November 26-27, 2018, CAMBODIA: Antibiotics are vital to treat infections in people, animals and plants, but their misuse can lead to treatment failure when microbes develop resistance. As a result, human deaths due to antimicrobial resistance (AMR) are estimated to increase from today’s 700,000 worldwide to 10 million in 2050. For comparison, that is more than the 8.2 million per year who currently die of cancer and 1.5 million who die of diabetes, combined. The antibiotic misuse in agriculture leads to production losses, unsafe or contaminated foods and soil, as well as water pollution by drug residues and resistant microbes.

In Cambodia, antimicrobial resistance (AMR) in the health sector and in agriculture, mainly in food producing terrestrial (land living animals e.g., dogs, pigs and chickens) and aquatic animals (water living animals and amphibians e.g., fish, lobsters and frogs), is driven by a lack of data to guide veterinarians and animal health providers in prescribing antimicrobials, limited capacity to diagnose and treat, poor application of biosecurity at the farm level, lack of awareness about the consequences of inappropriate antimicrobial use, and unrestricted access to antimicrobials. Additionally, improper and non-therapeutic use of antibiotics for disease prevention and growth promotion by farmers and stockbreeders is prevailing, often with antibiotics that are critically important for human medicine, threatening their effectiveness.

 In conjunction with the global efforts to combat AMR, Cambodia arranged the World Antibiotic Awareness Week (WAAW) 26 to 27 November 2018 at Kampong Cham province under the theme “Handle Food Safely and Combat AMR”. The event was jointly organized by the Ministry of Agriculture, Forestry and Fisheries (MAFF), the Ministry of Health (MoH), the World Health Organization (WHO), and the Food and Agriculture Organization of the United Nations (FAO).

A number of events were organized, including meetings with physicians, health care practitioners, veterinarians, village health workers (VHWs), village animal health workers (VAHWs), district and provincial veterinarians, and people engaged in the food value chain such as slaughterhouses workers. Some events also contributed to raise public awareness.  

About 500 people were targeted in the Market Event at Boeung Kok, which aimed to increase the understanding of risks linked to overuse of antimicrobials among the general public, particularly food retailers and consumers. Officials from national and sub-national levels of MAFF, MoH and Ministry of Environment (MoE), lecturers and students from Royal University of Agriculture (RUA), FAO and WHO walked from stall to stall, interacting with meat sellers, food retailers, and buyers on the risks of AMR and appropriate use of antimicrobials in human, animal, and aquaculture. Education materials containing useful information were distributed during a Tuk Tuk parade around the market, while an FAO animated video on AMR was played. 

In the organized community event, addressing VHWs and VAHWs from Kampong Cham province, the Deputy Director of Kampong Cham Provincial Department of Agriculture Forestry and Fisheries (PDAFF), Mr Katem Sonavan, explained that, “veterinarians are the guardians of antimicrobials in aquaculture, livestock, and agriculture. Their roles are very important. Therefore, they should pay special attention when prescribing antibiotics for the use in these sectors.”

Mr Ann Sinlong, Kampong Cham’s Office Chief of Animal and Public Health explained, “to reduce the use of antibiotics, all stakeholders including animal raisers, slaughterers, retailers, and others should practice good hygiene when handling with animals.”

In the meeting organized at the Kampong Cham City Slaugtherhouse, the slaughterhouse owner, Ms Chhun Sreymom, showed strong interest in delivered messages, “I regularly clean the slaughterhouse area and request provincial veterinarians to spray disinfectant once a week to kill bacteria.” After the meeting, having understood that sanitation and hygience practices are key, she expressed further commitment, “I will spread this information and ask my slaughterhouse workers, as well as retailers, to apply good hygiene when handling animals and carcasses.”  

The 2018 WAAW in Cambodia was a success, with national and sub-national levels living up to the challenge of joint multi-sectoral work. There was great enthusiasm, commitment, and full involvement showing a readiness to lead the action forward in combatting AMR in the country.

What is the difference between antibiotic and antimicrobial resistance?

Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines. Bacteria, not humans, become antibiotic resistant. These bacteria may then infect humans and animals and are harder to treat than non-resistant bacteria. Antimicrobial resistance is a broader term, encompassing resistance to drugs to treat infections caused by other microbes as well, such as parasites (e.g. malaria), viruses (e.g. HIV) and fungi (e.g. Candida) [1].