Health experts are calling for more attention to be paid to antimicrobial resistant pathogens. The issue has been referred to as a “silent epidemic”, and was responsible for the deaths of around 700,000 people in the South-East Asian and Western Pacific Regions in 2019 alone. 

Antimicrobials are medicines used to prevent and treat infectious diseases in humans, animals and plants. 

They include antiseptics, antifungals, antiparasitics and antibiotics. It is the misuse and overuse of antibiotics which is of the highest concern, according to the WHO.

Experts have warned that the issue is caused by limited public knowledge and the fact that many pharmacies sell antibiotics without a prescription. 

When pathogens that cause disease no longer respond to antimicrobial medicines, it is known as Antimicrobial Resistance (AMR), explained the WHO.

It added that when medicines become ineffective, infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability, and death.

To combat the issue, a total of 25 countries in the region, including Cambodia, have endorsed a joint position paper on AMR in the human health sector. 

The paper was released during an event held on the sidelines of the World Health Assembly in Geneva, Switzerland on May 28, said a WHO Western Pacific Region press release.

The paper expresses the determination of regional leaders to accelerate action on AMR over the next five years.

It warned that the nations of the WHO Western Pacific region will face excess economic costs of up to $148 billion due to AMR between 2020 and 2030, should the issue not be addressed.

“The endorsement of this joint position paper by 25 countries and areas across the Asia-Pacific region shows their determination to lead global efforts to tackle this fundamental threat to health and economies,” said Saia Ma’u Piukala, WHO regional director for the Western Pacific, according to the press release.

No specific data was released for each specific country listed in the joint paper, including Cambodia.

Nuth Sambath, president of the Institute of Medicine, Biology and Agriculture at the Royal Academy of Cambodia, acknowledged that public behaviour to AMR in Cambodia remains an issue, because people often buy medicine without a prescription or do not follow the instructions of their doctor.

“Sometimes, people do not follow the instructions or just buy medicine directly from a pharmacy without consulting a doctor. Sometimes, they borrow a prescription from a relative with a similar condition and go and buy the medication directly,” he said.

“Occasionally, they just remember the name of a medicine, without any knowledge of the correct dosage or length a course of drugs should be taken,” he added.

Sambath noted that similar practices are commonplace in neighbouring countries like Vietnam and Laos.

In European countries, he said, there are fewer cases of buying medicine without a prescription, but there are still cases in which people do not follow instructions correctly, such as failing to complete a full course of drugs.

“We must prevent the practice of patients purchasing medication without a prescription, and without consulting a medical professional,” he added.

He urged stricter legal controls on medication, as well as public awareness campaigns about the risks of using medicine inappropriately.

Ly Sovann, director of the Communicable Disease Control Department (CDC) at The Ministry of Health, told The Post that Cambodia has been combating AMR for years, in cooperation with the WHO, the American Society of Clinical Oncology (ASCO), UNFAO, the UN Environment Programme, Animal Health International and the US Center for Disease Control.

“We regularly follow up and update Cambodian medical professionals about the kinds of drugs that remain effective and those which are not,” he said.

“Cambodia is one of the leading countries in the Western Pacific Region in AMR prevention and response. We work closely with our neighbouring countries and other nations around the world to prevent the use of medication that pathogens have already developed a resistance to,” he continued.

“The health ministry strengthened these efforts by requiring pharmacies to demand a prescription from a doctor when selling antibiotics. They must not sell them without a script from a doctor, to avoid diseases becoming resistant,” he explained.

With the support of the WHO, AMR prevention programmes have also been put in place in hospitals across the country, according to Sovann.

He expected that more cooperation would be extended throughout the region to strengthen the fight against the “silent pandemic”.