Antimicrobial resistance (AMR) has become a pressing global health concern, with pathogens increasingly developing resistance to drugs designed to eliminate them. This crisis threatens to undermine decades of medical progress by rendering common infections difficult, if not impossible, to treat. Kenya, like many other nations, faces a growing challenge from AMR, as demonstrated by a 2019 report indicating that about 8,500 Kenyans died of easily treatable diseases due to medication failure. As the country steps up its fight against AMR, a new political declaration by the United Nations (UN) brings renewed focus on reducing deaths and ensuring sustainable national action to curb the spread of resistant pathogens.
The Global Scope of AMR
Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites adapt and no longer respond to medicines designed to kill them. This resistance allows infections to persist, spread, and become more dangerous, with significant implications for human health, animal welfare, and the environment. Globally, an estimated 4.95 million deaths per year are linked to bacterial AMR, making it one of the leading causes of death worldwide.
The United Nations has identified AMR as a critical threat that transcends national borders. The rising tide of resistant infections threatens not only public health systems but also food security and economic stability. It is a crisis that requires collective global action, as no country can effectively address the problem in isolation.
Kenya’s AMR Burden
In Kenya, the consequences of AMR are already being felt. According to data from the Institute for Health Metrics and Evaluation, an estimated 37,300 deaths in 2019 were associated with AMR, with 8,500 of these deaths resulting from diseases that should have been easily treatable if not for medication failure. These figures reflect the severity of the situation and underscore the need for urgent action.
Kenya has made commendable progress in developing national action plans to address AMR, but implementation has been slow due to inadequate funding and resource constraints. While the country ticks most of the boxes when it comes to strategic planning and policy frameworks, gaps remain in financing, infrastructure, and capacity-building. The challenge now is to accelerate the pace of action and secure the necessary resources to combat AMR effectively.
The 79th United Nations General Assembly High-Level Meeting on AMR
On September 21, 2023, world leaders convened at the 79th United Nations General Assembly for a high-level meeting on AMR. The outcome of this meeting was the approval of a political declaration that sets out a clear set of targets and actions to combat the growing threat of drug resistance. Although political declarations are not legally binding, they are significant in shaping global policy and guiding national responses.
One of the key targets of the declaration is to reduce the estimated 4.95 million annual human deaths associated with bacterial AMR by 10 percent by 2030. This ambitious goal reflects the urgency of the situation and the global commitment to reversing the rising tide of resistance. To achieve this, countries are called upon to establish sustainable financing mechanisms, improve infection prevention and control (IPC), and promote the responsible use of antimicrobials in human health, agriculture, and animal care.
Financing the Fight Against AMR
One of the central challenges in combating AMR is securing adequate funding. The declaration acknowledges the need for sustainable national financing to support AMR action plans. It calls for the establishment of a $100 million catalytic fund to help at least 60 percent of countries have funded national action plans on AMR by 2030. This fund is expected to act as a catalyst for diversifying funding sources and encouraging more contributors to the Antimicrobial Resistance Multi-Partner Trust Fund.
For Kenya, this funding could prove pivotal. Despite having a national action plan in place, progress has been hampered by limited financial resources. Establishing a dedicated national fund to support AMR initiatives would enable the country to scale up its efforts in surveillance, research, education, and healthcare capacity-building. Additionally, the funds could support the development of new antimicrobials and alternative therapies, which are essential to staying ahead of evolving pathogens.
The Role of the Environment in AMR
The UN’s declaration also recognizes the critical role that the environment plays in the development and spread of AMR. Environmental factors, such as the contamination of water sources with antimicrobial residues, contribute to the proliferation of resistant pathogens. According to Inger Andersen, the executive director of the United Nations Environment Programme (UNEP), the environment must be part of the solution to AMR if the global community is to reduce the burden of resistance and mitigate its risks.
In Kenya, pollution of water bodies and improper waste management in healthcare facilities and agricultural operations have been identified as key contributors to the spread of AMR. Reducing environmental contamination with antimicrobials will be essential to curbing the transmission of resistant pathogens. This will require strengthening regulations around the disposal of pharmaceutical waste, improving sanitation and hygiene infrastructure, and promoting sustainable agricultural practices.
Human Health and AMR
A significant portion of the UN’s declaration focuses on human health. One of the primary targets is to ensure that at least 70 percent of the antibiotics used for human health globally come from the World Health Organization (WHO) Access group. These antibiotics are classified as having relatively minimal side effects and a lower potential to contribute to AMR. By promoting the use of safer antibiotics, the declaration seeks to slow the emergence of resistance while ensuring that patients continue to receive effective treatments.
In addition to antibiotic stewardship, the declaration emphasizes the need for improved infection prevention and control (IPC) measures. By 2030, 100 percent of countries are expected to have basic water, sanitation, hygiene (WASH), and waste management services in all healthcare facilities. Meeting these targets will require substantial investment in healthcare infrastructure, particularly in low- and middle-income countries like Kenya.
Kenya has made progress in improving IPC measures, but challenges remain, particularly in rural areas where access to clean water and sanitation is limited. Strengthening IPC programs and ensuring that all healthcare facilities meet WHO’s minimum requirements will be critical to reducing the spread of resistant infections in hospitals and clinics.
Agriculture, Animal Health, and AMR
AMR is not just a human health issue; it also affects agriculture and animal health. The overuse and misuse of antimicrobials in livestock farming and food production contribute to the development of resistance in animal populations, which can then be transmitted to humans through the food chain. The UN declaration calls for a meaningful reduction in the quantity of antimicrobials used globally in agri-food systems by 2030.
In Kenya, agriculture is a key sector of the economy, and the use of antimicrobials in livestock farming is common. To address AMR in this sector, the country will need to prioritize infection prevention and control in animal health and promote the responsible use of antimicrobials. This includes adopting best practices in animal husbandry, improving veterinary oversight, and reducing the use of antibiotics as growth promoters in livestock.
The World Organisation for Animal Health (WOAH) has highlighted the devastating impact of AMR on livestock health and the economy. As Kenya seeks to strengthen its agricultural sector, addressing AMR will be essential to protecting both animal and human health and ensuring food security.
The Path Forward: Translating Commitments into Action
The UN’s political declaration on AMR is a significant step forward, but it is only the beginning. To translate these commitments into action, countries must invest in comprehensive national action plans that address the root causes of AMR. This includes improving surveillance and monitoring systems, expanding access to diagnostics, and promoting public awareness of the dangers of overusing and misusing antimicrobials.
For Kenya, the path forward will require a multi-sectoral approach that brings together healthcare professionals, policymakers, researchers, and communities. Strengthening collaboration between human health, animal health, and environmental sectors will be essential to addressing the complex challenges posed by AMR.
Moreover, Kenya will need to engage with international partners and donors to secure the necessary funding and technical assistance to implement its national action plan. The establishment of a national AMR fund, as recommended by the UN, could provide a sustainable source of financing for these efforts.
Conclusion
As Kenya joins the global effort to combat antimicrobial resistance, the stakes have never been higher. With thousands of lives lost each year to drug-resistant infections, the need for urgent action is clear. The UN’s political declaration on AMR provides a roadmap for reducing the burden of resistance, but success will depend on sustained political will, adequate financing, and effective collaboration across sectors.
By investing in AMR prevention and control, Kenya can protect the health of its citizens, safeguard its agricultural sector, and contribute to the global fight against one of the most pressing health challenges of our time.
