Drugs vs Bugs

Widespread abuse of antibiotics has led to patients not responding to treatment because bacteria causing infections have developed resistance to the drugs. 

In 2021 alone, the last year for which statistics are available, nearly 20,000 patients died because the antibiotics they were prescribed did not work for such diseases as tuberculosis, pneumonia and other infections. 

Now, public health experts are pushing for vaccines to address the growing threat of antimicrobial resistance (AMR) in Nepal. Vaccines are highly effective tool since they prevent infections, reduce the need of antimicrobial use thereby mitigate the emergence and spread of AMR.

Last week, the Global Antibiotic Resistance Partnership Nepal (GARP -Nepal) in collaboration with Nepal Public Health Foundation and The One Health Trust launched a policy brief titled ‘The Value of Vaccines to Mitigate Antimicrobial Resistance’. 

“We need to integrate vaccines more effectively into national AMR strategies and cross-sectoral collaboration under the One Health framework,” said Sharad Onta of the Nepal Public Health Foundation. “The solution to antimicrobial resistance in Nepal is prevention, since there is no cure for it. And vaccines are an effective tool.”

Narayan Dhakal of the Department of Drug Administration (DDA) agreed that preventing infections was easier and cheaper than treating it with antibiotics. He added: “Promoting WASH (Water, Sanitation, and Hygiene) and infection prevention measures can be effective complementary strategies.”

The launch event brought together a wide range of stakeholders, including representatives from the Ministry of Health and Population, the Department of Livestock Services, academia, clinical professionals, veterinarians and non-government stakeholders like World Health Organisation, and FHI360.

Overuse of antibiotics in the veterinary sector has also contributed to AMR in humans due to the chicken, eggs and various other meats in the food chain.  

Paras Kumar Pokharel of GARP-Nepal said: “Effective vaccination programs can lead to herd immunity, where a large proportion of the population is immune, protecting even those who are not vaccinated. So, maximise coverage and minimise anti-microbial uses.” 

Sameer Mani Dixit of the Centre for Molecular Dynamics Nepal (CMDN) said: “We need more action, not more words to fight AMR in Nepal.”

The GARP policy brief recommends actions that include sustained policy advocacy, use of health economics to demonstrate vaccine benefits, and learning from best immunisation practices. It calls for inclusion of the livestock sector, adherence to treatment guidelines, prioritisation of high-risk populations, and improved surveillance systems. 

The brief also emphasises the need for evidence generation, investment in vaccine development and regulatory support, international collaboration, and efforts to ensure equitable access, public education, and AMR awareness.