Article by Animals in Farming programme at the World Animal Protection (Africa office)
Antibiotics are an essential part of treating human beings and animals; from the child who needs antibiotics to treat an infection from a graze in the knee, the elderly person who needs antibiotics after a knee replacement surgery, to the cow that needs treatment. As Rudi Eggers, the World Health Organization (WHO) representative in Kenya says, ‘antibiotics are an essential part of our health and we cannot do without them.’
However, antimicrobial resistance (AMR), which results from the overuse and misuse of antibiotics in both human and animal medicine, has lately become a challenge, leading to problems in management of infections in both humans and animals. Antimicrobial resistance happens when microorganisms (such as bacteria, fungi, viruses, and parasites) become resistant to antimicrobial drugs (such as antibiotics) to which they were originally susceptible to. Microorganisms that develop resistance to most commonly used antimicrobials are referred to as “superbugs”.
The rise in antimicrobial resistance globally has led to 10 million people dying every year and will also account for 3 percent reduction in Gross Domestic Product (GDP) by 2050. This number is expected to rise to nearly one million by the year 2050. Data from sentinel sites in Kenya indicate high rates of resistance for respiratory, enteric and hospital acquired infections indicating that many available antimicrobial regimens such as penicillins and cotrimoxazole are unlikely to be effective against common infections. In livestock, antimicrobial resistance has been reported in E. coli isolates from beef and poultry showing resistance to common antimicrobial agents such as tetracycline, cotrimoxazole, streptomycin, ampicillin, quinolones and third generation cephalosporins at varying frequencies.
Antibiotics have served as the cornerstone of modern medicine. However, the persistent overuse or misuse of antibiotics and exposure to counterfeit drugs in human and animal health have encouraged the emergence and spread of antibiotic resistance. Antibiotics are used in both human and animal health to treat various infections, and health professionals (both human and animal) have raised concern over their availability over the counter, and the misuse of the drugs. This is one of the leading causes of resistance. Other causes are lack of access to quality healthcare for both humans and animals, and frequent movement of persons and livestock. It is against this backdrop that Kenya hosted Africa’s first Antimicrobial Resistance Awareness Week that aimed to increase global awareness of antibiotic resistance and to encourage best practices among the general public, health (animal and human) workers and policy makers to stem the spread of antibiotic resistance.
The Kenyan government has commemorated the world antibiotic awareness week (WAAW) since 2013 with calls for urgent action to avert antibiotic resistance. In 2013, the Kenyan Ministry of Health and the Ministry of Agriculture, Livestock and Fisheries began to implement sustainable measures to mitigate AMR risks. To take a lead on the African continent to combat AMR, the ministries jointly developed the antimicrobial resistance Policy and National Action Plan and a Communication Strategy through a One Health approach. The policy define the preventative actions to be taken while the Communication Strategy aims to sensitize different audience groups across relevant sectors on reducing AMR.
The 2019 WAAW was symbolic in demonstrating African solidarity amongst key AMR stakeholders in the region. It was the first time WAAW was celebrated regionally and also the first time it was jointly organized by the Regional Tripartite (FAO, OIE, WHO) and African Union (Africa CDC and AU IBAR). The global them for the Awareness Week was ‘Handle Antibiotics with Care’ while the national theme was “Tackling antimicrobial resistance together.” The global theme emphasized the need to use antibiotics safely and responsibly across sectors, from agricultural and livestock production to public health, and to mitigate the impacts of antimicrobial pollution contaminating water and soil.
The event was aimed at uniting the AMR stakeholders to strengthen their commitment and advocacy efforts towards AMR risk mitigation. By engaging a wide range of stakeholders and audience, WAAW envisions to raise awareness on AMR issues to the general public to create a holistic awareness throughout our society.
The week-long event highlighted the importance and the urgency of the impacts antimicrobial resistance has on humans, animals, and our eco-system. To reach out to different AMR stakeholders, including farmers, students, journalists, and regional policy makers, WAAW rolled out different regional, national or joint events throughout the week. The events included a press conference, high-level advocacy event, coordination meeting, farmer field day, symposium, a student photo-essay and live skit competition with One Health students’ clubs in Kenya and an industry AMR sensitization workshop.
A half-day World Antibiotic Awareness Week 2019 media sensitization and training was held on 15th November 2019 at the CGIAR AMR Hub at the International Livestock research Institute (ILRI) jointly with Kenya’s ministries of Health and Agriculture, Livestock, and Fisheries hosted, at the ILRI campus in Nairobi. The event was a curtain-raiser to the official launch of WAAW regional AMR awareness activities in Kenya. Twenty-five journalists from a cross section of Kenya’s media houses and magazine publishers attended the event and were joined by key speakers and observers from the Ministry of Health, the Directorate of Veterinary Services, the Kenya Medical Research Institute (KEMRI) and the University of Nairobi (UoN).
High-level advocacy event and press briefing
Figure 1: A group photo of the media training participants held at ILRI, Nairobi
This was a one-day press briefing and advocacy meeting held on 18th November 2019 at the Laico Regency Hotel. The high-level advocacy event involved gathering of 200 AMR stakeholders to strengthen commitment to support National Action plans (NAPs) implementation in African Countries. Panel discussions and a signing ceremony took place to demonstrate the political will to enhance advocacy efforts.
Antimicrobial Resistance was identified as a classical One Health problem because it has to be addressed at both human and animal sectors; it requires collaborative and coordinated action cross-countries; and it requires the public to change their attitudes, behaviour and practice. Public education, awareness and sensitization on the right use of antibiotics is paramount in waging war against misuse of antibiotics therefore stakeholders called on the need to enhance regulatory frameworks to control access.
Figure 2: Stakeholders after signing the postcard as a re-commitment to mitigate AMR
Farmers’ field day
A one-day farmers’ field day was held at the Ndumberi stadium on 20th November 2019 and reached 427 participants. The event gave farmers an opportunity to learn about responsible use of antibiotics and the connection to human health. This event also attracted government officials who committed to supporting farmers to improve their farming systems for productivity. Different stakeholders took the opportunity to exhibit their products/services and trained the farmers about interlinkages between misuse of antibiotics and emergence of antimicrobial resistance.
Figure 3: Participants in the AMR march holding the event banner outside the County Gov of Kiambu HQ
The symposium was a two-day event organized by the Biomereux as from 21-22 November 2019 held at Crowne Plaza for researchers and academics to exchange the most updated information on antimicrobial resistance.
Dr Muinde, a Research Manager at the World Animal Protection, presentation on animal welfare and antimicrobial resistance emphasized the critical role of consumer power and their role to voice their concerns to catalyze transformative change that safeguards human, animal and environmental health.
Figure 4: Dr Patrick Muinde, World Animal Protection
Student photo-essay and live skit competition with One Health students’ clubs in Kenya
A one-day student activity, themed, “what would the future be if antimicrobial resistance got worse?” was held on 23rd November 2019 at the Kenya National Theatre bringing together over 200 students from One Health student clubs across the country to celebrate the One Health spirit and raise awareness on the urgency of AMR issues and the importance of individual’s role from different sectors. The student event was marked with presentations, mentorship speeches by guests, music performances, live skit performances and awarding of the top essay winners. The activity was led by the World Animal Protection (Africa) in partnership with the Tripartite, ReAct group Africa, and BD.
Figure 5: A group photo of all the participants during the student at Kenya national Theatre (Photo-FAO)
The storytelling/Photo Essay Contest raised awareness about antimicrobial resistance (AMR) and its risks highlighting how the future will be like if antimicrobial resistance is not tackled. The challenge was to capture what the future will be like if AMR is not tackled through a camera lens and accompanying story.