Tackling AMR in Angola: How One Health and Better Surveillance Can Safeguard Public Health

The study emphasizes the urgent need for a "One Health" approach to combat antimicrobial resistance (AMR) in Angola and other African nations, highlighting the critical gaps in surveillance and regulation that exacerbate the threat to public health. It calls for stronger interdisciplinary collaboration, better regulations, and increased public awareness to effectively address the growing AMR crisis in the region.

A study conducted by researchers from CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine at the University of Lisbon, the Associate Laboratory for Animal and Veterinary Sciences, the BioISI-Biosystems and Integrative Sciences Institute at the University of Lisbon, and the Department of Animal Health at the Faculty of Veterinary Medicine at the University Jose Eduardo dos Santos in Angola, highlights the critical issue of antimicrobial resistance (AMR) in Angola and other African nations. This research emphasizes the need for a comprehensive "One Health" approach, which integrates human, animal, and environmental health, to effectively address the growing threat of AMR in the region.

The Growing Threat of AMR in Low-Income Countries

AMR is identified as a significant global threat, particularly in low- and middle-income countries (LMICs) like Angola, where various factors contribute to its high incidence. The study points to poor sanitation, overcrowding, and the widespread misuse of antibiotics in both human and veterinary medicine as key drivers of AMR. The researchers underscore the alarming scarcity of data on AMR in Angola, particularly concerning veterinary isolates, which hampers the development of effective public health strategies. The study reveals that in sub-Saharan Africa, including Angola, the incidence of AMR is exacerbated by a lack of regulations governing antibiotic use, the close interaction between humans, animals, and the environment, and the pervasive issue of poverty. In Angola, the national health plan currently lacks a focus on AMR control, and the country’s participation in international surveillance programs is minimal. This situation leaves a significant gap in the ability to monitor and combat the spread of resistant bacterial strains, which poses a severe threat to public health.

Social and Economic Drivers of Antimicrobial Misuse

The research further explores the social and economic drivers behind the spread of AMR in Angola and similar contexts. One of the major contributors is the limited public knowledge about antibiotics and the risks associated with their misuse. In many communities, antibiotics are commonly used as growth promoters in livestock and poultry, and they are often added directly to dairy products to extend shelf life. This widespread misuse extends to counterfeit medicines, which are prevalent due to weak regulatory frameworks. The sale of antibiotics without a prescription is a common practice, further contributing to the problem. The government’s lack of commitment and awareness regarding the AMR issue compounds these challenges, making it difficult to implement effective control measures. The study calls for better regulation, improved training for health professionals, and increased public awareness campaigns to mitigate the misuse of antibiotics and curb the spread of resistance.

Challenges in AMR Surveillance

Surveillance of AMR in Angola faces significant obstacles, including poor laboratory infrastructure, a shortage of trained personnel, and inadequate risk communication. The study highlights that while some African countries have made progress in establishing AMR surveillance systems, Angola remains far behind. The lack of a national action plan on AMR and the absence of comprehensive surveillance for zoonotic diseases are critical gaps that need to be addressed. The researchers advocate for increased international cooperation and support to build capacity in LMICs like Angola, where the challenges are particularly acute.

Impact on Public Health and the Need for Collaboration

The study also delves into the implications of AMR for public health in Angola. The rise of multidrug-resistant bacteria in human and veterinary medicine has severe consequences, making infections harder to treat and leading to higher morbidity and mortality rates. The researchers stress the importance of adopting the "One Health" approach, which encourages interdisciplinary collaboration between human, animal, and environmental health sectors. This approach is seen as essential to addressing the complex and interconnected factors that drive AMR.

Urgent Call for Action in Angola

The study concludes by calling for a concerted effort to improve AMR surveillance and control in Angola and other African nations. The researchers emphasize that the implementation of a "One Health" approach, coupled with stronger regulations, better public education, and enhanced international cooperation, is critical to combating the growing threat of AMR. Without these measures, the region will continue to face significant public health risks associated with the spread of resistant bacterial strains. The study's findings underscore the urgency of addressing AMR in Angola and similar contexts, where the potential for antibiotic resistance to cause high mortality and morbidity rates may be even greater than in developed countries due to the higher burden of bacterial infections, poor diagnostic capabilities, and limited access to quality antibiotics.