Study: Only 16 pc of Kenyans can access life-saving antibiotics
Kenya is massively under-treating life-threatening infections caused by carbapenem-resistant Gram-negative bacteria, which are resistant to even the most powerful last-line-of-defense antibiotics.
What you need to know:
In Kenya, a mere 16 per cent of patients can navigate the complex journey from feeling unwell to receiving proper treatment for CRGN infections.
In hospitals across the country, a silent crisis is unfolding. Patients suffering from drug-resistant infections could be dying not because medicine has failed to develop treatments, but because they cannot access them.
The Lancet medical journal says only 14.5 per cent of patients in low-income and middle-income countries can access critical antibiotics to fight carbapenem-resistant gram-negative (CRGN) infections. These are bacterial infections that have become resistant to the carbapenem class of antibiotics, often the last line of defence.
In Kenya, a mere 16 per cent of patients can navigate the complex journey from feeling unwell to receiving proper treatment for CRGN infections. This is slightly higher than the 14.5 per cent access rate across all LMICs studied, but still devastatingly low compared to the 82 per cent access rate in high-income countries.
The treatment journey reveals multiple breakpoints. The study found that 63.9 per cent of CRGN patients in Kenya reach a healthcare provider, but only 26.5 per cent receive a blood culture test – the critical diagnostic tool needed to identify resistant infections. Even among the lucky few who get diagnosed, only 63.2 per cent can access the vital antibiotics.
Global access
"Nearly all deaths caused by antibacterial resistance occur in low- and middle-income countries, and they need more resources," said Dr Jennifer Cohn, GARDP's global access director and senior author of the study.
Dr Emmanuel Tanui, the AMR Focal Point at the Ministry of Health, was unreachable for comment on Kenya's local context.
Over the past quarter century, antimicrobial resistance has emerged as a major global health threat. It is estimated that almost 1.1 million deaths annually are a direct result of AMR—more than the combined deaths from HIV/AIDS and malaria in 2022.
Overwhelmingly, low-income and middle-income countries bear this burden—nearly 90 per cent of AMR-related deaths each year are estimated to occur in LMICs, the study notes.
"Today, a child born in Africa is 58 times more likely to die from a drug-resistant infection in the first five years of life than one born in a high-income country.
With bacterial drug resistance rates continuing to increase, and without concerted action, almost 40 million cumulative deaths are projected by 2050," adds the study.
The researchers noted that the massive treatment gap could have come about because of limited access to diagnostics. Without proper and timely diagnostic testing, healthcare providers may not be able to identify CRGN infections accurately and prescribe the appropriate antibiotics.
Also read: Alarm over rising antibiotic resistance
They added that even when a patient has already been diagnosed, the necessary "reserve" antibiotics active against CRGN bacteria may not be readily available or affordable in many LMICs. Inadequate infrastructure, supply chain issues, and a lack of trained healthcare professionals further exacerbate the problem.
The researchers are now calling for a concerted effort to close this treatment gap. Their recommendations include investing in and strengthening diagnostic capabilities to ensure timely and accurate identification of CRGN infections, addressing barriers to accessing essential "Reserve" antibiotics, including registration processes, pricing, and supply chains, investing in overall healthcare infrastructure, training of healthcare workers, and efficient supply management and conducting more research to better understand and address the specific barriers along the treatment pathway in LMICs.
Heart disease
Another study published in Nature Medicine journal shows that climate change fuels antimicrobial resistance in low income countries. High or increasing temperatures promoted resistance to some infections.
On the other hand, air pollution also plays a part by ensuring that dust particles penetrate deep into the lungs and enter the bloodstream, which could lead to heart disease, stroke and worsening of respiratory conditions, consequently increasing the demand for antibiotic treatments.
The study also states that high population density elevated the transmission of some infections. Besides, human mobility, driven by the growing international tourism industry, saw travellers visit regions with high levels of resistance, increasing their risk of encountering resistant bacteria, which they may carry back to their home countries, thereby potentially contributing to the worldwide dissemination of these pathogens.
