In the wake of National Antibiotics Awareness Week (14 to 20 November), the spotlight will fall on the critical role that vaccines are likely to play in curbing anti-microbial resistance (AMR) – at least in the foreseeable future until a new stream of antibiotics are brought to market, which according to experts may still be a long way off.
One of the country’s leading providers of antibiotics, Pharma Dynamics, will over the next few months be embarking on a national education campaign aimed at both healthcare practitioners and consumer to address the dangers of AMR, whilst promoting the responsible use of antibiotics. This supports the framework set by the National Department of Health (NDoH) to boost vaccine uptake within the public and private health systems by 2024.
Annemarie Blackmore, Pharma Dynamics’ Antimicrobials Category Manager, says the effective roll-out of the World Health Organisation’s (WHO) expanded programme of immunisation (EPI) is paramount in the ongoing fight against antibiotic-resistant superbugs. “Antibiotic resistance is when an antibiotic has lost its ability to effectively control or kill bacterial growth and is caused by the unnecessary and incorrect use of antibiotics.”
She explains that vaccines have the potential to decrease disease, which can in turn reduce the need for antibiotic use. “However, South Africa is still some way off in meeting its immunisation targets, which given the alarming rise in superbugs in recent years, has now become a top priority.”
The total immunisation coverage in the country over the 2013/2014 period stood at 84.4% according to the latest district health barometer by the Health Systems Trust – an NPO with a focus on improving health systems in the country. The figure points to a drop in almost ten percentage points from the 94% coverage, which was recorded the year prior, indicating a significant decline in the overall administration of vaccines.
Blackmore notes that there are some logistical and supply issues that could potentially play a role, such as a lack of access, as well as long queues and extended waiting periods particularly in the public sector. “Certain provincial health departments also failed to renew a memorandum of understanding that allowed medical staff in the private sector to use government vaccines.”
She adds that there also remains a misconception that vaccines could cause autism in children, which has sparked a wide debate on social media and the news around the safety of vaccines.
“The outcry by parents and healthcare-givers was triggered by news reports of a now retracted British study that linked autism to the childhood vaccine for Measles, Mumps and Rubella (MMR). The study has since been proven fraudulent by an investigation published in the British Medical Journal (BMJ), but the damaging effects remain, and as a result, many parents are in two minds about whether to vaccinate their children.”
Dr Malcolm Miller, Intensivist and Anaesthesiologist at the University of Cape Town’s (UCT) academic hospital, adds his voice to the debate.
“Contrary to these mistaken beliefs, vaccines are and will continue to play a pivotal role, and even more so in the next two to three decades, in combatting anti-microbial resistance. As an example, if rolled out globally, the pneumococcal conjugate vaccine – used to protect against the streptococcus pneumonia bacterium – could effectively avert 11.4 million days of antibiotic use per year in children under the age of five. Meningitis and pneumonia are life-threatening diseases caused by this bacterium, which kill more than an estimated 800 000 children annually, yet some still choose not to vaccinate against it. S.pneumoniae is one of the vaccines that form part of the NDoH’s expanded programme of immunisation.”
According to Dr Miller there is more than a 30-year void in the discovery of new types of antibiotics, with no registered classes of antibiotics having been discovered since 1984, which reaffirms the importance of using what precious antibiotics we do have, responsibly. “Already AMR is estimated to kill more than 700 000 people globally per year. If not addressed, 10 million people are expected to die annually because of drug-resistance by 2025.”
To succeed will require a concerted effort by all, including big pharma.
Blackmore’s message to consumers is clear. “The onus of antibiotic stewardship does not only fall on the shoulders of medical professionals. Everyone can and should play their part by vaccinating themselves and their loved ones against the diseases outlined in the expanded immunisation programme. To access this list, visit http://pharmadynamics.co.za/wp-content/uploads/2016/11/VaccinatorsManualFinal.pdf.”