Health Talk | The crucial role of effective vaccine coverage in tackling antimicrobial resistance

A comprehensive, people-centred approach applied across health systems is needed to prevent, diagnose and treat infections.

There is growing evidence for the need to make better use of vaccines against vaccine-preventable diseases to reduce the burden of antimicrobial resistance (AMR) and mortality associated with it.

Vaccines can be essential in reducing the overall AMR burden as they prevent infections, reduce the use and overuse of antimicrobials, and slow the emergence and spread of drug-resistant pathogens.. (HT PHOTO)

A new report by the World Health Organisation (WHO) finds that vaccines against 24 pathogens could reduce the number of antibiotics needed by 22% or 2.5 billion defined daily doses globally every year, supporting worldwide efforts to address antimicrobial resistance.

While some of these vaccines are already available but underused, others would need to be developed and brought to the market as soon as possible, says the WHO report.

AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines, making people sicker and increasing the risk of illness, death and the spread of infections that are difficult to treat.

According to experts, AMR is driven largely by the misuse and overuse of antimicrobials, and, yet, at the same time, many people around the world do not have access to essential antimicrobials.

Each year, nearly 5 million deaths are associated with AMR globally, according to the WHO report.

Vaccines can be essential in reducing the overall AMR burden as they prevent infections, reduce the use and overuse of antimicrobials, and slow the emergence and spread of drug-resistant pathogens.

The new report expands on a WHO study published in BMJ Global Health last year. It estimates that vaccines already in use against pneumococcus pneumonia, Haemophilus influenzae type B (Hib, a bacteria causing pneumonia and meningitis) and typhoid could avert up to 106,000 of the deaths associated with AMR each year. An additional 543,000 deaths associated with AMR could be averted annually when new vaccines for tuberculosis (TB) and Klebsiella pneumoniae, are developed and rolled out globally. While new TB vaccines are in clinical trials, one against Klebsiella pneumoniae is in the early stage of development.

“Addressing antimicrobial resistance starts with preventing infections, and vaccines are among the most powerful tools for doing that,” said Tedros Adhanom Ghebreyesus, WHO Director-General. “Prevention is better than cure, and increasing access to existing vaccines and developing new ones for critical diseases, like tuberculosis, is critical to saving lives and turning the tide on AMR.”

Vaccinated people have fewer infections and are protected against potential complications from secondary infections that may need antimicrobial medicines or require admission to the hospital. The report analysed the impact of already licensed vaccines as well as vaccines in various stages of development.

It found that every year, vaccines against Streptococcus pneumoniae could save 33 million antibiotic doses if the Immunisation Agenda 2030 target of 90% of the world’s children were vaccinated, as well as older adults. Typhoid could save 45 million antibiotic doses if their introduction was accelerated in high-burden countries.

Malaria caused by Plasmodium falciparum could save up to 25 million antibiotic doses, which are often misused to try to treat malaria.

Also, TB could have the highest impact once they are developed, saving between 1.2 to 1.9 billion antibiotic doses – a significant portion of the 11.3 billion doses used annually against the diseases covered in this report.

The economic impact globally is another factor as hospital costs of treating resistant pathogens evaluated in the report are estimated at $730 billion each year.

A comprehensive, people-centred approach applied across health systems is needed to prevent, diagnose and treat infections. This approach recognises vaccination as core to preventing AMR and is especially impactful when combined with other interventions. Governments, especially of low and middle-income countries that have high vaccine-preventable diseases burden, need to go back to the drawing board and devise a better strategy to ensure that their target population is fully covered.

Rhythma Kaul, national editor, health, analyses the impact of the most significant piece of news this week in the health sector