The ReWaterMENA project, a multi-partner, four-year initiative that started in 2018 aims to expand the safe reuse of water in the Middle East and North Africa (MENA). The project is funded by the Swedish International Development Agency (SIDA) and led by the International Water Management Institute (IWMI). The project is regional in scope and has specific activities in Egypt, Jordan and Lebanon. In Jordan, activities are conducted in partnership with the Royal Scientific Society.
Antimicrobial resistance (AMR) also known as the silent pandemic, is a serious global health threat and low- and middle-income countries are likely to be the most affected in terms of economic burden and public health. Deaths from drug resistant infections are projected to increase from 700,000 to 10 million annually. Antibiotics have found their way into wastewater and recently more studies have highlighted the role of wastewater as a significant environmental reservoir of AMR. This environment is conducive for the global spread of multi-resistant bacteria and other microorganisms and for antimicrobial resistant genes to persist. Wastewater treatment processes can assist in removing or reducing the antimicrobial resistant bacterial load. However, the impact on the resistant genes is limited as they are not degradable and therefore are able to spread amongst other microbial communities in the environment through gene transfer, a process by which bacteria transfer resistant genes. In addition, another growing area of concern is the uptake of these antibiotics by crops irrigated by treated wastewater.
Antibiotics play a pivotal role in a pandemic both as prophylaxis, as well as pre-emptive treatment of secondary bacterial infections, which can be difficult to distinguish between viral pneumonia and bacterial pneumonia. While the number of COVID-19 infections in Africa does not rival those seen in Europe or America, they are gradually increasing and so is the fear of the impact this infection may have on the continent’s low- and middle-income countries (LMICs). According to the World Bank, nearly 645 million people live in the rural areas in sub-Saharan Africa. Three quarters of this population lack the facilities at home to wash their hands with soap and water, which is one of the key measures of preventing infection and spread of SARS-CoV-2. Moreover, many people in LMICs are already battling malnutrition and other endemic infectious diseases, which raises the question of how they will cope with the COVID-19 pandemic.
One of the key strategic objectives of the World Health Organisation’s global antimicrobial resistance (AMR) action plan is to improve public awareness and understanding of this issue. Very few AMR awareness campaigns have targeted the animal production sector, particularly in low- and middle-income countries (LMICs) where rural communities can be geographically difficult to access via traditional face-to-face community engagement methods. Aquaculture is a major food production industry in Bangladesh and across Asia, an area which poses a significant risk to global AMR dissemination. A pilot study sought to investigate the potential for digital communication materials to rapidly and effectively communicate AMR messages to rural aquaculture farmers in Bangladesh.
The CGIAR Antimicrobial Resistance Hub, led by the International Livestock Research Institute (ILRI), applies a One Health approach to support the efforts of low- and middle-income countries (LMICs) in controlling agriculture-associated AMR risks, through promoting and facilitating transdisciplinary partnerships.
The recently adopted CGIAR AMR strategy recognizes the need for evidence on links between agriculture (crops, livestock and aquaculture) and public health outcomes. Based on evidence generated, the hub develops solutions that are locally relevant and applicable, while being adaptable to other contexts.
We conduct context-driven and systems-oriented research that combines social and biological sciences. With AMR research in agriculture and aquaculture and understanding linkages to public health outcomes, we can reap solutions emerging from our transdisciplinary approach.
We aim to reduce and refine AMU in agriculture and aquaculture and its impact on the environment, and to facilitate evidence-based communication around agriculture-associated AMR. This will help to mitigate AMR risks for people and contributes to improving the sustainability of global food and health systems.
The implementation framework of our strategy is organized into five pillars.
Judiciously addressing antimicrobial resistance is especially important in low- and middle-income countries, where poverty exacerbates cycles of inequity
Tackling antimicrobial resistance helps sustain small-scale agriculture and aquaculture and improve poor people’s access to nourishing food
Particularly in poorer countries already facing a high disease burden, antimicrobial resistance increases the likelihood that medical and veterinary treatments will fail
The problem of antimicrobial resistance can exacerbate gender inequality by increasing the risks faced by female primary caregivers of contracting antimicrobial-resistant infections
Over- and misuse of antibiotics and other antimicrobial drugs can contaminate soil and water resources, endangering people’s access to safe drinking water
It has been estimated that if not stemmed, antimicrobial resistance could cost the global economy up to USD100 trillion by 2050
Rational use of antibiotics and other antimicrobial drugs in good animal and fish husbandry practices is key to safeguarding the longer-term effectiveness of these important drugs
Only large networks of interdisciplinary partnerships and collaborators will be able to meet the many challenges presented by the growing development of antimicrobial resistance