Silent pandemic: Why antimicrobial resistance demands our attention

__________________

OPINION

By Dr Loryndah Olive Namakula

This November, as Uganda joins the world to mark the World Antimicrobial Resistance Awareness Week (18–24 November), we are reminded that one of the greatest threats to global health is unfolding quietly around us: antimicrobial resistance (AMR). AMR has the potential to make simple infections deadly once again, but this can be prevented. Everyone has a role to play.

You can join the fight against AMR by using antimicrobials only when prescribed by a healthcare worker, completing doses, participating in vaccination, ensuring proper sanitation and hygiene, and, for farmers, using antimicrobials only to treat animals, not as an animal growth product. Most importantly, spread awareness about AMR. This is the first step towards mitigation. 

Antimicrobials, including antibiotics, antivirals, and antifungals, have saved countless lives since their discovery. But today, these lifesaving medicines are losing their power. Bacteria, viruses, fungi, and parasites are adapting, developing resistance, and rendering once-effective treatments useless. The result is that common infections are becoming harder and sometimes impossible to treat.

Antimicrobial resistance happens when bacteria, viruses, fungi, and parasites adapt and stop responding to medicines designed to kill them. As a result, infections last longer, spread more easily, and become more difficult to cure. Without action, minor infections, injuries, routine surgeries, and even childbirth could once again become life-threatening. We could enter a post-antibiotic era, where simple infections become deadly once again.

The World Health Organisation calls AMR a “silent pandemic” and describes it as one of the top ten global public health threats facing humanity. Each year, it is estimated that nearly 5 million deaths worldwide are associated with drug-resistant infections.

Here in Uganda, the threat is real. Studies show rising antimicrobial resistance among common bacteria that cause pneumonia, diarrhea, and bloodstream infections. A study by the Uganda National Institute of Public Health, using national antimicrobial resistance surveillance data from 2018–2021, highlighted a concerning rise in antibiotic resistance in Uganda over the four-year period, with significant increases observed across different classes of antibiotics, including commonly used agents. Health workers across districts have reported challenges finding effective antibiotics for patients, a warning sign that AMR is already undermining our health system.

Antimicrobial resistance is not just a hospital problem. It is a public health emergency that affects everyone. Antimicrobial resistance is caused by the misuse and overuse of antibiotics in both humans and animals. Many people buy antibiotics over the counter without prescriptions, stop treatment too early, or use antibiotics for viral illnesses such as the flu, where they offer no benefit. This causes antimicrobial resistance.

The problem extends beyond human medicine. In livestock farming, antibiotics are sometimes used to promote animal growth rather than to treat disease. This contributes to resistance that can later reach humans through food, soil, and water. Because microbes know no borders, AMR has become a global health security threat. A resistant infection that emerges in one country can quickly spread to another through travel and trade.

To control this growing threat, scientists rely on epidemiology and surveillance. Through systems like the WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS), countries collect data on resistance patterns to guide treatment and prevention. Uganda participates in this global effort through national laboratories and field epidemiologists who monitor antimicrobial resistance trends and investigate outbreaks. Without reliable data, health workers and policymakers are essentially fighting blind. By knowing which drugs are losing effectiveness, they can guide appropriate prescriptions and prevent further misuse.

But AMR is not a fight for scientists and doctors alone. Every Ugandan has a role to play. You can join the fight against antimicrobial resistance by using antibiotics only when prescribed by a qualified health worker, and never share or keep leftover medicines. Always complete the full treatment course, even if you feel better. Practice good hygiene, wash hands regularly, prepare food safely, and maintain clean surroundings to reduce infections.

Vaccinate yourself and your children, because vaccines prevent diseases that would otherwise require antimicrobials, reducing the need for antimicrobials. Support responsible farming by buying food from farmers who use antibiotics appropriately. Most importantly, talk to family and friends about the danger of misuse. Awareness is the first step toward change.

The fight against antimicrobial resistance demands collective effort. Policymakers must invest in laboratories, surveillance, and public education. Health professionals must prescribe wisely, and farmers must reduce unnecessary antibiotic use in animals. If we fail to act, the medicines that have protected us for decades could stop working. But if we act together, with knowledge, responsibility, and determination, we can preserve these life-saving drugs for generations to come.

As Uganda joins the World in marking the World Antimicrobial Resistance Awareness Week, let this be a call to action. Let us remember that this silent threat can be reversed through collective action. By spreading awareness, using antibiotics responsibly, strengthening surveillance, and supporting public health efforts, we can safeguard the effectiveness of these precious medicines for generations to come. 

The writer is a Field Epidemiology Fellow with the Uganda Public Health Fellowship Program, hosted at the National Public Health Emergency Operations Center (NPHEOC), Ministry of Health.