Deaths by AMR Keeps Increasing

Anti Microbial Resistance (AMR) is still a serious threat to global public health, including Indonesia. The deaths rate from AMR itself is increasing every year. Some countries has made strict rules regarding the use of antibiotics. Then what about Indonesia?

In Workshop The Prudent Infection Management To Support Antimicrobial Resistance Control Program, at Gramik FK UNAIR, Head of National Committee for Antimicrobial Resistance Control Program (PPRA) of Indonesian Health Ministry, Hari Paraton ,dr., Sp.OG(K)., emphasized the AMR threat requires serious and continuous attention.

“If we dont take it seriously then it is predicted that by 2050 there will be 10 million deaths rate. And Asia wil contribute 4.7 million deaths rate,” he said.

Hari said MRA is a serious global issue, which means that the spread of bacteria can go everywhere, not only locally, the spread of bacteria can reach abroad. “The world also recognizes this issue, but the intensity is different,” he said.

Compared to other countries such as Myanmar, Thailand, Vietnam, Japan, the Philippines, Singapore, and Malaysia, there are two countries that are considered not taking this problem seriously. They are Timor Leste and Indonesia.

A few countries noted that there was an increase in death rate from resistant bacteria. The World Health Organization (WHO) noted that there were 480 thousand new cases of multidrug-resistant tuberculosis (MDR-TB) in the world. In 2013 there were 700 thousand deaths due to resistant bacteria. In the same year, America displayed 23 trillion deaths per year.

In Thailand with 70 million inhabitants, the death rate is 38 thousand. Then Indonesia with 256 million, the equivalent for death assumption is 135 thousand per year.

“In Thailand whose PPRA team has good track record , there were 38 thousand deaths. How about Indonesia? Currently there is no official data for it,” he said.

Reported from The Review on Antimicrobial Resistance (RAR) Hari estimates, if there is no global and effective action, AMR will kill 10 million people worldwide every year by 2050.

“This number overtook death by cancer , which is 8.2 million people per year and in total losses cost reached more than USD 100 trillion,” he explained.

Since 2002 there has been bacterial resistance to antibiotics in few hospitals across Indonesia. The 2013 survey concluded that six hospitals identified E-coli and Klebsiela pneumonia had produced the Extended Spectrum Beta Lactamase (ESBL) enzyme in the range of 40-60 percent. That means, all antibiotics starting from generation I to IV do not work to kill bacteria.

Hari said the cause of bacteria resistance to drugs was due to the high use of antibiotics. 50-80 percent of antibiotics are given irrationally or without indication. In addition, the spread of antimicrobial resistance in hospitals is high, because the lack of understanding and preventive efforts.

“These data shows that antimicrobial resistance has indeed become a problem that must be resolved immediately. Awareness in community about antibiotic resistance is needed,” he said.

Cancer contributes 8.5 million deaths. “So, the highest cause of death is resistant bacteria,” he said.

Hari thinks that without controlling antimicrobial resistance, it is estimated that morbidity and mortality rates due to antimicrobial resistance are going to increase. In 2013 all hospitals in the world were signaled to reduce deaths from antimicrobial resistance by 25 percent.

Hari said that he had identified some issues that would be carried out and be the concern to the PPRA Committee for the next few years. Among other things, by educating around 120,000 doctors to understand antimicrobial resistance problem.

Also handling 2,500 hospitals to run an antibiotic use control program. “There are more than 9,000 health centers that must be educated to use antibiotics wisely, and there must be a limitation for 24,000 pharmacies to sell antibiotics,” he concluded.

Source: Unair News

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