KARACHI: Antimicrobial resistance (AMR) is the third leading cause of deaths in Pakistan that directly or indirectly results in 1 million deaths in the South Asian country annually, officials and public health experts said on Sunday.

They said this at a press conference in Karachi in connection with the National Antimicrobial Stewardship Summit 2024, organized by Getz Pharma drug manufacturer in collaboration with the National Health Services Ministry, Health Services Academy (HSA) and the National Institute of Health (NIH).

Around 300,000 people die annually due to drug-resistant bacteria, while AMR contributes to 700,000 deaths because of complications following treatment of diseases, according to the experts.

The deaths are linked with “irrational use” of antibiotics as Pakistan is the third largest consumer of antibiotics in the world, after China and India, and consumed antibiotics worth Rs126 billion in 2023 alone.

“Antimicrobial resistance is now the third leading cause of death after cardiovascular disease and maternal and neonatal disorders in Pakistan because we now have infections caused by bacteria that are not responding to third- and fourth-generation antibiotics,” said Prof. Shahzad Ali Khan, vice-chancellor of the Health Services Academy in Islamabad.

“Abuse of antibiotics by doctors, quacks, and people themselves is making these important medicines highly ineffective,” he said, urging people not to use antibiotics without the advice of trained and qualified physicians.

The summit was attended by over 1,400 health care professionals, including health secretaries and directors-general from federal and provincial governments, officials from the NIH, Drug Regulatory Authority of Pakistan, medical societies and health care regulatory authorities, senior physicians and policymakers.

Khan maintained that antibiotics were “wonder drugs” that saved millions of lives during world wars and pandemics, but their “irrational use or abuse” had led to AMR, which was now becoming a global public health concern.

“Self-medication, unjustified prescription of antibiotics by quacks and physicians, taking antibiotics for a shorter duration, and the production of substandard antibiotics by some companies are some of the major causes of antimicrobial resistance,” he said.

Prof. Javed Akram, former Punjab health minister and president of the Pakistan Society of Internal Medicine (PSIM), said AMR was the third major challenge facing Pakistan after population growth and non-communicable diseases (NCDs).

“People are now dying due to infections that are extremely hard to treat due to the resistance developed by bacteria against these medicines,” Akram said.

“On one hand, Pakistan has become the world capital of diabetes and other non-communicable diseases, and on the other, we have developed Extremely Drug-Resistant (XDR) typhoid, Multi-Drug Resistant (MDR) TB, and various other infections that are extremely hard to treat with most of the available antibiotics. This is because we have been using antibiotics like candies.”

He urged people not to consume antibiotics on their own, saying antibiotics have similar side effects as cancer treatment therapies.

Dr. Afreenish Amir, an NIH representative and senior microbiologist, said AMR had spread to almost all countries and regions, including Pakistan, owing to the “misuse and overuse” of antibiotics.

“This contributes to the increasing burden of infections due to resistant bacteria while limiting treatment options for managing such infections,” she said.

The experts also highlighted the “overuse and abuse” of antibiotics for livestock and said it was responsible for 80 percent of AMR in the veterinary sector. They called for creating awareness among the masses regarding the irrational use of antibiotics in humans, livestock and poultry.

In his keynote address, Prof. Zulfiqar Bhutta, a renowned pediatrician and public health scientist, urged people to get their children vaccinated against typhoid, saying Pakistan was the only country in the world where the Typhoid Conjugate Vaccine (TCV) was being administered to children to prevent the drug-resistant, water-borne disease.

Dr. Wajiha Javed, an associate director of public health at Getz Pharma, said over-the-counter availability of antibiotics, use of these medicines for a shorter duration, and unnecessary prescription of antibiotics by quacks and doctors should be looked into by the authorities.

She said substandard antibiotics containing less or low-grade raw materials were also responsible for AMR and announced that her firm was working work with the government to develop a national action plan on AMR.

On the occasion, a declaration was also signed between the Health Services Academy, NIH and Getz Pharma for the implementation of Antimicrobial Stewardship (AMS), while Memorandums of Understanding (MoUs) were also signed with 13 medical societies in this regard.

ISLAMABAD: Pakistan’s Prime Minister Shehbaz Sharif and President Asif Ali Zardari on Sunday expressed concerns about the crash landing of a helicopter carrying President Ebrahim Raisi in Iran’s northwest and extended their wishes and prayers for his well-being.

The helicopter carrying Iranian President Ebrahim Raisi and Foreign Minister Hossein Amirabdollahian landed roughly when it was crossing a mountainous area in heavy fog on the way back from a visit to Azerbaijan, according to Iranian media.

The bad weather was complicating rescue efforts, the IRNA state news agency reported. Interior Minister Ahmed Vahidi told state TV that one of the helicopters in a group of three had “come down hard,” and that authorities were awaiting further details.

“Heard the distressing news from Iran regarding Hon. President Seyed Ibrahim Raisi’s helicopter. Waiting with great anxiety for good news that all is well,” PM Sharif said on Twitter.

“Our prayers and best wishes are with Hon. President Raisi and the entire Iranian nation.”

President Asif Ali Zardari said he was “deeply concerned” after hearing news about the helicopter incident.

“My heartfelt prayers & good wishes for the well-being & safety of President Raisi so that he may continue to serve the Iranian nation,” he said on X.

Reacting to the development, former foreign minister Bilawal Bhutto-Zardari said their thoughts were with President Raisi, FM Amirabdollahian and the brotherly people of Iran during this critical time.

“We earnestly pray for their safety and swift recovery,” he said in a post on X.

Raisi, 63, was elected president at the second attempt in 2021, and since taking office has ordered a tightening of morality laws, overseen a bloody crackdown on anti-government protests and pushed hard in nuclear talks with world powers.

In Iran’s dual political system, split between the clerical establishment and the government, it is the supreme leader rather than the president who has the final say on all major policies.

But many see Raisi as a strong contender to succeed his mentor, Supreme Leader Ayatollah Ali Khamenei, who has strongly endorsed Raisi’s main policies.

In April, Raisi arrived in Islamabad on a three-day official visit to Pakistan as the two Muslim neighbors sought to mend ties after unprecedented tit-for-tat military strikes earlier this year.

The Iranian president had held delegation-level meetings in the Pakistani capital as well as one-on-one discussions with Pakistan’s prime minister, president, army chief, Senate chairman and National Assembly speaker.

During the visit, Raisi had also overseen the signing of eight agreements between the two countries that covered different fields, including trade, science technology, agriculture, health, culture, and judicial matters.