by Salla Sariola
Kaisa Haukka and Salla attended the AMR – One Health conference in Benin. The event was organized by AMRIWA partners in Benin, Prof Dissou Affolabi and his team. The event was attended by West African researchers and doctors and WHO staff working on AMR. During a round table discussion., Dr. Bernadette Ramirez from WHO asked participants to raise their hands about their backgrounds to get a sense which fields the members of the audience came from. The point that she was making was that to tackle AMR, a One Health approach was needed because resistant bacteria move between human, animal and environmental sources. When she asked how many people in the audience were from environmental studies, one person raised her hand, Kaisa. When the animal and veterinary side was enquired, about 6 people raised their hands. The rest were from clinical backgrounds, apart from one social scientist, Salla.
The presentations were a mix of talks by WHO policy makers about global recommendations; concerning microbiological and clinical prevalence, and regarding different methods used to gauge the prevalence of AMR. Among the talks there were also presentations that described practices that spread AMR, and the unregulated and wide use of antimicrobials for humans and animals. Listening to the talks, very quickly it became clear that development plays an important role in the spread of AMR, meaning that why AMR spreads is as a complicated multi-sectorial problem defined by absences: infrastructure, and technical skills. Issues underlying the spread of AMR that the participants identified included: not of following basic sanitation practices (such as hand wash) in some hospitals and health care centres; expectations for rapid recovery by people that leads to the use of pharmaceuticals without prescription; low awareness of antibiotics among pharmacists and health care practitioners; unavailability or imprecision in diagnostic tests; weak collaboration between different government sectors; absence of regulation for animal antibiotic use; over-medication with antibiotics both as treatment and as prophylaxis for both humans and animals; absence of AMR surveillance structures nationally and regionally; disconnect between researchers and policy makers and practitioners; the list goes on… These challenges provide some explanations for why Africa has the highest number of AMR related deaths in the world. Clearly, there is much scope for social sciences to emphasize that AMR is not merely a biological condition but that the practices that drive its spread are social. Biomedicine alone cannot solve this multi-faceted issue.