Debate: How can we change antimicrobial use to prevent the rise of superbugs?

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Panel discussion
Photo credit: Chris Norman / Chemonics International


Concern that microorganisms are becoming resistant to common antimicrobial drugs, such as antibiotics and malaria treatments, is sparking debate across the globe. Antimicrobial resistance could lead to the rise of superbugs, creating a global health security risk — the UN warned last year that the number of deaths caused by antimicrobial resistance could reach 10 million by 2050.

How can policy makers, and antimicrobial producers, prescribers, and users, be encouraged to prevent the overuse of antimicrobials? And what can be done to curb the rise of drug-resistant infections in low- and middle-income countries? Following a panel discussion, run by Chemonics International in partnership with The Economist Intelligence Unit, exploring new and emerging behaviour change strategies aimed at preventing the rise of antimicrobial resistance, we hosted an interactive online debate to further explore these important issues. The two-hour debate included specialist panellists as well as views from SciDev.Net readers, and comments from social media.

Our panelists were:
  • Claire Heffernan, Director, London International Development Centre
Claire Heffernan researches the behavioural drivers to resilience, and adaption to the rise in antimicrobial resistance across the global South. As the former Head of Infection and Immunity at the University of Bristol, Heffernan initiated the Risk and Resilience Hub, which explores four interlinked critical global challenges: climate change and health, antimicrobial resistance, sustainable food systems and disease emergence.
  • Eric Fèvre, Professor of Veterinary Infectious Diseases at the Institute of Infection and Global Health, University of Liverpool
Eric Fèvre is Chair of the World Health Organization Working Group on Zoonotic Neglected Tropical Diseases, and jointly based at the International Livestock Research Institute, Nairobi, Kenya. Fèvre manages a range of field-orientated projects researching disease transmission and control at the interface between animals and human beings. His work includes the epidemiology of antimicrobial resistance.
  • Christie Peacock, Founder and Executive Chair, Sidai Africa Ltd
Sidai Africa is a social enterprise in Kenya offering quality livestock and crop products, and services, through a network of branded retail outlets. Peacock, an animal scientist and former Chief Executive of FARM-Africa, has worked in agricultural development in Africa and South East Asia for nearly 40 years.
  • Wondie Alemu, Antimicrobial Resistance Prevention and Containment Adviser
Wondie Alemu is an Ethiopian healthcare policy and antimicrobial resistance expert. Alemu brings practical, health facility-level challenges and solutions to the fore of the discussions.
  • Sian Williams, Policy Officer for Wellcome Trust’s Drug-Resistant Infections Priority Programme, supporting Wellcome’s expanding policy and advocacy work on the topic of antimicrobial resistance (AMR).
Her main interest lies in translating science for evidence-based policy, leading work focused on environmental dimensions of AMR as well as behaviour change for antimicrobial stewardship.

We asked the panelists, the following questions, along with others raised by our readers:

1) Is the battle against superbugs a matter of biology and medicine, or a matter of society and behaviour? What are the driving factors in antimicrobial misuse?
2) Who needs to lead behaviour change – the doctor, the patient, the drug company, or the policymaker?
3) What’s the priority in changing behaviour, where should efforts be focused? Why has it been so hard to change behaviour towards antimicrobials?
4) How would addressing the overuse and incorrect use of antimicrobials improve lives? Do you have some examples of successful behavioural change?
5) What are the obstacles preventing the better use of antibiotics, antivirals, and other antimicrobial drugs? What’s needed to overcome those obstacles?


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