DOCTORS in Pakistan have called for improving sanitation, health and education as part of the SDGs in the wake of a global study that warns against the dangers posed by high levels of antimicrobial resistance, or AMR. The analysis, apparently a comprehensive one, was carried out in 74 cities in 60 countries, including Pakistan, and involved the examination of raw sewage samples. It led to the establishment of two categories, with Pakistan listed alongside those parts of the world where AMR is high. The exercise involved two doctors from Aga Khan University who were part of the experts’ team in the forefront of the country’s fight against the unprecedented outbreak of drug-resistant typhoid in 2016. It is with alarm that they have asked for urgent measures to effectively tackle AMR that may be an even more complicated subject to treat than understanding why the typhoid patients did not react the way they were supposed to. Antimicrobial resistance is a broader term in comparison to resistance to antibiotics. According to definitions provided by UK Research and Innovation, whereas antibiotics are medicines used to prevent and treat bacterial infections, antimicrobial resistance includes “resistance to drugs to treat infections caused by other microbes as well, such as parasites (eg malaria), viruses (eg HIV) and fungi …”

Doctors advise quick planning and implementation of strategies that target sources of increased AMR. Planning and execution are that much more difficult in a land where health is not a priority issue and does not go beyond the usual rhetoric. Obviously, the tackling of something as unheard of here as antimicrobial resistance would take quite a lot of initiative, the foremost need at the outset being for local healthcare managers to fully educate themselves about the danger and how that is apparently inherent in how we live our lives now. In that respect, a start may be made with a well-thought-out national campaign in the media that makes people aware without causing a scare. The campaign must begin now.

Published in Dawn, March 17th, 2019