United News of Bangladesh

“Stop referring to a coming post-antibiotic era — it’s already here.”- This statement was made by the US Centre for Disease Control and Prevention Report (2019) almost within a century of the invention of the first antibiotic by Sir Alexander Flemming. Now, globally, Antimicrobial Resistance (AMR) is the 3rd leading cause of death. In 2019, about 4.95 million premature deaths occurred due to AMR which was higher than HIV/AIDS or malaria and this could rise to more than 10 million by 2050.  Bangladesh also cannot escape the AMR threat. In 2019, about 26,200 deaths were attributed to AMR, and 98,000 deaths were directly related to AMR. Among 204 countries, Bangladesh was ranked 75 according to the age-standardized mortality rate affiliated with AMR per 1,00,000, which is alarming and needs proper action to control.  What is AMR? Antimicrobial Resistance (AMR) is a condition where microbes, bacteria, and viruses evolve in such a way that the drugs that were previously used against them are no longer effective, thus leading to serious illness and in some cases death.  AMR is now a global concern that almost all countries including Bangladesh are suffering from. And, there is a heavy burden on the Sub-Saharan African countries. However, there is inadequate data regarding AMR-related fatalities in low-income countries.  Read more: Edible oil in drums poses a threat to public health: PROGGA Misuse or overuse of the antimicrobials is a significant driver of resistance. If the treatment is too long or short or incorrect, this increases the chance of antimicrobials becoming resistant. If this occurs then it creates more opportunities for microbes to develop and multiply. AMR scenario in Bangladesh AMR is a serious public health concern as Bangladesh has a decentralized healthcare system. In Bangladesh, most healthcare facilities are concentrated in secondary and tertiary hospitals.  Besides these, the domestic pharmaceutical industries are now providing 97% of the countries’ medicine. Privately owned pharmacies and dispensaries resulted in easy access to the drugs. According to a  CAPTURA report in collaboration with UK Aid, uncontrolled pharmacies in Bangladesh resulted in possible misuse of antibiotics. It is estimated that almost 50.9% of the total antibiotics were purchased without prescription, which is an alarming situation. The number of AMR deaths in Bangladesh is higher than deaths caused by diseases like chronic respiratory diseases, tuberculosis, respiratory infections, diabetes, kidney diseases, and digestive diseases.  Read more: Infections cause 20-40% of newborn deaths in Bangladesh: Study Due to the decentralised healthcare system, AMR surveillance in Bangladesh is difficult to monitor. To prevent this situation from worsening, the government should take steps for monitoring in collaboration with the research centres like icddr,b, IEDCR, and different NGOs working on the healthcare facilities. Furthermore, international organisations like WHO, US-CDC, FFCGB, and USAID need to play crucial roles in controlling the situation. Analysis of the policy issue According to a WHO report, Southeast Asian countries have the highest risk of AMR among all the WHO regions. Bangladesh is no exception to this. In Bangladesh, antimicrobials are widely available as over-the-counter drugs.  This situation became more complicated due to the presence of unqualified providers in the informal sector along with unethical marketing practices of the pharmaceutical companies. Besides human health hazards, the AMR has a drastic impact on the animals and the environment too (National Library of Medicine, n.d.).  Impacts on human health A recent research in Dhaka showed that in the case of Urinary Tract Infection (UTI), the most used antibiotics like Amoxicillin (82%), Azithromycin (75%), and Cefixime (64.5%) were found resistant among 1308 samples used.  Read more: HMPV Virus Outbreak: Causes, Symptoms, Treatment and Prevention Another newspaper report shows that almost 18% of bacteria isolated from children affected with pneumonia were resistant to all routinely used antibiotics like ampicillin, gentamicin, ciprofloxacin, and ceftriaxone. The report also showed that the frequent use of antibiotics to treat general colds, flu, and mild diarrheal illness is mostly responsible for fueling the AMR in the community.  It has been observed that almost all age groups are more or less resistant to antibiotics but the children and youth are mostly affected by its effect. Economic impact In 2019, the World Bank found that the impact of AMR is also negatively affecting the world economy. The report estimated that by 2050, unchecked AMR would reduce the world GDP by 3.8% and push 28 million people into poverty. As a developing country, Bangladesh will also be a sufferer of this problem as due to AMR, people are now spending more on healthcare compared to other spending.  A recent analysis showed that unaddressed AMR on livestock would cost global GDP up  to $950 billion and its spread from livestock to humans would cost up to $5.2 trillion of world GDP (World Health Organisation, 2024). Read more: Read more: Should You Drink Hot or Cold Water? Environmental impact Multi-drug-resistant bacteria have already affected the ecology of Bangladesh. Common resistant phenotypes included common antibiotics like Ampicillin, Tetracycline, Aztreonam, Nalidixic acid, and Ciprofloxacin.  How does this issue affect different groups of people? According to a report by Medical News Today, the most affected group by AMR is children under 5 years with pneumonia. Almost 18% of the total isolated bacteria are resistant to all routinely used antibiotics.  The unsafe drinking water and poor sanitation are responsible for some common diseases which creates the demand for the widespread availability of over-the-counter antibiotics from the local pharmacies. Besides this misconception about antibiotics, weak surveillance processes, and less awareness among the sellers and patients are continually contributing to the growing AMR according to a report by the Dhaka Tribune. The irrational use of antibiotics in animal feed like poultry farms, and defective water management in the city are also spreading AMR among city people.  Read more: How to Fix Your Sleep Routine: Know the Do's and Don'ts A report by the Business Standard shows that 8 of the 12 antibiotics used in poultry farms were ineffective by at least 40% against the most common bacteria like E.coli.  Comparative analysis Different countries around the world are taking different approaches to tackle the situation like the One Health approach, Surveillance, Stewardship, awareness building, and agricultural steps.  USA The USA has taken steps like strengthening national One Health surveillance efforts, assuring advanced and innovative diagnostic tests, running an Antimicrobial stewardship program and national awareness week, promoting improved international collaboration to slow down the AMR among the people, etc. Besides, the US Government enforced the FDA regulations to restrict antibiotics in animal feeds. These initiatives resulted in a 15% reduction in overall antibiotic prescriptions in the last decade. However, resistance persists due to continuous overuse of antibiotics in outpatient care and agricultural misuse.  Read more: Effective Home Remedies to Combat Bad Breath UK The UK has taken the National Action Plan focusing on the One Health approach, assuring strict regulation, and public campaigns named “Keep Antibiotics Working”. These measures helped to reduce 23% of human antibiotic consumption between 2014 and 2020. In recent years, the UK has undertaken a long-term plan“Confronting AMR 2024 to 2029.” However, in the case of rural areas, this problem is still prominent.  India India initiated the National Action Plan in 2017 to address this issue. Besides this, they started surveillance through the Indian Council of Medical Research. These resulted positively in creating awareness against AMR. However, inadequate data was found regarding the use of antibiotics in the agricultural sectors. Bangladesh Bangladesh also initiated a national action plan to improve surveillance along with the One Health approach and stewardship. Besides this, different surveillance units are active in different hospitals to combat the situation. Public awareness has been created but is limited. Weak enforcement of regulations of antibiotics, the profit-maximizing attitude of pharmaceutical companies, and unregulated pharmacies lead to the persistence of the AMR situation. Read more: Colon Cancer: Everything You Need to Know Key lessons for Bangladesh The developed countries exhibited a long-term plan to slow down the AMR problems. Furthermore, they are successful in reducing the percentage of AMR to a great extent. They are now working on surveillance and creating public awareness in curbing the effects of the AMR. Moreover, the developed countries are taking action to reduce the effect on the agricultural sectors which Bangladesh lacks.  Proposed solutions and reforms   Bangladesh needs to take both short-term and long-term plans to curb the effect of AMR. Here are some proposed solutions: - Introducing DHIS2 for every patient so that the diseases and prescriptions are documented and developed in such a way that if antibiotics are prescribed then signals will be sent to professionals. This will help to review the necessity of antibiotics.- Pharmaceutical companies should be properly regulated so that they cannot put pressure on doctors to prescribe unnecessary antimicrobials.- Public awareness should be created from the root level. The concept of AMR and its dreadful effect can be included in the national curricula.- The authorities may take initiatives to regulate the pharmacies and take the selling of antibiotics under surveillance. This will help the authorities to track the record of selling antibiotics.- Traditional methods of treatment like Unani, Ayurvedic medicines, and Homeopathy need to be revived by doing research.- The private sector in collaboration with NGOs may take initiatives to raise awareness among the rural people.- The international development partners need to collaborate with the government for funding and propose policies that are effective in different countries.- Doctors along with pharmacists should be properly trained about the AMR effects.- Mobile health courts may be established to regulate the local pharmacies. - The farmers need training and proper awareness should be created to control the use of antibiotics in the agricultural and livestock sectors.- The tannery industries should be taken under surveillance to reduce water pollution which is responsible for evolving germs in different ways. Read more: Why You Should Try Walking Backwards Conclusion In the 21st century, Antimicrobial Resistance (AMR) is a global concern, and Bangladesh is at high risk. Proper actions and reforms in the healthcare sector may control the situation. In this case, proper steps should be taken by the government in collaboration with the private sectors, like NGOs, development partners, doctors, and pharmaceutical companies. And, most importantly, the mass population of the country should stand against the AMR effects. Otherwise, it would result in health hazards, economic problems, and environmental concerns to a greater extent.

Over 50 percent of life-threatening bacterial infections are becoming resistant to treatment, the World Health Organization (WHO) has said in its new report. Also, high levels of resistance to treatment are reported in bacteria frequently causing bloodstream infections in hospitals, according to the Global Antimicrobial Resistance and Use Surveillance System report, published Friday, based on 2020 data from 87 countries. Antimicrobial resistance undermines modern medicine and puts millions of lives at risk, WHO chief Tedros Adhanom Ghebreyesus said. Within the context of national testing coverage, the report, for the first time, analyses antimicrobial resistance (AMR) rates, tracking trends in 27 countries since 2017. It reveals high levels of bacteria resistance, frequently causing life-threatening bloodstream infections in hospitals, such as Klebsiella pneumoniae and Acinetobacter spp, which require treatment with last-resort antibiotics, such as carbapenems. However, eight percent of those infections caused by Klebsiella pneumoniae were resistant to carbapenems, increasing the risk of death. Bacterial infections are becoming increasingly resistant to treatments, with over 60 percent of Neisseria gonorrhoea infections, a common sexually transmitted disease, showing resistance to ciprofloxacin, one of the most widely used oral antibacterials. Read: WHO: Digital app released to boost physical activity, help get children moving And over 20 percent of E.coli isolates, the most common pathogen in urinary tract infections, were resistant to ampicillin and co-trimoxazole, first-line drugs, as well as second-line treatments known as fluoroquinolones. Although most antimicrobial resistance trends have remained stable over the past four years, bloodstream infections due to resistant E.coli, Salmonella, and gonorrhoea infections have jumped by at least 15 percent compared to 2017 rates. More research is needed to discover why AMR has increased and the extent to which infections are related to hospitalisations and antibiotic treatments during the Covid-19 pandemic, according to the UN health agency. The pandemic also meant that several countries were unable to report data for 2020, it added."To truly understand the extent of the global threat and mount an effective public health response to AMR, we must scale up microbiology testing and provide quality-assured data across all countries, not just wealthier ones," Tedros said. New analyses show that countries with lower testing coverage – mostly low and middle-income countries (LMICs) – are more likely to report significantly higher AMR rates for "bug-drug" combinations. This may be partly because only a limited number of referral hospitals in many LMICs provide data for the WHO report. Read: Health must be at the centre in COP27 climate change negotiations: WHO These hospitals often care for the sickest patients who may have received previous antibiotic treatment. Meanwhile, in terms of antibiotic consumption, 65 percent of 27 reporting countries met the WHO's target of ensuring that at least 60 percent of antimicrobials are first or second-line treatments. "These 'ACCESS' antibiotics are effective in a wide range of infections with a relatively low risk of creating resistance. However, insufficient testing coverage and weak laboratory capacity, particularly in LMICs, make AMR rates difficult to interpret," the UN agency said.

Bangladeshi scientists made history by discovering a new antibiotic called Homicorcin. From the bacteria found in Jute seeds, they have discovered this outstanding antibiotic, which will fight against the powerful bacteria and save the lives of many patients. The study was published on May 27 in the ‘Scientific Reports’ journal of the international publisher Nature. Let's get to know more about this groundbreaking discovery. Background to Homicorcin discovery Starting from people's daily lives, Jute has long since enriched Bangladesh economically. So there has been a lot of significant work in different fields with this Golden Fiber. Bangladesh's famous geneticist late Dr. Maksudul Alam discovered the Jute gene design in 2010. Mubarak Ahmed Khan, Chief Scientific Adviser of Bangladesh Jute Mills Corporation, made various useful things from Jute. Among them Jutin (corrugated sheet) in 2009 and Sonali Bag (Polythene) in 2016 are notable. Finally, in the middle of 2021, the country's researchers found a life-saving medicine from that Jute. The antibiotic 'Homicorcin' is named after the scientific name of bacteria and Jute. Read: 'Golden fibre' no longer holds glitter for Khulna jute farmers Research for the antibiotic Six members have worked in the research for 3 years in the Molecular Biology Lab of Dhaka University. Among them, the senior Dhaka University Professor of Biochemistry and Molecular Biology, Professor Haseena Khan, Professor Dr. Mohammad Reazul Islam, and Professor Aftab Uddin of the Department of Genetic Engineering and Biotechnology lead the study. AHM Shafiul Islam Mollah, a member of the Bangladesh Council for Scientific and Industrial Research (BCSIR) also joined with them. Besides, 3 students of the Department of Biochemistry and Molecular Biology of the Faculty of Biological Sciences, Dhaka University, Shammi Akhter, Mahbuba Ferdous, Badrul Haider, and Al Amin were also researchers. Haseena Khan, who has been researching Jute for a long time, discovered various kinds of micro-organisms in Jute while studying the mystery of its life. The interest to know their characteristics basically leads to the new research. Amazing information comes out of the study. More than 50 micro-organisms live in the grooves of Jute fibers. These include a bacterium called ‘Staphylococcus hominis’ that makes something from its own body that kills other bacteria. That means the bacterium is behaving like a deadly antibiotic. Researchers have identified 5 variants of this antibiotic. Two of these have already been mentioned in the report. Work is still going on with the effectiveness of the remaining 3. Read: BUILD explores producing paper pulp from the whole jute plant Efficacy of Homicorcin Homicorcin can work very well in patients whose antibiotics are no longer working. This antibiotic can fight many powerful bacteria. There are some bacteria known as Superbugs that no conventional antibiotic can cure. This new antibiotic has also been successful in these cases. There are basically two types of antibiotics. One is Broad-Spectrum, which works in all types of micro-organisms. Another is the Gram-Positive and Gram-Negative. With just one broad-spectrum antibiotic, resistance to many germs can be developed simultaneously. So researchers have found this category to be very effective. But the problem is - once the antimicrobial resistance builds up, the antibiotic no longer works. Happily, Homicorcin did not fall into the Broad-Spectrum category. Not only that, but it has also changed the earlier perception of researchers about the category of Gram-Positive and Gram-Negative. Read: International tender called for reopening closed jute mills: Jute Minister In the end How quickly Homicorcin antibiotic reaches the public depends on adequate funding from the Government and pharmaceutical companies. It usually takes at least 5 years to market any antibiotic. Therefore, joint efforts of all Government and non-Government sectors to ensure a fast supply of this life-saving medicine are in high demand of time.

A lack of new treatments for common infections has left people dangerously exposed to the “world’s most dangerous bacteria”, the UN health agency said on Thursday.  The alert from the World Health Organization (WHO) is delivered in a report showing that none of the 43 antibiotics in development today sufficiently addresses the growing threat posed by 13 priority drug-resistant bacteria.  “The persistent failure to develop, manufacture, and distribute effective new antibiotics is further fuelling the impact of antimicrobial resistance and threatens our ability to successfully treat bacterial infections,” said Dr. Hanan Balkhy, WHO Assistant Director General on antimicrobial resistance.  Those most at risk are young children and those living in poverty, but antibiotic-resistant infections can affect anyone, said WHO partner AMR.  Youngsters at risk  According to WHO, three in 10 newborns who develop blood infections die, because the antibiotics that are used to treat sepsis are no longer effective.  Bacterial pneumonia – another preventable illness which has developed resistance to available drugs – is also a major cause of childhood mortality among under-fives.  WHO’s annual Antibacterial Pipeline Report, notes that almost all antibiotics available today are variations of those discovered by the 1980s.   We rely hugely on them in all areas of our lives, from having a tooth out at the dentist, to organ transplants and cancer chemotherapy.  Unproductive pipeline   But after reviewing antibiotics that are in the clinical stages of testing, as well as those in development, the report highlighted a “near static pipeline” of production, which WHO’s Haileyesus Getahun likened to the “Achilles heel” of global health security.   “Opportunities emerging from the COVID-19 pandemic must be seized to bring to the forefront the needs for sustainable investments in research and development of new and effective antibiotics,” said Mr. Getahun, WHO Director of Antimicrobial Resistance Global Coordination.    “We need a global sustained effort including mechanisms for pooled funding and new and additional investments to meet the magnitude of the antimicrobial threat.”   Only a few drugs have been given early-stage approval by regulators in recent years “and most of these agents…offer limited clinical benefit over existing treatments, WHO said, with the warning that the “rapid emergence of drug-resistance to these new agents” was a certainty.  Fractional gains  This was despite the fact that “some promising products” were in different stages of development, as only a fraction of these will make it to market in a sector hampered by the small return on investment from successful antibiotic products, which has limited the interest of most large pharmaceutical companies.   “Overall, the clinical pipeline and recently approved antibiotics are insufficient to tackle the challenge of increasing emergence and spread of antimicrobial resistance,” the UN agency concluded.  Driving research  To promote investment in antibiotics development, WHO and partner Drugs for Neglected Diseases initiative (DNDi) have set up the Global Antibiotic R&D Partnership (GARDP) to develop innovative treatments.   The UN health agency has also been working closely with other non-profit funding partners such as the CARB-X to accelerate antibacterial research.  Another important new WHO-partnered initiative is the AMR Action Fund, that was set up by pharmaceutical companies, philanthropists and the European Investment Bank; its aim is to strengthen and accelerate antibiotic development through pooled funding.