September 2, 2024
JAKARTA – The Health Ministry has launched a new national action plan to tackle antimicrobial resistance (AMR) amid rising global concern over what experts describe as a “silent pandemic”.
AMR occurs when a microorganism develops a capacity to survive exposure to a medicine designed to stop its growth or kill it, such as antibiotics to treat bacterial infections and antivirals to treat viral infections. As a result, standard treatments become ineffective and infections persist, potentially spreading to others.
The new strategy targets the next five years until 2029 and focuses on strengthening capacity across laboratories nationwide for a more comprehensive, integrated system to monitor AMR and detect cases swiftly.
It also covers promoting the reasonable use of antibiotics in hospitals, including tightening their use and preventing their improper administration by healthcare workers, as well as educating the public on the dangers of AMR.
Health Services Director General Azhar Jaya said a coordinated response from various stakeholders, including academics, the private sector and the general public was crucial to ensure the effective implementation of the policy to combat AMR.
“We need a strong commitment from the central government, regional administrations, and hospital heads to be able to implement the new policy,” Azhar said in a statement last week.
A Kompas investigative report published in March revealed that many doctors often inappropriately administer antibiotics to patients, such as to treat diseases that don’t require antimicrobial agents such as dengue fever, vertigo, the common cold and constipation.
Doctors also frequently administer antibiotics that belong to the Watch category in the Access, Watch and Reserve (AWaRe) tool of the World Health Organization (WHO), which have a greater likelihood of contributing to antibiotic resistance.
All existing antimicrobials belong to one of three categories in the WHO’s AWaRe tool.
Drugs in the Access category are highly targeted compounds and are relatively unlikely to contribute to AMR. Antibiotics in the Watch category have a greater likelihood of triggering AMR, so they should be used more sparingly and for specific patients with severe illness. Reserve antibiotics are for use as a last resort in life-threatening infections that indicate resistance to multiple drugs.
Read also: Indonesia takes pains to stop excessive use of antibiotics
The Indonesian Pharmacists Association (IAI) recently acknowledged that a large number of drugstores nationwide sold antibiotics to consumers without a doctor’s prescription due to a lack of monitoring from health authorities.
Growing issue
According to the WHO, AMR was a contributing factor in 4.95 million global deaths in 2019, including 1.27 million deaths that were caused directly by drug-resistant infections.
According to the United Nations health agency, AMR is one of the top 10 global threats to public health. It is predicted that the number of annual deaths directly caused by AMR could rise to 10 million by 2050 if business continues as usual.
A 2019 study by the Institute For Health Metrics and Evaluation at the University of Washington estimated that in 2019 in Indonesia, 34,500 deaths were attributable to AMR and 133,800 deaths were associated with AMR.
The study also stated: “The number of AMR deaths in Indonesia is higher than deaths from digestive diseases, respiratory infections and tuberculosis, chronic respiratory diseases, enteric infections, and maternal and neonatal disorders.”
Read also: FAO calls on countries to do more to tackle antimicrobial resistance
The UN’s Food and Agriculture Organization (FAO) has warned that failure to curb AMR could “turn back the clock on modern medicine” because it could render antimicrobials completely useless, leading to the deaths of millions from previously treatable infections.
‘One health’ approach
Aside from limiting the use of antimicrobials in treating human patients, the government is also looking to curb the use of antibiotics in animal husbandry, including fisheries.
The Agriculture Ministry recently hosted a workshop to educate the private sector and poultry businesses about the dangers of AMR and how to use antibiotics responsibly.
“Strong dedication and leadership from the government and the private sector is necessary to successfully curb AMR. In Indonesia, private entities hold a very large share in the poultry industry, including the supply chain,” Animal Health Director Imron Suandy said.
Antibiotics have been used for decades in fish and livestock farming to treat infections, prevent disease and promote faster growth of animals.
But economic growth, compounded by an increasing human population and rising demand for food, has led to the overuse of antibiotics for animal health and in animal food production globally, exacerbating AMR.