Combating Antimicrobial Resistance through Vaccination and Improved Sanitation

Strategic Insights -

Antimicrobial resistance (AMR) poses a significant threat to global health, with millions of lives lost each year due to untreated infections. While vaccines and antibiotics are often used to treat infections, many people do not understand the crucial role that vaccination plays in preventing infections and reducing the spread of antibiotic-resistant bacteria. In South Africa, where AMR is a major public health concern, vaccination has been shown to have a significant impact on reducing morbidity and mortality. However, there is a need to integrate AMR and vaccination strategies to maximize the benefits of vaccination in preventing infections and reducing the need for antibiotics.

Key Takeaways:

  • Vaccines can reduce the emergence and transmission of susceptible and drug-resistant strains, lower the risk of secondary infections, and reduce the need for antimicrobial use.
  • In South Africa, vaccines such as pneumococcal conjugate vaccine (PCV) have led to a significant reduction in disease caused by penicillin-resistant isolates in children under two years old.
  • Vaccines targeting viruses can mitigate AMR by lowering the occurrence of secondary bacterial infections and reducing the number of viral infections that are inappropriately treated with antibiotics.
  • The rotavirus vaccine could prevent an estimated 6% of cases of diarrhea in children under two years of age annually, while the maternal (RSV) vaccine was shown to reduce the number of antibiotic prescriptions in the first three months of life.
  • Investing in vaccine access and development is crucial in low- to middle-income countries, where AMR disproportionately impacts people living in poverty.
  • Improved access to clean water, sanitation, and hygiene, as well as aligning infection prevention standards in hospitals with those in high-income countries, could prevent 247,800 and 337,000 AMR-associated deaths annually, respectively.

Statistics:

  • 77,784 deaths in South Africa in 2021 were due to infections, with 35,054 associated with AMR and 8,485 due to bacterial resistance to antibiotics.
  • 1 in 5 infections is due to antibiotic-resistant bacteria.
  • Every year, 700,000 people die worldwide due to antibiotic resistance.
  • 70% of all antibiotics use is in low- and middle-income countries.
  • In South Africa, just 30% of the population aged over 65 years are vaccinated against seasonal influenza, with an estimated 11,000 inappropriate antibiotic prescriptions averted annually.

Sources:

  • World Health Organization
  • University of Cape Town
  • South African National Department of Health
  • The Global Antibiotic Partnership — South Africa (GARP-SA)
  • Dr Elloise du Toit, Antimicrobial Resistance (AMR) consultant and microbiologist
  • Dr Erta Kalanxhi, Fellow and Director of Partnerships at the One Health Trust
  • Professor Adrian J Brink, Wernher and Beit Professor and Chair; Head of the Division of Medical Microbiology at the Faculty of Health Sciences, University of Cape Town.