Ghana recorded 2,100 AMR-related deaths in 2019, experts warn of farm-related risks

Ghana recorded an estimated 2,100 deaths attributable to antimicrobial resistance (AMR) in 2019, with experts warning that inappropriate antibiotic use in livestock and fish farming could worsen the country's public health burden.

Animal health expert Dr Benjamin Kissi Sasu says the misuse of antimicrobials in food production, poor farm hygiene and inadequate waste management could accelerate the spread of drug-resistant infections.

He warns that unsafe practices on farms could expose consumers to antibiotic residues in animal products, while contaminated waste could spread resistant organisms through the environment.

Speaking on the threat posed by antimicrobial resistance in Ghana's food value chain, Dr Sasu said the issue should concern consumers because animal products form part of many people's diets.

"Every human being, or many of us, whether we like it or not, take animal products, either fish or meat or milk or honey," he said.

He said farmers without adequate knowledge of antimicrobial use could inadvertently introduce antibiotic residues into food products.

"If farmers who, in doing their business, are not well-informed, may just do anything, providing food that we think is safe, but ending up having food that has antibiotic residue, whereby we are taking the drugs that will be given to the hospitals when we are sick," he said.

Dr Sasu explained that medicines used to treat infections in humans and animals may contain the same active ingredients, although their formulations could differ.

He also raised concerns about the disposal of animal waste, warning that disease-causing organisms could spread through contaminated water and other environmental pathways.

"Today, we are finding that most farmers do not adhere to strict biosecurity. They do sometimes, sometimes, and sometimes they do not," he said.

He added that some farmers dealing with animal deaths rely on advice from colleagues instead of seeking professional veterinary assistance.

Antimicrobial resistance occurs when bacteria and other disease-causing organisms develop the ability to withstand medicines that previously killed them or stopped their growth.

This makes infections more difficult to treat and increases the risk of severe illness and death.

Dr Sasu said global projections suggest AMR could be associated with approximately 10 million deaths annually by 2050 if countries fail to take decisive action. More than a quarter of the projected deaths are expected to occur in Africa.

He said Ghana's estimated 2,100 AMR-attributable deaths in 2019 showed the need for stronger national interventions.

"In Ghana, just looking at our 2019 data, this is the few work that we have done. We are able to say 2,100 lives have been lost due to antimicrobial resistance. Just in Ghana. That's our 2019 data," he said.

Although he said Ghana had not yet reached an alarming stage, he stressed the need to strengthen implementation of the country's national action plan on antimicrobial resistance.

He also called for improved surveillance and coordinated action across human, animal and environmental health systems.

Meanwhile, the UK government-funded Tackling Deadly Diseases in Africa Programme Two is supporting efforts to strengthen Ghana's response to antimicrobial resistance through capacity building, surveillance and improved practices in food production.

The programme is also being implemented in Kenya, Uganda, Malawi and Zambia, working with government institutions, private sector organisations and civil society groups to improve preparedness against infectious disease threats.

Its Technical Lead in Ghana, Esther Odame Aseidu, said interventions have included training farmers in the Eastern and Western Regions to promote responsible antimicrobial use in livestock and poultry production.

"We've been able to build capacity of farmers in the Western and Eastern Regions to enhance their knowledge and improve their practices when it comes to antimicrobial use on their farms for their livestock, for their poultry," she said.

She said the training also covers biosecurity, farm hygiene and the use of data to guide decisions on antimicrobial use.

The programme has additionally supported surveillance activities at fish farms and slaughterhouses to identify practices that could contribute to antimicrobial resistance.

Ms Odame Aseidu stressed that the threat cannot be addressed by focusing on human health alone, as activities on farms and in the environment also have implications for public health.

"The happenings in the farms, the happenings in water bodies, and also our own actions influence antimicrobial resistance. So it's important that these sectors collaborate when it comes to antimicrobial resistance," she said.

She added that the programme intends to extend its capacity-building efforts to the human health sector, including training for clinicians and pharmacists on appropriate antimicrobial prescriptions in health facilities.

She clarified that the selection of the Eastern and Western Regions for the farmer training was based on the availability of established farmer field schools and did not mean antimicrobial misuse was necessarily more prevalent in those areas.

According to her, the programme would consider extending the training to other regions as additional resources become available.

Beyond antimicrobial resistance, the programme supports countries to strengthen systems for preventing, detecting and responding to infectious disease threats, including cholera and meningitis outbreaks.

Ms Odame Aseidu said its priority was to help countries establish effective systems to prevent outbreaks and detect threats early enough to limit their impact.

Dr Sasu said a comprehensive report covering six years of antimicrobial resistance data across the human, animal and environmental health sectors was expected to be presented on November 18.

The experts say stronger implementation of Ghana's national action plan, responsible antimicrobial use, improved farm biosecurity, proper waste management and collaboration across the three sectors are essential to protecting public health and preserving the effectiveness of medicines.