Anti -Microbial Update September 2021 Vol 3 No 1

Introduction

Confronting the scourge of COVID-19 vaccine nationalism: The world could learn from African indigenous values and Ubuntu principles by Prof Ames Dhai

Wthin four months of the World Health Organisation (WHO) approving a COVID-19 vaccine for emergency use, one billion jabs have been administered globally. This global milestone is an unprecedented scientific achievement as never before have so many in the world been vaccinated only sixteen months after a virus has been discovered. As of 27th April 2021, 7.3% of the world’s population of 7.79 billion have received at least one dose. However, according to a number of scientists 75% of the population globally will require to be vaccinated if the pandemic is to be contained.

The looming pandemic collision between COVID-19 and antimicrobial resistance by Dr Vindana Chibabha

Antimicrobial resistance (AMR) is often described as the “silent pandemic”. In 2016, AMR was declared by the World Economic Forum as the next great global challenge. This was in response to a report which estimated that 700 000 deaths per year were attributed to AMR. Furthermore, by the year 2050, it is likely that 10 million deaths per year will be caused by AMR. This call to action led to the publishing of the WHO’s Global Action Plan which details 5 objectives to combat AMR. The WHO also released the Global Priority Pathogens List which classifies antimicrobial resistant pathogens according to the severity of the threat into critical, high and medium priority categories, to allow prioritisation of antimicrobial drug development.

Antifungal use in Africa by Dr Duncan Nyukuri

The use of antifungal therapy in Africa is low leading to high mortality among patients with invasive fungal infections. The Global Action Funds for Fungal Infections estimates that each year, 47.6 million people in Africa are infected with a fungal disease out of which 1.7 million will have a serious fungal infection. In people with good immune function, fungi do not usually cause serious infections and mortality. However, in immunocompromised individuals, fungal infections can cause debilitating invasive illnesses leading to disability and death. Significantly, Africa has the highest number of people living with HIV/ AIDS worldwide with 25.7 million people in 2018 and two-thirds of all new HIV infections.

First line options: What to choose by Dr Moeketsi Mathe

In 2021, both doctors and HIV infected patients have more options than ever before with regards to which antiretroviral drugs to include in the first line antiretroviral treatment (ART) regimen. Tenofovir in combination with emtricitabine or lamivudine have been well established as the nucleoside reverse transcriptase inhibitor (NRTIs) backbone for first line ART in HIV infected treatment naïve patients in the absence of contraindications. During the early days of ART, only efavirenz, nevirapine or lopinavir/ritonavir were available as a third drug to use in combination with the two drug nucleoside backbone.