
Reducing the emergence and spread of waterborne antimicrobial resistance (AMR) in Ethiopia from a One Health perspective
Abstract
Antimicrobial resistance (AMR) is an increasing global health problem with serious impacts in Ethiopia. Environmental waters play a key role in the transmission and spread, and potentially in the development of resistance. The elevated presence of AMR and antimicrobials in Ethiopian water systems arises from inadequate waste management coupled with poorly regulated antimicrobial use (AMU) in the human, animal and agricultural sectors. The continued and inconsistent use of antimicrobials by healthcare providers and community-scale drug consumption drives AMR development in the gut of users, which spreads via wastes and water in Ethiopia. However, the massive use and misuse of antimicrobials is also common among animal health care providers, including unskilled and animal husbandry practitioners, which also results in waste releases and the environmental transmission and spread of AMR.
Surveillance should prioritize monitoring AMU and AMR, with a specific focus on water as a key conduit for AMR spread and a critical point for detection and control. However, monitoring studies must quantify the relative exposures from different AMR sources in parallel with health studies, i.e., One Health studies that provide integrated data that promote greater recognition and action of water environment in National Action Plans, which is currently not adequately supported in Ethiopia. Only through integrated studies across all sectors will develop solutions to locally and globally increasing AMR.
Strategies to mitigate AMR must involve: Encouraging prudent antimicrobial use and stewardship in humans and animal; Reducing inadequately treated fecal wastes to the environment: Strengthening standardized and integrated AMR surveillance and modelling; Championing water and One Health in National Action Plans for reducing AMR; Promoting sustainable “best buy” technologies and practices for water pollution control and health risk mitigation; Increasing training, education, and awareness; and Improving policy and institutional capacities to create an enabling environment for the effective implementation of all previous recommendations.
Citation
Graham, D. W.; Mateo-Sagasta, J.; Haile, A. T.; Moodley, A.; Goshu, G.; Kibret, M. 2024. Reducing the emergence and spread of waterborne antimicrobial resistance (AMR) in Ethiopia from a One Health perspective. Colombo, Sri Lanka: International Water Management Institute (IWMI). CGIAR Initiative on One Health. 20p.