infections, and both maternal and neonatal disorders. 
 
The UN’s Food and Agriculture Organization (FAO) last year stated this most harshly when it predicted that if nothing is done to slow down AMR, antimicrobials will be rendered completely useless, leading to millions of deaths from otherwise easily treated infections. 
 
‘One health’ approach 
 
Apart from placing some restrictions on the antimicrobials usage in treatment of human patient, the government is also intending to reduce the antibiotics to fish farming and other livestock production. 
 
Commerce Agriculture Ministry has for the last few days conducted a sensitization workshop on AMR to the private sector and poultry businesses. 
 
The Animal Health Director, Imron Suandy, explained: “To effectively address AMR requires strong commitment of the government and the entrepreneurs; Indonesia is a country with a large portion of private sectors investing in chicken production and distribution channels. 
 
Antibiotics have been employed for many years in fish and livestock farming for treatment for diseases, disease prevention and enhancement of animals’ growth rate. 
 
However, economic development has made it worse through the increment of human population hence the high demand for food has made the use of antibiotics for animals and animal feeds a major drive to AMR.