Khalid Mahmood, Managing Director & CEO, Getz Pharma, speaking at the National Antimicrobial Stewardship (AMS) Summit
Antimicrobial Resistance (AMR) is the third leading cause of death in Pakistan, where it is estimated that around 300,000 people die annually due to drug-resistant bacteria, while AMR contributes to 700,000 deaths annually, health officials, public health experts, physicians, and policymakers said on Sunday. Deploring that Pakistan is the third largest consumer of antibiotics in the world after China and India, they noted that antibiotic medicines worth Rs. 126 billion were consumed in 2023 alone in Pakistan. They urged people not to purchase and use antibiotics without the advice of trained and qualified physicians.
“Antimicrobial resistance is now the third leading cause of death after cardiovascular disease and maternal and neonatal disorders in Pakistan because we now have infections caused by bacteria that are not responding to third- and fourth-generation antibiotics. Abuse of antibiotics by doctors, quacks, and people themselves is making these important medicines highly ineffective,” Prof. Shahzad Ali Khan, Vice Chancellor of Health Services Academy (HSA) Islamabad, told a news conference at Getz Pharma’s dedicated and segregated Astola manufacturing factory in Karachi.
The press conference was held in connection with Pakistan’s first National Antimicrobial Stewardship Summit 2024, organized by Getz Pharma in collaboration with the Ministry of National Health Services, Regulations & Coordination (MoNHSRC), Health Services Academy (HSA) and the National Institute of Health (NIH) Islamabad.
The AMS summit was attended by over 1,400 healthcare professionals, including health secretaries and director generals from federal and provincial governments, officials from NIH Islamabad, the Drug Regulatory Authority of Pakistan, office-bearers of 13 medical societies, healthcare regulatory authority officials, senior physicians, policymakers and students.
Prof. Shahzad Ali Khan maintained that antibiotics are ‘wonder drugs’ that saved millions of lives during world wars and pandemics, but their irrational use or abuse has led to Antimicrobial Resistance, which is now becoming a global public health concern.
(L-R) Dr. Afreenish Amir, Project Director of AMR/National Fungal Disease Surveillance System, NIH, Prof. Javed Akram, Former Punjab Health Minister and President of the Pakistan Society of Internal Medicine (PSIM) and Dr. Shahzad Ali Khan, Vice Chancellor, Health Services Academy, sharing their insights at the National Antimicrobial Stewardship (AMS) Summit press conference
“Self-medication, unjustified prescription of antibiotics by quacks and physicians, taking antibiotics for a shorter duration, and the production of substandard antibiotics by some companies are some of the major causes of antimicrobial resistance,” he added. Former Punjab Health Minister and President of the Pakistan Society of Internal Medicine (PSIM), Prof. Javed Akram, lauded Getz Pharma for organizing the summit on this important issue and termed antimicrobial resistance as the third major challenge facing Pakistan after population growth and non-communicable diseases (NCDs).“People are now dying due to infections that are extremely hard to treat due to the resistance developed by bacteria against these medicines,” Prof. Akram deplored. “On one hand, Pakistan has become the world capital of diabetes and other non-communicable diseases, and on the other, we have developed Extremely Drug-Resistant (XDR) typhoid, Multi-Drug Resistant (MDR) TB, and various other infections that are extremely hard to treat with most of the available antibiotics. This is because we have been using antibiotics like candies,” he opined. Urging people to consider antibiotics as poison, he said people should not consume antibiotics on their own like they do with cancer drugs, saying antibiotics have similar side effects as cancer treatment therapies.
NIH representative and senior microbiologist Dr. Afreenish Amir said AMR has spread to almost all countries and regions, including Pakistan, owing to the “misuse and overuse” of antibiotics. This contributes to the increasing burden of infections due to resistant bacteria while limiting treatment options for managing such infections. Health experts also highlighted the overuse and abuse of antibiotics in the livestock sector and claimed that the abuse of antibiotics in the veterinary sector was responsible for 80 percent of AMR. They called for creating awareness among the masses regarding the irrational use of antibiotics in humans, livestock, and poultry sectors.
Renowned pediatrician and public health scientist Prof. Zulfiqar Bhutta, in his keynote address, urged people to get their children vaccinated against typhoid, saying Pakistan is the only country in the world where the Typhoid Conjugate Vaccine (TCV) is being administered to children to prevent them from the drug-resistant water-borne disease. Dr. Wajiha Javed, Associate Director of Public Health at Getz Pharma, said over-the-counter availability of antibiotics, use of these medicines for a shorter duration, and unnecessary prescription of antibiotics by quacks and doctors should be looked into by the authorities. She added that substandard antibiotics containing less or low-grade raw materials were also responsible for AMR and announced that Getz Pharma was working with NIH and the government to develop a national action plan on AMR.
On the occasion, a declaration was also signed between the Health Services Academy (HSA), NIH Islamabad, and Getz Pharma for the implementation of Antimicrobial Stewardship (AMS) while Memorandums of Understanding (MoU) were also signed with 13 medical societies for Antimicrobial Stewardship.
National Antimicrobial Stewardship Summit Abstract Poster Award Winners
The summit also featured a ceremony for the Abstract Poster Award Winners, celebrating outstanding contributions from across Pakistan. Around 216 abstracts were submitted, and the jury selected three winners.
1st Position
Rational use of antibiotics in an intensive care unit: A retrospective study of the impact on clinical outcomes and mortality rate
Names: Muhammad Ali, Humaira Naureen, Muhammad Haseeb Tariq, Muhammad Junaid, Farrukh, Abubakar Usman, Shahana Khattak & Hina Ahsan
Institute: Salim Habib University
2nd Position
WHO Point Prevalence Survey to Describe the Use of Antimicrobials at a Tertiary Care Center in Pakistan: A Situation Analysis for Establishing an Antimicrobial Stewardship Program
Names: Quratulain Shaikh, Samreen Sarfaraz, Anum Rahim & Aneela Hussain
Institute: Sind Infectious Diseases Hospital and Research Center
3rd Position
Behavioral Drivers Of AMR In Economically Challenged Country: Insights From A Public KAP Survey
Names: Ale Zehra, Warisha Sheikh, Abeera Afzal & Alizay Zaheer
Institute: Dow University of Health Sciences
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