Saturday letter2
There is an increasing global problem of antimicrobial resistance, whereby antibiotics are no longer effective for the treatment of infectious diseases which they were specifically designed to fight. Antibiotics save millions of lives each year by fighting off bacterial infections. They have been the backbone of medicine, yet many of us take them for granted. Achieving Universal Health Coverage (UHC) won’t be possible without paying close attention to this most pressing global health threat.
The world indeed has moved from a period of inevitable deaths from infections and undiscovered medication for strange infections to self-inflicted deaths from human greed. The consequences of antibiotics abuse help to accelerate the level and spread of resistant bacteria. Increasing availability of antibiotics has accelerated this alarming downside: the drugs losing their ability to kill the microbes they were created to conquer. Hard-wired to survive, many bacteria have evolved to outsmart the medications.
Drug abuse, especially abuse of codeine and tramadol, is one challenge that threatens the future of the country. One major issue that is neglected in the fight against drug abuse in Nigeria is increasing use of antibiotics as a form of contraception, cold and flu, every febrile illness tagged as typhoid, unconfirmed sexually transmitted disease (stds), and for every case of diarrhea with a simple overwhelming level of patronization from clients having no idea of the possible consequences.
In Nigeria, anyone goes to the Proprietary Patent Medicine Vendors (PPMVs), hawkers, small shopkeepers who provide on-the- spot diagnosis and treat anything with buying just a few tablets instead of the full course — not enough to vanquish an infection but enough to allow bacteria to mutate and gain resistance for their complaints ranging from diarrhoea, pain, wounds, and at the slightest hint of a cough or cold. These people don’t have a pharmacist’s degree or a medical training but are taking advantage of the ignorance of others to go about their business.
Still, they confidently reach the people. This signifies state failure, institutional malfunction or breakdown in regulatory and legal frameworks.
Another, is the case of diarrhea, most of which is viral and would go on their own, but most Nigerians would rather take flagyl or the red and yellow capsule drug named as system flushers. What rather presents a precarious picture is the case of using antibiotics especially Ampiclox as a form of contraception or preventing STDs which is very rampant and poses a great danger to the users themselves. This calls for increased knowledge and awareness about sexual health.
An average citizen who is already resistant to common and affordable antibiotics ends up spending more in procuring expensive antibiotics to achieve the same result. Antimicrobial resistance increases the financial burden of healthcare, particularly in health systems where out-of-pocket payments predominate, like Nigeria.
We can’t effectively mitigate the growing problem of antibiotic abuse and resistance without dealing with lax oversight attitude of antibiotic use, non-compliance with prescribed dosage as well as duration of usage of the drug, chaotic drug distribution network which calls for strong political commitment at both national levels and the entire international community to curb the menace. In effect, it is therefore paramount for us to have a good drug distribution system that can guarantee safe, efficacious and affordable medicines across all levels of health care delivery in Nigeria.
Yusuf Hassan Wada, Usmanu Danfodiyo University Sokoto
