Holistic approach needed to stop antibiotic abuse

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Interdepartmental efforts to end the misuse and abuse of antibiotics, although delayed, are welcome. The Minister of Health, who chaired the inter-ministerial meeting on October 4, indicated that the general directorate for drug administration and other authorities such as the general directorate of health services, the ministry of fishing and farming and the Food Safety Authority had been asked to step up surveillance and control the widespread use of antibiotics and the sale of drugs without a prescription. The prescription was born as the unapproved use of antibiotics relentlessly contributes to it. On April 25, 2019, the High Court also called on the government to stop sales of over-the-counter antibiotics. The court issued the order amid growing human resistance to antibiotics. A study conducted by Bangabandhu Sheikh Mujib Medical University in 2016-2018, made public in November 2019, showed that high overuse of antibiotics created a great risk of antimicrobial resistance. The study, conducted on behalf of the Directorate General of Drug Administration with support from the World Health Organization, found that antibiotic consumption in 2018 was 21.78 defined daily doses per 1 000 inhabitants, compared to 19.87 in 2017 and 16.65 in 2016. The 2018 figure marked an increase of 30.8 percentage points compared to the 2016 figure, suggesting a serious concern about the use of antibiotics.

A situation like this not only puts the current population at risk, but also endangers the lives of people in the future, because the misuse and abuse of antibiotics, even in cases where antibiotics are not needed, allow bacteria to mutate and adapt to counter antibiotics, leading to antimicrobial resistance. The minister, who also issued a warning about the human consumption of antibiotics through meat and fish, noted that the Drugs Bill 2020, which the cabinet approved on August 11 for passage in as a law, provides for severe penalties against pharmacists in the event of overuse. – the sale of antibiotics over the counter and for doctors in the event of a prescription for antibiotics that can be qualified as misuse. But simply enacting a law, with punitive provisions, no matter how strict or severe, would make no sense unless authorities enforce the law and take a holistic approach to ending misuse. and antibiotic abuse. In addition, national health managers should also ensure that antibiotics, which enter humans through agricultural products, where antibiotics are used as an input, and through meat and fish, where antibiotics are used in animal feed and fodder, are also not abused or misused. All authorities responsible for public health, food and agriculture should work in coordination within an overarching legal framework to end the misuse of antibiotics.

The responsibility to end the misuse of antibiotics lies not only with patients, but also with food producers, cattle farmers and poultry farmers. But above all, everything rests on a horde of public bodies whose mandate is to take care of health, agriculture, food, fishing and breeding. The government must therefore overhaul the protocols for the administration and sale of antibiotics and involve all stakeholders in its fight against the misuse and abuse of antibiotics.

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