“What’s needed in Bangladesh — and in low- and middle-income countries more broadly — is a global commitment to support research and data collection on AMR, and investment in the basic interventions that will reduce it.”

                                                         - Dr. Senjuti Saha, Deputy Executive Director, Child Health Research Foundation 

In September of 2024, world leaders convened at the 79th session of the United Nations General Assembly in New York to address the growing problem of bacteria, fungi, and protozoans developing resistance to antimicrobial drugs. Historically, solutions have primarily targeted high-income countries, despite approximately 4.3 million of the estimated 5 million deaths linked to drug-resistant infections occurring in low- and middle-income countries. In anticipation of the UN meeting, four specialists from Bangladesh, Brazil, Nigeria, and the Middle East shared their insights with Nature on the crucial changes needed in their regions.

To bring Bangladesh into this crucial conversation on antimicrobial resistance (AMR), Dr. Senjuti Saha highlighted Bangladesh’s unique challenges in navigating AMR. At the Bangladesh Shishu Hospital and Institute, the nation’s largest children's hospital, the harsh reality is stark: six out of every ten babies in their first month of life infected with multidrug-resistant Klebsiella pneumoniae die within days.

A major barrier in combating AMR, as Dr. Senjuti points out, is the lack of reliable data on bacterial infections and their antibiotic responses. In Bangladesh, most treatments occur in community clinics and pharmacies rather than hospitals, leading to skewed data that misrepresents the true resistance levels. This can result in the premature use of last-resort antibiotics when earlier options might still be effective.

Such practices could inadvertently exacerbate the resistance problem. Dr. Senjuti advocates for better protocols and basic interventions in healthcare settings to drastically improve patient outcomes.

To protect vulnerable infants, particularly those at the Shishu hospital, she argues that the most effective strategy is preventing infections from taking hold in the first place. This includes investing in maternal nutrition during pregnancy, ensuring pregnant individuals receive proper antenatal and perinatal care, and adopting delivery practices that minimise the risk of infections.

Other experts also raised concerns about AMR in their regions. Ana Cristina Gales from Brazil highlighted the urgent need for better hygiene practices in hospitals and public awareness of AMR. Iruka N. Okeke from Nigeria pointed out that despite high antimicrobial usage, many lack access to essential medications, urging improved sanitation and infection prevention. Nour Shamas, a consultant from Lebanon, discussed how political instability complicates AMR interventions and called for integrating AMR strategies into humanitarian efforts.

Read the opinion piece here: https://www.nature.com/articles/d41586-024-02971-9