The purpose of antimicrobial drugs is to combat diseases that can be of bacterial, viral and parasitic origin. But when they are misused or overused, these microorganisms can mutate genetically causing resistance to these drugs1. Antimicrobial Resistance (AMR) is a serious global threat to human and animal health, affecting food safety, food security and the economic well-being of millions of small and large-scale agricultural productions2.
AMR is considered a multisectoral problem of great importance worldwide, which is why health organizations such as the Food and Agriculture Organization of the United Nations, the World Organization for Animal Health and the World Health Organization created the "One Health" approach. This approach is implemented to have a better coordination and elaboration of programs that comprise the interface between human and animal health, food production and agro-ecological environments, with the purpose of preventing and being prepared for future threats, such as zoonotic diseases, food safety and AMR.
AMR is considered a major threat to modern medicine and to the sustainability of an effective response to the threat of infectious diseases. For such reason the World Health Assembly, in May 2015, adopted the Global Action Plan on Antimicrobial Resistance, where five objectives were established : (i) to have better communication and education on antimicrobial resistance with the aim of creating understanding and awareness of the issue; (ii) to strengthen this knowledge through surveillance and research; (iii) to reduce the incidence of infections by implementing effective biosecurity, hygiene and infection prevention measures; (iv) to optimize the use of antimicrobial drugs in human and animal health; and (v) to intensify sustainable projects and investments for the development of new drugs, vaccines and diagnostic means3.
This resolution commits the member countries to develop national and multisectoral action plans with a "One Health" approach, which is why in Ecuador the National Plan for the Prevention and Control of Antimicrobial Resistance was established to fight AMR and to have national action plans harmonized with the global action plan.
In order to establish a national plan, it is of vital importance to know the consumption data of antibiotics generally used in infectious diseases, both in humans and animals. Ecuador does not have this information, so it is hypothesized that the indiscriminate and inappropriate use of antibiotics has caused serious consequences such as increased morbidity and mortality of patients suffering from infectious processes, as well as an increase in the cost of health care due to the search for options that can combat infectious diseases with antibiotics that do not present resistance and that do not determine a high cost4.
The Ecuadorian State has been working against AMR since 2017, through the Ministry of Health and the Ministry of Agriculture and Livestock, executing the National Plan for the Prevention and Control of Antimicrobial Resistance. The focus is the rational use of antimicrobials and effective sanitation measures to reduce the incidence of infections, involving health technicians from Health, Agriculture, Environment, Aquaculture and Fisheries, with the aim of integrating and working together to seek mechanisms to help mitigate AMR. This, through analysis and research work in the laboratory and in the field with activities that help to socialize and raise awareness of this problem to all those involved, especially those who are linked to food, animal health, environment and human health5.
The Agency for Phytosanitary and Zoosanitary Regulation and Control AGROCALIDAD is responsible for regulating the registration of companies and products for veterinary use, for which it has issued Technical Manual 003. This manual makes special mention to the use of Colistin, as part of the formulation of products for veterinary use and consumption, since it represents a risk to public health as an antibiotic of restricted use in human medicine, which is generally used in multi-resistant diseases. For this reason, AGROCALIDAD prohibits the manufacture, formulation, importation and distribution of products containing Colistin6.
AGROCALIDAD is also working on a proposal for the restriction of antimicrobials that are used as growth promoters. The aim is to eliminate the indiscriminate use of antibiotics by prohibiting the registration, importation, manufacture, formulation, and marketing of these active ingredients generally used in the animal production chain.
In conclusion, although advances in medical research are promising in the field of prevention and treatment of AMR, global actions are required to reduce the dissemination and mitigate the negative effects of resistant bacteria, viruses, fungi, and parasites that affect living beings in different ecosystems. The commitment of governments and the support they receive from the different actors in the commercialization chain (private companies, laboratories, distributors, users) play an important role in the fulfillment of actions to reduce the inappropriate prescription of antimicrobials, increase immunization against pathogens, disease prevention and control measures, and strengthen pharmacovigilance of resistant pathogens in human, agricultural and veterinary medicine.
Veterinarians, as the main actors in animal health, have a fundamental role to play in the fight against antimicrobial resistance, for which they must encourage their proper use under prescription, promote good hygiene, biosafety, and vaccination practices, and promote the correct diagnosis of infectious diseases in animals.
Footnotes
1. Resistencia a Los Antimicrobianos. OPS/OMS | Organización Panamericana de la Salud. (n.d.). Retrieved January 31, 2023, from https://www.paho.org/es/temas/resistencia-antimicrobianos.
2. CCNASWP / Fiji calls for closer collaboration as FAO/WHO regional meeting gets underway in Nadi. Home | CODEXALIMENTARIUS FAO-WHO. (n.d.). Retrieved January 31, 2023, from https://www.fao.org/fao-who-codexalimentarius/en/
3. Publications. Food and Agriculture Organization of the United Nations. (2016). Retrieved December 22, 2022, from http://www.fao.org/publications
4. Ministerio de Salud Pública del Ecuador, Plan Nacional para la prevención y control de la resistencia antimicrobiana; Quito, Viceministerio de Gobernanza y Vigilancia de la Salud,, 2019, Disponible en: . (2019, November 18). Retrieved from https://www.salud.gob.ec/msp-presento-plan-nacional-para-la-prevencion-y-control-de-la-resistencia-antimicrobiana-ram-2019-2023/.
5. Agrocalidad prohíbe El Uso del Antibiótico Colistina en animales. AGROCALIDAD. (2019, February 25). Retrieved December 25, 2022, from https://www.agrocalidad.gob.ec/agrocalidad-prohibe-el-uso-del-antibiotico-colistina-en-animales/
6. Resistencia Antimicrobiana en producción animal. OPS/OMS | Organización Panamericana de la Salud. (n.d.). Retrieved December 20, 2022, from https://www.paho.org/es/panaftosa/resistencia-antimicrobiana-produccion-animal .
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