Concerns are mounting that a number of antibiotics are increasingly losing effectiveness to treat common illnesses in Tanzania and beyond, however, the efforts to tackle the public health menace still hang on the shoulders of a divided community of scientists.
Professor Robinson Mdegela, an experienced vet, believes that Tanzanian scientists must give up their comfort zones and advocate the One Health approach—fight as one community—against the resistant micro-organisms.
Prof Mdegela is not alone in the crusade. In Tanzania, the clamour for oneness among scientists is growing at the moment when vets, medics, pharmacists, food scientists and researchers remain worlds apart amid a growing push for the One Health campaign.
The One Health concept arose after the scientific community realised that human or livestock or wildlife health can’t be discussed in isolation anymore and they laid out plans that require everyone working together.
Resistance knows no borders
Researchers say resistant bacteria don’t know borders. Those arising in humans or animals and the environment may spread from one to the other and from one country to another. That’s why scientists from diverse fields have been called upon to unite.
But, Prof Mdegela says, “The challenge is, that each time we come to a roundtable as scientists, the first thing some look out for is, who is more superior to the other.”
“One says, I am a vet and the other says I am a human doctor…well, this shouldn’t be a point when people are dying of cholera or rift valley fever or bird flu,” explains Prof Mdegela, a specialist in Fish and Ecosystem Health.
“No one is safe, the human and animal sectors, our food chain and the environment; all are threatened, we all must join forces.,’’ Mdegela told Your Health on the side-lines of the 10th scientific conference of Catholic University of Health and Allied Sciences (CUHAS), themed: One Health Research at Bugando, Is our approach on the right track?
Why One Health?
Banking its hopes on the One Health approach, the government launched the National Action plan on Antimicrobial Resistance 2017 – 2022. That was in April last year and Prof Mdegela was on the team of experts who contributed to developing the action plan.
“[This] resistance affects not only human health, but also other sectors such as animal health, agriculture, food security, water and sanitation and economic development,’’ reads part of the action plan, that urges all sectors to unite in the fight.
It is projected that without interventions, antimicrobial resistance will kill more people than cancer by 2050 globally. The World Health Organisation (WHO) says that antibiotic resistance causes people in most countries, including Tanzania, to be sick for longer and increases the risk of death.
The WHO has so far warned further that it would soon be impossible to treat common infections such as Urinary Tract Infections (UTIs) and respiratory tract infections due to the growing threat of antibiotic resistance.
Last week, as CUHAS researchers teamed up with policymakers and experts from University of Glasgow during the launching of a project, dubbed, Supporting the National Action Plan for Antimicrobial Resistance (SNAP-AMR) in Tanzania, the call for scientists to work unison was apparent.
The SNAP-AMR project is expected to raise the profile of opportunities and tackle barriers surrounding responsible use of medicines in human and animal health, livestock and in communities.
CUHAS has embarked on plans to encourage young researchers at the university to embrace the One Health strategy through advocacy campaigns and mind-set change, but, success of the university’s plan relies largely on the extent to which the institution will collaborate with non-human health sectors.
“For many years, scientists got used to doing things in solo, as individual clusters, based on their specialisation...if we are to tackle resistance, we will have to beat off these boundaries,” says CUHAS’ Deputy Vice Chancellor- academic, research and consultancy, Prof Stephen Mshana.
Beyond hospital premises
Research evidence shows that the burden of antimicrobial resistance goes beyond hospital premises. Dr Nyambura Moremi, who now works as the Director of National Health Laboratory, has previously established how resistance to antibiotics has gone far to affect communities in Mwanza Region, the animals, including dogs, sheep, goats, chicken, pigs and environment in general.
During a study, she says, there were strains of bacteria which were found to be shared among street children. The strains had been isolated from their playgrounds including along Mirongo River in Mwanza.
Multi-drug resistant bacteria could also be traced in the waste coming from Mwanza city sewage system that are also discharged into Lake Victoria, as the researchers tried to track down the notorious strains of bacteria.
Dr Moremi and a team of researchers found that the Tilapia fish from Lake Victoria, retail sources, the meat sold by vendors and the fresh juices sold in restaurants were found to be contaminated with the multi-resistant bacteria.
Experts have previously cautioned that highly resistant organisms are passed from animals on to humans through meat, milk and other animal products.
No sector is safe
Findings of a situation analysis contained in a 2016 publication titled Preface to GARP-Tanzania Situation Analysis and Recommendations on Antibiotic Resistance warned of strong collaboration of veterinary and human health sectors of the threat of resistance is to be tackled holistically.
Prof Said Aboud, one of the experts behind the situation analysis, highlighted how animal products contribute to the rise of antibiotic resistance.
“This contributes to the decline towards ineffective antibiotics, like an approaching siren, getting louder and louder,” he explained.
Is government plan backed?
The Director General of Bugando Medical Centre (BMC), Prof Abel Makubi says that in low income countries such as Tanzania, more advocacy and understanding is needed to clearly and effectively practice one health. That’s why, he said, it was time now students in health be nurtured.
“In Tanzania, the Prime Minister’s Office has released the One Health Strategic Plan but little attention has been given to its implementation. We all agree, however, on the need for collaborative, multi sectorial approach,” he said in his commentary during the CUHAS scientific conference.