WORLD Antimicrobial Awareness Week (WAAW) is observed annually from 18-24 November to raise awareness, promote understanding, and encourage best practices among all stakeholders to combat antimicrobial resistance (AMR). This year’s theme, “Educate, Advocate and Act Now”, highlights the need to educate stakeholders about AMR, advocate for bold commitments, and take concrete actions to prevent and address AMR.
A 2014 report projected that the failure to contain AMR could lead to 10 million deaths globally by 2050. 1 Similarly, a 2024 report by the World Organisation for Animal Health and the World Bank estimated that AMR could reduce global economic output by USD1.5 trillion annually. Malaysia recorded 3,500 AMR-related deaths in 2019 alone, underscoring the urgency of addressing this clear and present danger.
AMR refers to resistance to antibiotics, antivirals, antifungals, and antiprotozoals. A multisectoral, multidisciplinary, and multi-stakeholder approach is needed to combat this issue. On 26 th September 2024, the United Nations General Assembly High Level
Meeting on Antimicrobial Resistance endorsed a political declaration to tackle AMR, reinforcing commitments to reduce its impact on humans, animals, and the environment. Since 2017, Malaysia has acted by forming the National Antimicrobial Resistance Committee (NARC) which coordinates efforts to combat AMR through the implementation of the Malaysian Action Plan on Antimicrobial Resistance (MyAP-AMR).
Antimicrobials are used in humans, animals, and plants, making it essential to engage all stakeholders to increase awareness and encourage urgency to tackle AMR effectively. In the animal health sector, various measures have already been implemented, but there is a need to strengthen and enhance these initiatives.
The role of education and awareness
A lack of awareness and insufficient knowledge of the mechanisms and risks of drug resistance exacerbate AMR in animals while its spread to humans and the environment has been reported. Continuous education programmes are crucial to inform stakeholders about AMR and its implications.
Phasing out antimicrobial use as growth promoters
The use of antimicrobials in animal feed as growth promoters impacts AMR. Recognising this, Malaysia’s Department of Veterinary Services has banned 14 antimicrobials for use in feed additives and growth promoters. This aligns with global efforts to phase out medically important antimicrobials for non-therapeutic purposes.
Strengthening veterinary prescriptions
Understanding infections and proposing appropriate treatment should be based on proper evaluation by professionals. Veterinarians should use treatment guidelines and the use of antimicrobial sensitivity tests (AST) to identify the microbes causing the infections. Narrow-spectrum antimicrobials should be used as compared to broad-spectrum ones to reduce the occurrence of AMR.
Continuous reporting of antimicrobial use and AST results by private practitioners to the Department of Veterinary Services is vital for monitoring the impact and spread of AMR and assessing the effectiveness of interventions.
Exploring alternatives to antimicrobials
Evidence-based alternatives, such as organic acids and their salts, phytogenic additives, prebiotics, probiotics, and direct-fed microbial enzymes, should be considered for use in the animal industry. However, its use must consider cost, efficacy, and its unintended consequences.
Enhancing biosecurity measures
Reducing antimicrobial use in farms necessitates robust biosecurity measures, including customised vaccination programmes, proper nutrition, and effective animal husbandry practices such as proper hygiene, sanitation, and management of manure. Improved housing systems for farm animals, such as closed-house farming systems for poultry and swine will enhance productivity, reduce disease burden, and lower mortality rates. Despite their benefits, adoption remains low in Malaysia. Government support in streamlining approvals and reducing costs could facilitate wider adoption.
Closed-house farming systems not only improve animal health and productivity but also mitigate the environmental impact of farming. Collaboration between the public and private sectors is essential to modernise farming infrastructure. Such initiatives would position Malaysia’s agricultural sector for sustainable growth while addressing critical issues like antimicrobial resistance.
Addressing online sales and disposal practices
The unregulated online sales of antimicrobials and illegal drugs contribute to self-medication and AMR. Strict enforcement of regulations and public reporting through platforms such as https://moh.spab.gov.my is essential. Veterinarians should also educate farmers and pet owners about the proper disposal of expired or unused antimicrobials to minimise environmental exposure.
Antimicrobials are essential for treating infections, but their use must be prudent, responsible, and appropriate. Addressing AMR requires collective responsibility from all stakeholders, emphasising solutions and collaboration. WAAW 2024 is a crucial opportunity to unite efforts in combating this global challenge with a whole-of-society approach.
Datuk Dr Quaza Nizamuddin Hassan Nizam, a Professor at the Faculty of Health and Medical Sciences, Taylor’s University. He previously served as the Director-General of the Department of Veterinary Services Malaysia (2017-2020) and as the President of the Federation of Asian Veterinary Associations (2020-2022).
