How the chaos of war breeds deadly superbugs that spread across the world

The war in Gaza will leave its mark in many ways, long after the recently negotiated ceasefire agreement between Israel and Hamas.

One legacy is how the chaos of war provides a perfect storm for the rise of antimicrobial resistance.

The microbes then evolve to withstand the drugs designed to kill them. These microbes turn into superbugs, rendering previously effective treatments ineffective and previously survivable infections fatal.

We have already seen examples of antimicrobial resistance In Gaza and other conflict zones around the world.

Antimicrobial resistance is a growing problem worldwide. It not only threatens human health, but also agricultureIN Food security AND economy.

Managing antimicrobial resistance is elaborate. This requires approaches including infection prevention, strategic constraints on how antimicrobials are used, and tough health systems in the first place.

In conflict zones, the opposite is clearly perceptible.

Healthcare systems are being disrupted

Armed conflicts Devastating healthcare infrastructure. Such conflicts often occur in places with limited resources For starters.

There are hospitals and diagnostic laboratories damaged or destroyedand supplies are depleted. Health care workers are being killed or displaced.

Conflict zones remain with less ideal diagnostic, treatment and care capabilities.

This makes preventing and controlling infection extremely tough.

Vaccination is also disrupted

Disrupted vaccination programs can influence the development of antimicrobial resistance in many direct and indirect ways.

For example, in conflict zones, less vaccinations against bacterial diseases lead to more infections, Increased need for antibioticsand risk Antimicrobial resistance is developing.

Less vaccination against viral diseases may make people in conflict zones more vulnerable to these viral infections and, in turn, secondary bacterial infections. This leads to the utilize of antibiotics as a preventive measure or as a treatment, promoting the development of antimicrobial resistance.

Antibiotics are overused and misused

Injuries, infections and needy hygiene are common in conflict zones. This leads to over-reliance on antibiotics, especially those that act against the widest range of bacteria.

Ideally, broad-acting antibiotics would be used sparingly and after diagnostic testing. However, treatment is needed and diagnostic capabilities are at risk. So broadly acting antibiotics are used much more frequently, further promoting the development of resistance.

Also a problem is less control over who has access to antibiotics in war-torn regions. Without prescriptions, professional supervision, or diagnostic testing, antibiotics are used in ways that fuel further resistance. This includes using them “just in case”, using those that are not effective for that infection or injury, or using them for too long or not long enough.

For all these reasons, Abuse and misuse Antibiotics, although often unavoidable, escalate the likelihood that resistant microbes will emerge and spread.

Wounds, infections, antibiotics

Armed conflict leads to a huge number of traumatic injuries. As chief surgeon Sergiy Kosulnykov at Mechnikov Hospital in Dnipro, Ukraine he said last year:

Every blast is an open wound, and every open wound is an infection.

Treatment of these injuries requires antibiotics. However, in conflict zones, the closing microbes are often like this Resistant to many drugs. This is especially true when the microbes are acquired on the battlefield, in field hospitals, or in other high-risk environments. Once antimicrobial resistance begins, these circumstances make it easier for microbes to become resistant to additional antibiotics.

Unhygienic living conditions

Refugee camps and shelters for displaced populations are often overcrowded and lack access to immaculate water and adequate sanitation.

Thus, infections and resistant microbes occur and spread more frequently, worsening epidemics and supporting the evolution and spread of resistant microbes.

A wider breakdown water and sanitation infrastructure It also supports the spread of waterborne microbes, increasing the prevalence and spread of resistant microbes.

Lack of supervision and monitoring

Effective management of antimicrobial resistance depends on exact diagnostic testing and tough surveillance systems to track patterns of resistance and inform treatment recommendations.

Conflict disrupts these systems, leaving authorities blind to emerging trends of resistance. This disruption also delays the implementation of effective countermeasures.

Global spread of resistant pathogens

Conflict generates a huge pool of AMRs that can infect or colonize many people in the conflict zone and beyond. Movement of people in the conflict zone and beyond contributes to this spread beyond borders.

Refugees and displaced people often transmit resistant microorganisms to regions with no or less prior exposure, contributing to the global spread of antimicrobial resistance.

Acinetobacter Baumanii Bacteria that are highly resistant to many antibiotics are one example. They have proven problematic treatment in United States military personnel who have returned with combat injuries from Afghanistan and Iraq. The same bacteria have been reported in the UK as a potential source of life-threatening infections that spread easily in hospitals.

IN AfghanistanIN GauzeIN SyriaIN UkraineIN Yemen And elsewhere, multi-antibiotic-resistant bacteria emerged and thrived during conflicts and continue to do so.

What should we do about it?

Antimicrobial resistance in conflict-affected regions requires urgent action as well as peace. This includes rebuilding and maintaining health systems, improving sanitation, regulating the utilize of antibiotics, and ensuring access to immaculate water and vaccines.

International cooperation and sustainable investment are imperative to mitigate the devastating impact on those affected by conflict.

Without this, antimicrobial resistance becomes another disastrous legacy of war, threatening human health and safety for generations to come.