By Sharon Atieno

Curtailing pollution from hospital and community wastewater, effluent from pharmaceutical production, run-off originating from plant and animal agriculture and other forms of waste and releases, is crucial in reducing the spread and emergence of antimicrobial resistance (AMR).

This is according to a new report released by the United Nations Environment Programme (UNEP) dubbed Bracing for superbugs: strengthening action in the One Health response to antimicrobial resistance launched at the Sixth Meeting of the Global Leaders Group on AMR in Barbados.

AMR occurs when a disease-causing organism does not respond to medicine making treatment difficult. The World Health Organization (WHO) estimates that it will lead to 10 million deaths by 2050 if no action is taken.

The report finds that locations such as rivers, lakes and oceans, which over time receive pollution, are more likely to harbour microorganisms with antimicrobial-resistant genes (ARGs) and mobile genetic elements (MGEs), a genetic material that can be transferred from one species to another. These can fuel AMR development and provide a source of AMR spread within the environment.

The report notes that soil also harbours ARGs and can act as a transient source for AMR spread as they retain their previous exposure history to pollutants and AMR.

Additionally, with ARGs and resistant bacteria found to be present in biological aerosols from windborne dust and water vapour from wastewater treatment plants and landfills, airborne transmission of AMR has been found to be possible.

“The bottom line is that getting serious about AMR means preventing environmental pollution. Limiting the discharge of antimicrobial-laced waste to the environment is important for everyone – because every sector is guilty of adding to the AMR burden,” Inger Andersen, Executive Director of UNEP said during the report’s launch.

With reference to the report’s recommendations which calls for priority actions to address key pollution sources, she called on the pharmaceutical sector to upgrade manufacturing processes, overseen by strong regulatory and inspection systems.

While urging the agriculture sector to look hard at pesticide use and avoid using antibiotics that correspond to those used as last resort in human medicine, Ingersen said the healthcare sector, must put up strong infection prevention control programmes to reduce antimicrobial use and wastewater treatment to prevent biological pollution and limit environmental contamination.

Additionally, she called on the Municipal systems to improve their treatment of wastewater, which is currently too often discharged directly into the environment.

“Action in the sectors most responsible must be backed with national action plans. With international standards, realignment of subsidies and investments, and more research and surveillance,” Ingersen said.

“And all of this must be done through the ‘One Health’ approach – which recognizes that the health of people, animals, plants and the environment are interdependent. There is simply no way we can deal with AMR unless we take a joined-up approach to all aspects of the problem.”

“The environmental crisis of our time is also one of human rights and geopolitics – the antimicrobial resistance report published by UNEP today is yet another example of inequity, in that the AMR crisis is disproportionately affecting countries in the Global South countries,” said Prime Minister Mia Amor Mottley, Chair of the One Health Global Leaders Group on Antimicrobial Resistance.

“We must remain focused on turning the tide in this crisis by raising awareness and by placing this matter of global importance on the agenda of the world’s nations.”