Good governance, clean water, and sanitation for fighting global antibiotic resistance

An international team of researchers from Center for Disease Dynamics, Economics and Policy, Australian National University and Cardiff University and the Monarch Institute published a new study recently which talked about how that the multiplication of disease-causing antibiotic-resistant organisms is associated with many social and environmental factors such as poor sanitation, unsafe water, and higher incomes. The findings of the study were published recently in the journal Lancet Planetary Health.

The study was based on the economic and public health data that was collected from 73 countries, found that better infrastructure and better governance were especially connected to lower measures of antimicrobial resistance.

What might come under good governance? It includes lower corruption, political stability, rule of law, and absence of violence; while infrastructure includes factors like sanitation, safe water, internet accessibility, urbanization, and access to electricity.

The authors of the paper stressed that improving sanitary conditions, increasing people’s access to clean water, and making sure of good governance, and increasing public health expenditures at the same time, all are necessary if we want to reduce global antimicrobial resistance.

Though the consumption of antibiotics is known to lead to the emergence and maintenance of antimicrobial resistance- the research team discovered that antibiotic use was not significantly linked with higher antimicrobial resistance.

What they did find out was that reducing antibiotic consumption is not enough to control antimicrobial resistance because the process of contagion–which is the spread of resistant strains– appears to be the dominant factor.

“While reducing antibiotic consumption is important, we have to remember that resistance genes are already widely disseminated in the environment,” said Ramanan Laxminarayan, who is one of the study’s authors. “Preventing transmission of resistant pathogens through investments in improved water and sanitation, and primary health care are central to our ability to tackle antimicrobial resistance.”

“There are no magic bullets here,” Laxminarayan added. “Any new antibiotic will run into the same challenges as existing ones and resistance will emerge rapidly unless we take the problems of improving the health system head-on.”

The original study article, titled “Anthropological and socioeconomic factors contributing to global antimicrobial resistance: a univariate and multivariable analysis” can be found here: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30186-4/fulltext

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