Bayad Nozad: Antimicrobial resistance in conflict zones

bayad_nozadThe UN’s declaration on antimicrobial resistance (AMR) was signed by every member of the United Nations General Assembly. Unfortunately, not all member states have the necessary infrastructure to ensure action is taken on the same scale in every part of the world.

The challenges faced by war-torn countries in addressing AMR is significantly important to the rest of the world as microbes do not recognize borders and do not differentiate between peace and wartime.

It is evident that man-made conflict disrupts health systems, contributes directly towards instability of staff availability and supply line for medication and vaccination, and increases the possibilities of sudden closure of healthcare facilities and displacement of people.

This chaotic situation continues in the post-conflict phase and it takes significant amount of time and effort to restore some of the functionalities of the health systems. Actions that are necessary to control AMR include: antibiotic stewardship, infection prevention and control, microbiological surveillance, testing bacteria for resistance before selecting and administering antibiotics, and also isolation of patients with resistant bacteria; these are impossible to implement under such conditions in conflict zones.

For example, prevention of TB through vaccination, detection, and control requires diagnostic facilities, screening of contacts, and treatment. War-torn countries are not always able to provide this management and, as such, contribute directly to increasing number of cases of multi-drug resistant TB.

Additionally, in times of war, countries typically divert resources to meet military needs rather than the health needs of the population. These unfortunate circumstances present an environment for bacteria to develop resistance mechanisms against traditional antibiotics and also provide opportunity for emerging pathogens to spread.

Bayad Nozad is a Fellow with the Faculty of Public Health with a special interest in Blood Borne Viruses. This blog post represents his views only and no one else.