By Yi Whan-woo
The misuse and overuse of antimicrobials for years have made bacteria learn how to fight back and build antimicrobial resistance (AMR) that can render drugs ineffective.
The health crisis associated with multidrug resistant bacteria is becoming more serious with COVID-19, as more antibiotics are being used to treat coronavirus-infected patients.
The slowly-developing nature of AMR can be more fatal than COVID-19 because it evolves into the "next pandemic" while being unnoticed by the public, according to International Centre for Antimicrobial Resistance Solutions (ICARS) Director of Operations Helle Engslund Krarup.
In a written interview with The Korea Times this month, Krarup accordingly thanked Korea for its commitment to the campaign against AMR even before COVID-19 raised awareness of it.
She referred to Korea's funding of millions of euros for AMR-related research, saying it is "a testament to its commitment to fighting this silent AMR pandemic."
Krarup appreciated Korea's "positive attitude toward the work of ICARS" as expressed by former Health and Welfare Minister Park Neung-hoo during a recent online seminar in Korea.
Titled "Evidence to Action," the seminar was co-hosted by ICARS, the Embassy of Demark in Korea and the International Vaccine Institute (IVI), a U.N. Development Programme-affiliated organization headquartered in Seoul.
The seminar centered on action in low- and middle-income countries. This was in line with the goal of ICARS, which was founded in Copenhagen in 2019 under the initiative of the Danish government and the World Bank.
"We felt a strong sense of alignment with all parties when putting together this event, and we look forward to collaborating further," Krarup said.
The Danish government plans to make ICARS an independent organization in 2021.
The following is a Q&A transcript.
Q: To what extent is the public around the world aware of the threats posed by AMR as the "next pandemic" and "silent pandemic," and what does ICARS do to raise global public awareness?
A: Awareness of AMR is definitely increasing around the world. Unfortunately, infections that do not respond to antimicrobials is increasingly common. This raising interest of the global society and individual governments is very promising. However, there is still a long way to go in order to prevent that AMR over time will evolve to a true pandemic. ICARS works both at the national and international level to advocate for implementation research as an important means for developing cost effective context-specific solutions that will create sustainable AMR mitigation thereby adding to the global efforts against AMR.
COVID-19 has demonstrated how a global health crisis can spread across borders and severely disrupt daily life. COVID-19 has very likely increased the problems with AMR because of the high use of antibiotics for patients admitted to hospital with COVID-19. But at the same time, it has created momentum for the fight against drug-resistant infections, and we see more and more action on this front. AMR is already making life difficult for healthcare workers around the world, especially in low- and middle-income countries, so the time to act is now. Awareness on its own is not enough ― we need context-specific solutions on the ground.
Q: How serious is the death rate from AMR compared to other deadly diseases such as COVID-19?
A: At the moment the world is in the middle of the COVID-19 pandemic that until now has caused more than 1.65 million deaths with countries going in lockdown all over the world in order to control the spread of the virus. This has already led to severe economic consequences for many individuals as well as for the world economy. However, the crises of COVID-19 is expected to be passing within the next one to two years.
In comparison, AMR is estimated already to cause 700,000 lost lives annually and this number is increasing. If nothing is done the AMR crisis will continue to increase and it has been estimated that by 2050 10 million people will die annually due to drug resistant infections. Furthermore, the World Bank has estimated that already in 2030, the economic loss due to drug resistant infections could yearly exceed $1 trillion. However, unlike COVID-19, the AMR crisis is a sneaking slow-moving crisis and thereby escape the attention of most people. From the above figures it is, however, clear that AMR over time poses a far larger risk for human health, has much higher economic impact than the COVID-19 crises, and therefore needs full attention from the global society.
Q: Please explain how Denmark has advanced in AMR-related research and development to become the home of ICARS.
A: The Danish research community has taken a One Health approach to AMR mitigation for more than 20 years, combining veterinary science with human medicine and environmental research to better understand how AMR affects and is affected by the interaction of these three areas. Translating this research into action requires rational use of antimicrobials, also named antibiotic stewardship along with limiting transmission of drug resistant microorganisms.
Denmark has had AMR stewardship built into the practice of medicine ever since the 1970s. The Danish AMR surveillance system takes a clear One Health approach, and Denmark has one of the world's lowest resistance levels in both humans and animals. The Danish experience has shown that AMR stewardship and other AMR mitigating actions only works if all relevant stakeholders are involved. This learning is brought into ICARS where we through partnerships bridge the gap between governments, local researchers and practitioners.
ICARS started at the initiative of the government of Denmark together with the World Bank, but as much as it was a Danish project in the beginning, it has always been our aim to become an independent international organization funded by different nations and foundations committed to our mission.
Q: Considering the serious nature of AMR, what topics were discussed at the latest online seminar in Korea and how did they support better measures for mitigating AMR, especially in low- and middle-income countries?
A: There are plenty of webinars about AMR these days, most of them focusing on what should be done to reduce drug-resistant infections around the world. We wanted our event to bring something new and to focus on action in low- and middle-income countries (LMICs), where the problem is most prominent. That is why we invited speakers from Bangladesh and Vietnam to share examples of what they are doing in practice on the ground to tackle this issue. We were very pleased that over 500 attendees tuned in from more than 40 countries, many of them government officials or high-level researchers in LMICs.
I would like to take this opportunity to thank our co-hosts, the International Vaccine Institute and the Danish Embassy in Korea for their tremendous efforts in making this webinar a success.
Q: How competent is Korea in terms of its medical research and healthcare system as an international partner in the fight against AMR? And besides being the home of IVI, what merit does Korea have that led to it being picked as the venue of the latest online seminar?
A: Korea is an ideal partner in such an event due to its strong commitment to fighting drug-resistant infections at a national and global level. Similar to Denmark, Korea takes a One Health approach to AMR mitigation and has a solid National Action Plan focusing on AMR surveillance, stewardship, research and international collaboration. Korea's AMR research fund reached 65 million euros in 2017, a testament to its commitment to fighting this silent AMR pandemic long before COVID-19 increased the awareness of it.
We are honored by Korea's positive attitude toward the work of ICARS, as expressed by his Excellency the Minister for Health and Welfare, Park Neung-hoo at the webinar. Korea and Denmark have a close diplomatic relationship supported by the Danish Embassy in Seoul. Furthermore, the AMR projects of IVI are oriented toward the same mission as ICARS ― eliminating drug-resisting infections globally. As such, we felt a strong sense of alignment with all parties when putting together this event, and we look forward to collaborating further.
Q: You mentioned that ICARS aims to become independent from the Danish government. When will this happen? Please explain the progress being made to turn ICARS into an independent international institution.
A: ICARS is currently putting together an international Board of Directors, which will set its strategic direction for the coming years. We expect the Board to be functioning and for ICARS to become an independent, self-owned, self-governed organization in the spring of 2021. However, being independent does not mean that we are alone. And while we are still receiving support from the Danish government, we need national and international partners to join us in our mission. That is why we are inviting other countries and large foundations to become founding members of ICARS.
We are receiving a lot of interest from LMIC governments to co-develop projects with us, but we cannot do this alone. Moreover, resistance in one country can spill over to other parts of the globe in a similar way that COVID-19 did. AMR is a global problem, and we hope that partners from all around the world will come together and join our efforts to solve it.
The misuse and overuse of antimicrobials for years have made bacteria learn how to fight back and build antimicrobial resistance (AMR) that can render drugs ineffective.
The health crisis associated with multidrug resistant bacteria is becoming more serious with COVID-19, as more antibiotics are being used to treat coronavirus-infected patients.
 |
| Helle Engslund Krarup, director of operations at International Centre for Antimicrobial Resistance Solutions (ICARS) / Courtesy of ICARS |
In a written interview with The Korea Times this month, Krarup accordingly thanked Korea for its commitment to the campaign against AMR even before COVID-19 raised awareness of it.
She referred to Korea's funding of millions of euros for AMR-related research, saying it is "a testament to its commitment to fighting this silent AMR pandemic."
Krarup appreciated Korea's "positive attitude toward the work of ICARS" as expressed by former Health and Welfare Minister Park Neung-hoo during a recent online seminar in Korea.
Titled "Evidence to Action," the seminar was co-hosted by ICARS, the Embassy of Demark in Korea and the International Vaccine Institute (IVI), a U.N. Development Programme-affiliated organization headquartered in Seoul.
The seminar centered on action in low- and middle-income countries. This was in line with the goal of ICARS, which was founded in Copenhagen in 2019 under the initiative of the Danish government and the World Bank.
"We felt a strong sense of alignment with all parties when putting together this event, and we look forward to collaborating further," Krarup said.
The Danish government plans to make ICARS an independent organization in 2021.
The following is a Q&A transcript.
Q: To what extent is the public around the world aware of the threats posed by AMR as the "next pandemic" and "silent pandemic," and what does ICARS do to raise global public awareness?
A: Awareness of AMR is definitely increasing around the world. Unfortunately, infections that do not respond to antimicrobials is increasingly common. This raising interest of the global society and individual governments is very promising. However, there is still a long way to go in order to prevent that AMR over time will evolve to a true pandemic. ICARS works both at the national and international level to advocate for implementation research as an important means for developing cost effective context-specific solutions that will create sustainable AMR mitigation thereby adding to the global efforts against AMR.
COVID-19 has demonstrated how a global health crisis can spread across borders and severely disrupt daily life. COVID-19 has very likely increased the problems with AMR because of the high use of antibiotics for patients admitted to hospital with COVID-19. But at the same time, it has created momentum for the fight against drug-resistant infections, and we see more and more action on this front. AMR is already making life difficult for healthcare workers around the world, especially in low- and middle-income countries, so the time to act is now. Awareness on its own is not enough ― we need context-specific solutions on the ground.
Q: How serious is the death rate from AMR compared to other deadly diseases such as COVID-19?
A: At the moment the world is in the middle of the COVID-19 pandemic that until now has caused more than 1.65 million deaths with countries going in lockdown all over the world in order to control the spread of the virus. This has already led to severe economic consequences for many individuals as well as for the world economy. However, the crises of COVID-19 is expected to be passing within the next one to two years.
In comparison, AMR is estimated already to cause 700,000 lost lives annually and this number is increasing. If nothing is done the AMR crisis will continue to increase and it has been estimated that by 2050 10 million people will die annually due to drug resistant infections. Furthermore, the World Bank has estimated that already in 2030, the economic loss due to drug resistant infections could yearly exceed $1 trillion. However, unlike COVID-19, the AMR crisis is a sneaking slow-moving crisis and thereby escape the attention of most people. From the above figures it is, however, clear that AMR over time poses a far larger risk for human health, has much higher economic impact than the COVID-19 crises, and therefore needs full attention from the global society.
Q: Please explain how Denmark has advanced in AMR-related research and development to become the home of ICARS.
A: The Danish research community has taken a One Health approach to AMR mitigation for more than 20 years, combining veterinary science with human medicine and environmental research to better understand how AMR affects and is affected by the interaction of these three areas. Translating this research into action requires rational use of antimicrobials, also named antibiotic stewardship along with limiting transmission of drug resistant microorganisms.
Denmark has had AMR stewardship built into the practice of medicine ever since the 1970s. The Danish AMR surveillance system takes a clear One Health approach, and Denmark has one of the world's lowest resistance levels in both humans and animals. The Danish experience has shown that AMR stewardship and other AMR mitigating actions only works if all relevant stakeholders are involved. This learning is brought into ICARS where we through partnerships bridge the gap between governments, local researchers and practitioners.
ICARS started at the initiative of the government of Denmark together with the World Bank, but as much as it was a Danish project in the beginning, it has always been our aim to become an independent international organization funded by different nations and foundations committed to our mission.
Q: Considering the serious nature of AMR, what topics were discussed at the latest online seminar in Korea and how did they support better measures for mitigating AMR, especially in low- and middle-income countries?
A: There are plenty of webinars about AMR these days, most of them focusing on what should be done to reduce drug-resistant infections around the world. We wanted our event to bring something new and to focus on action in low- and middle-income countries (LMICs), where the problem is most prominent. That is why we invited speakers from Bangladesh and Vietnam to share examples of what they are doing in practice on the ground to tackle this issue. We were very pleased that over 500 attendees tuned in from more than 40 countries, many of them government officials or high-level researchers in LMICs.
I would like to take this opportunity to thank our co-hosts, the International Vaccine Institute and the Danish Embassy in Korea for their tremendous efforts in making this webinar a success.
Q: How competent is Korea in terms of its medical research and healthcare system as an international partner in the fight against AMR? And besides being the home of IVI, what merit does Korea have that led to it being picked as the venue of the latest online seminar?
A: Korea is an ideal partner in such an event due to its strong commitment to fighting drug-resistant infections at a national and global level. Similar to Denmark, Korea takes a One Health approach to AMR mitigation and has a solid National Action Plan focusing on AMR surveillance, stewardship, research and international collaboration. Korea's AMR research fund reached 65 million euros in 2017, a testament to its commitment to fighting this silent AMR pandemic long before COVID-19 increased the awareness of it.
We are honored by Korea's positive attitude toward the work of ICARS, as expressed by his Excellency the Minister for Health and Welfare, Park Neung-hoo at the webinar. Korea and Denmark have a close diplomatic relationship supported by the Danish Embassy in Seoul. Furthermore, the AMR projects of IVI are oriented toward the same mission as ICARS ― eliminating drug-resisting infections globally. As such, we felt a strong sense of alignment with all parties when putting together this event, and we look forward to collaborating further.
Q: You mentioned that ICARS aims to become independent from the Danish government. When will this happen? Please explain the progress being made to turn ICARS into an independent international institution.
A: ICARS is currently putting together an international Board of Directors, which will set its strategic direction for the coming years. We expect the Board to be functioning and for ICARS to become an independent, self-owned, self-governed organization in the spring of 2021. However, being independent does not mean that we are alone. And while we are still receiving support from the Danish government, we need national and international partners to join us in our mission. That is why we are inviting other countries and large foundations to become founding members of ICARS.
We are receiving a lot of interest from LMIC governments to co-develop projects with us, but we cannot do this alone. Moreover, resistance in one country can spill over to other parts of the globe in a similar way that COVID-19 did. AMR is a global problem, and we hope that partners from all around the world will come together and join our efforts to solve it.
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