Due to the excessive use of antibiotics, which according to the World Health Organization (WHO) will cause 10 million deaths by 2050, experts from UNAM, academia, government authorities, and companies issued the Declaration for the Control of Antimicrobial Resistance in Mexico City 2021, in which they stated that Mexico and the world should reduce the use of these compounds by half in the next decade. The first step is to reduce them by 30 percent in the next three years.
Gathered at the Seminar "Antimicrobial Resistance: integral approach. One health. Urgent actions needed", organized by the UNAM, through the University Program for Health Research (PUIS), and the National Academy of Medicine of Mexico, the specialists called on the three levels of government, educational institutions, trade associations, members of the pharmaceutical and agricultural industries, as well as civil society organizations to join forces to achieve the goals proposed in this Declaration and have a positive impact on the control of AMR in Mexico.
The coordinator of PUIS and of the University Plan Network for the Control of Antimicrobial Resistance (PUCRA), Samuel Ponce de León Rosales, reminded that nowadays it is clear that prevention in professional practice must be the key to avoid the appearance of drug-resistant microorganisms, besides the fact that it will allow being in better harmony with the environment. For this reason, he stressed the need to create a General Coordination to stop Antimicrobial Resistance (AMR) that will allow working together with the universe of actors involved in the issue.
"We do not see microbial resistance as brutally as we see COVID-19, that is why it is difficult for us to implement actions, even though we know the scenario in the short and medium-term, because as the WHO said: how many millions of deaths will there be after 2040; or the Davos Forum, what this situation will cost the world. Clearly, in the next decade, we need to reduce the consumption of antibiotics by 50 percent at a global level and for this, we need to ensure that the objectives set are converted into standards and regulations".
During the closing of the meeting, Eric Ochoa Hein, from the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, was in charge of reading the Declaration in which it is recognized that the use and abuse of antibiotics have generated that the world is in the midst of a threat to all sectors and to combat it, actions are needed at local and national level in which everyone participates. The declaration adds that the agricultural industry is one of the industries that use these compounds the most, which is why they should be mainly advised to avoid the use of antibiotics for human use in food production.
Furthermore, an awareness campaign should be generated in society starting with basic education, a task in which universities and academies can help by incorporating in their curricula contents related to AMR and its combat. Since the inappropriate use of antimicrobials is mainly to treat upper respiratory infections or diarrhea, the document indicates that their routine prescription should be avoided; therefore, their control represents an advance that should be monitored by the responsible authorities.
In relation to uncomplicated acute urinary tract infections, the best medical practice should be emphasized, with the aim of updating recent cases of resistance. The text also specifies that it should be ensured that, when necessary, antimicrobials are sufficient and in continuous supply, in order to favor proper adherence to the correct prescription. Moreover, private and adjacent outpatient clinics should be continuously educated by the regulatory authority.
The experts recognize the Federal Commission for Protection against Sanitary Risks and the National Service for Agri-Food Safety and Quality as the highest authorities to regulate and supervise antimicrobial prescription practices for human use and in veterinary medicine, animal husbandry, and agribusiness, respectively; the National Water Commission (Conagua) is also asked to monitor the dispersion of resistant bacteria in the liquid. Research in this area for epidemiological surveillance, detection of genes, development of diagnostic tools or therapies for treatment should be considered a priority in the national research and development agenda, the document emphasizes.
During the closing event, the director of the National Center for Diagnostic Services in Animal Health (CENASA), Rogelio Estrada Rodríguez, del, commented that Mexico is a member of multiple international organizations attentive to human and animal health, and has the National Strategy for Action against Antimicrobial Resistance, published in the Official Journal of the Federation on June 5, 2018. He also suggested creating a specialized epidemiological unit for AMR.