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OneHealth Approaches Contribute Towards Antimicrobial Resistance: Malaysian Perspective
Vanitha Mariappan1, Kumutha Malar Vellasamy2, Nor Alia Mohamad3
1Centre of Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Abstract:
On a global scale, antimicrobial resistance (AMR) is recognized as a One Health challenge due to the continual and increased development and distribution of resistant microbes and genes among humans, animals, and the environment. These sectors contribute to the increase in AMR, as antibiotics are widely used in healthcare to treat or prevent bacterial infection; as growth enhancers, therapeutics and metaphylactics in animal husbandry; and transmitted in the environment through irrigation using wastewater or inappropriate disposal and treatment of human and agricultural waste. However, there is a major drawback in terms of the lack of research assessing the coexistence of AMR in these sectors. Extensive research highlighted food-animal manufacture structures that are likely to harbor reservoirs or promote transmission of AMR, in addition to increasing human colonization with AMR commensal bacteria. Numerous antibiotic stewardship policies have been designed and implemented in medical practices and animal husbandry in high- and middle-income countries. However, research concentrating on high-income settings, attitudes, emotions, and beliefs on the utilization of antimicrobials remain underexplored in lower- and middle-income countries such as Malaysia. Microbiological, epidemiological, and social science exploration are required at community and farming across the One Health range to fill huge gaps in information and knowledge of AMR. Manipulating human activities and character associated with antibiotics is a multifaceted progression that includes elements like knowledge, social behavior, attitudes, approaches, social standards, socioeconomic settings, peer pressure, experiences, and biophysical environment. Therefore, understanding these aspects in the utilization of antimicrobial drugs among the different sectors is essential to develop and implement policies to curb AMR development and transmission that overarch all sectors within the One Health consortium in Malaysia.
Insights
Antimicrobial resistance (AMR) is a global One Health issue. Understanding human behavior and socioeconomic factors in Malaysia is crucial for developing effective AMR control policies across human, animal, and environmental sectors.
Area of Science:
- One Health
- Microbiology
- Epidemiology
- Social Science
Background:
- Antimicrobial resistance (AMR) is a significant global health challenge, exacerbated by antibiotic use in human healthcare, animal husbandry, and environmental contamination.
- While antibiotic stewardship policies exist, research on AMR in lower- and middle-income countries, particularly concerning human attitudes and behaviors, remains limited.
- Food-animal production systems are recognized as potential reservoirs and transmission routes for AMR, impacting both animal and human health.
Purpose of the Study:
- To highlight the critical need for integrated research on antimicrobial resistance (AMR) across human, animal, and environmental sectors in Malaysia.
- To emphasize the lack of understanding regarding the coexistence of AMR in these interconnected sectors within lower- and middle-income countries.
- To underscore the necessity of exploring social, behavioral, and environmental factors influencing antimicrobial drug utilization to inform policy development.
Main Methods:
- Review of existing literature on AMR in human, animal, and environmental contexts.
- Identification of research gaps, particularly in socio-behavioral aspects of antimicrobial use in Malaysia.
- Call for integrated microbiological, epidemiological, and social science research.
Main Results:
- AMR development and spread are driven by widespread antibiotic use in healthcare, agriculture, and environmental pathways.
- Existing research predominantly focuses on high-income settings, neglecting the unique challenges in lower- and middle-income countries like Malaysia.
- Human activities, behaviors, and socioeconomic factors significantly influence antimicrobial utilization and AMR transmission.
Conclusions:
- Effective AMR containment requires a One Health approach, integrating human, animal, and environmental perspectives.
- Understanding the complex interplay of knowledge, attitudes, and behaviors related to antimicrobial use is essential for policy-making in Malaysia.
- Further research encompassing microbiological, epidemiological, and social science dimensions is imperative to address AMR comprehensively.
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