Antimicrobial Resistance: Challenges in Wartime - Ukrainian Perspective

Abstract

The excessive and uncontrolled use of antibiotics in healthcare and agriculture has become the main cause of antibiotic resistance and the spread of antibiotic-resistant microorganisms in the environment. Every year, antibiotic resistance continues to grow worldwide, posing a significant challenge for humanity. The World Health Organization recognizes antibiotic resistance as one of the top 10 global threats to public health, jeopardizing the achievement of the United Nations Sustainable Development Goal. The consequences of antimicrobial resistance extend beyond the effective treatment of infections; it is a public health issue with global consequences. Socioeconomic losses and environmental threats are closely linked to this problem. Moreover, antibiotic resistance has long-term and unpredictable consequences related to wars and military conflicts. The impact of the war and a clear understanding of the global scope of antibiotic resistance as a result of hostilities can be seen through the outcome of russia's invasion of Ukraine on February 24, 2022. This military conflict not only highlighted the importance of preserving human life and promoting peaceful development at both national and global levels but also revealed potential risks for various global environmental issues, particularly the increasing spread of antibiotic resistance. The disruption caused by the war has transformed the issue of antibiotic resistance in Ukraine from a national concern to a powerful factor that affects the global scale of this problem, transcending borders. During the war, resources and priorities have shifted toward military needs, relegating human health and environmental protection to secondary importance. Migration and loss of highly qualified medical specialists and biologists, deterioration of the environmental situation, sanitary, hygienic conditions, lack of food resources and medicines, and other factors directly and indirectly contribute to the emergence and spread of antibiotic resistance globally. This review demonstrates the relevance of the issue of antibiotic resistance, the main mechanisms of the development and spread of antibiotic resistance, the global scale and consequences of antibiotic resistance due to the war in Ukraine and aims to provide an overview of international initiatives to reduce antibiotic resistance, in particular the “One Health” concept and strategies, which are currently being implemented. Solving the issue of antibiotic resistance globally and at the level of the country affected by war requires a comprehensive approach, which includes mandatory systematic surveillance of antibiotic resistance, control of the use of antimicrobial drugs, informing all segments of society about the use of antimicrobial drugs and the consequences of antibiotic resistance, the introduction of educational programs to prevent an improper use of antibiotics, environmentally safe methods of waste disposal in medical, food, and other enterprises that produce or use antibiotics, safe disposal of antibiotics, etc.