Wednesday | 15 January 2025 | Reg No- 06
বাংলা
   
Wednesday | 15 January 2025 | Epaper

Educate people about AMR 

Published : Monday, 18 November, 2024 at 12:00 AM  Count : 448
Asif All Mahmud Akash
Antimicrobial resistance (AMR) posing health and socioeconomic repercussions globally is ubiquitously manifested, at least through its death toll of 7 million each year. But when it comes to dealing with this pressing public health issue, actions are quite flimsy due to the wicked nature of AMR, especially in low- and middle-income countries (LMICs). 

Say, Bangladesh is considered a hotspot of AMR due to the unbidden growth of resistant bacteria primarily driven by poor healthcare standards and misuse of antibiotics. A weak drug regulatory regime has been another issue. It becomes worse where there are health system bottlenecks as well as whatever amenities exist are unevenly distributed. 

In Bangladesh, around 68% of people live in rural areas, where there aren't enough trained doctors or healthcare services. As a result, many people turn to informal health providers, and pharmacies become their main place for treatment. However, pharmacy staff often don't have enough knowledge about antibiotics and may not give proper instructions. This lack of understanding can lead to the misuse of antibiotics. Meanwhile, people's knowledge, attitude, and practice (KAP) are other big factors in this respect as evidenced by contemporary studies. 

The theme of World Antimicrobial Awareness Week (WAAW) 2024 which focuses is educating the public and stakeholders about the dangers of AMR, could not be more timely or relevant to the extent of Bangladesh. Enlightening people, particularly at the grassroots level holds profound potential for long-term positive change. By raising awareness about the dangers of indiscriminate antibiotic use, we can begin to shift behaviors that contribute to the spread of resistant bacteria. At the same time, education can make it possible to bring them under the compliance process which is one core feature of the bottom-up approach of regulation. 

Health workers, such as Family Welfare Assistants (FWA), Family Welfare Visitors (FWV), and Health Assistants (HA), who already have direct access to communities, can play a critical role in AMR education. These frontline workers are trusted by local populations and are in a unique position to raise awareness, correct misconceptions, and advise on proper antibiotic use. However, for this to be successful, there needs to be strong support from the government in the form of initiatives that enable these workers to effectively carry out their educational role.
 
Notwithstanding, challenges must be addressed. First, the Directorate General of Drug Administration (DGDA) has limited activities at the sub-district level where AMR is most acute. Strengthening the DGDA's regulatory presence in rural areas is crucial to controlling the misuse of antibiotics. This includes monitoring the sale of antibiotics, ensuring pharmacies follow guidelines, and preventing the distribution of substandard or counterfeit drugs. The lack of regulatory enforcement at this level allows the uncontrolled sale of antibiotics, which exacerbates the AMR problem. Expanding DGDA activities to the grassroots level could be a game-changer.
Second, pharmaceutical promotional activities have reached down to the grassroots level. Pharmacies and drug stores in rural areas are frequently influenced by these promotional activities, which encourage the indiscriminate sale and use of antibiotics. This undermines public health efforts to curb AMR. Raising awareness among pharmacy staff, informing them about the dangers of overuse, and tightening regulations on pharmaceutical marketing would help mitigate this issue.

Third, the importance of community-based interventions cannot be overstated. As mentioned already health workers, particularly FWAs, FWVs, and HAs, are already embedded in local communities and have the trust of the people. Empowering these workers to take on additional responsibilities related to AMR education would ensure that correct information about antibiotics reaches the population. This could include educating the public about the dangers of self-medication, encouraging proper antibiotic use, and spreading awareness about the consequences of AMR. These interventions would also involve strengthening the role of local leaders and community influencers in advocating for responsible antibiotic use.

Moreover, fostering partnerships with local NGOs, community leaders, and health workers would further strengthen the regulatory framework, ensuring that AMR awareness and responsible antibiotic use reach every corner of the country.

The challenge of combating AMR in Bangladesh is complex and requires a multifaceted approach. However, the key to success lies in education, both at the grassroots level and among healthcare providers. By focusing on educating the public, strengthening regulatory enforcement, and ensuring the proper use of antibiotics, Bangladesh can take significant steps to reduce the threat of AMR.

It is time to recognize that educating the roots of society those in rural areas who are most at risk-can have far-reaching effects in the fight against AMR. With the right initiatives, support, and community-based interventions, Bangladesh can make meaningful strides toward curbing this "silent killer" and securing better health outcomes for its population.

The writer is a contributor



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