Penicillin, discovered by Alexander Fleming in 1928, became known as the “” for its instrumental role in the Second World War, when the Allied forces relied heavily on the antibiotic to treat wound infections and perform surgeries. Antibiotics are the most commonly known antimicrobial today, yet we are quite far from the optimism of the 1940s when some predicted a “” despite evidence that select were resistant to the drug.

In his 1945��,��Fleming predicted that the improper use of antibiotics would cause future . He was referring to the threat of antimicrobial resistance, defined by the (CDC) as “the ability of microbes to resist the effects of drugs.” As humans have developed and utilized antibiotics, bacteria have concurrently evolved to resist some of these antimicrobials. Even though some individuals are at a greater risk of death from antimicrobial resistance than others, antibiotic-resistant infections threaten everyone. Without action to diminish the severity and spread of antimicrobial resistance, the threat will continue to to unprecedented levels.

Ironically enough, to penicillin was identified three years prior to its introduction to the market. For other drugs such as Levofloxacin, Methicillin, Ceftazidime and Ceftaroline resistance was detected within two years of each antibiotic’s public release. On the other hand, it has taken approximately 15 years to detect resistance to drugs such as Vancomycin and Erythromycin. This lag time is not a much of a comfort, considering that resistance can exist long before it is detected. published by the United States National Library of Medicine and National Institutes of Health have shown that intrinsic resistance exists, yet humans across the world are contributing to acquired resistance through multiple practices.

Doing It All Wrong

To begin, the that antibiotics are ineptly prescribed up to 50% of the time. Corroborating statistics from the state that between the years 2000 and 2010, global human antibiotic consumption increased by 36%. Secondly, antibiotics that are commonly used in humans have been administered to livestock raised for slaughter. This action quickly spreads resistant genes, as humans come into contact with animal sources through consumption or other means. Furthermore, an additional major factor that contributes to the spread of antimicrobial resistance is the transmission of resistant bacteria strains from person to person. For example, inadequately designed hospitals with improper enable bacteria to easily spread from one host to another. To make matters worse, developing countries in the tropics face adverse that impact antimicrobial storage capacity leading to drug degradation and ineffectiveness.

Despite the inherent threat of antimicrobial resistance, advances in technology can be seen as a great source of hope for humanity. The detection, identification and characterization of microorganisms have all been improved as a result of new technology. have greatly enhanced laboratories’ ability to combat rapid nosocomial pathogenic modification. Health care-associated infections are globally relevant, as they account for 7% of infections in developed countries and 10% of infections in developing countries, as cited by the .

in microbiological and molecular epidemiology, in addition to active participation in surveillance efforts, have enabled professionals to better approach antimicrobial resistance. For example, current developments explained by in the American Journal of Clinical Pathology include susceptibility testing, improved culture techniques and the implementation of nucleic acid probes have made the identification of infectious agents more rapid and precise.

In fact, DNA probe tests have yielded near . In addition to the aforementioned innovations, of Mayo Clinic’s Division of Clinical Microbiology has acknowledged that microbiologists are moving away from conventional antimicrobial resistance susceptibility techniques based on phenotype and are beginning to make assessments based on genotype. Cockerill ascertains that while many advocate genotype assessment are more relevant (as in some cases organisms cannot be easily cultured to attain phenotype), phenotype takes longer to ascertain than genotype, and conventional phenotype testing methods are affiliated with higher biohazard risks.

Nevertheless, there are valid reservations to the use of genotypic DNA and polymerase chain reaction referred to by the , Michigan State University and the CDC. One that genotypic methods only detect the presence of resistance, whereas phenotypic methods detect gene or mutation growth patterns in response to an antibiotic. As a result, it is worth noting that rapid testing kits relying on genotypic methods are susceptible to that hinder proper . In short, it is imperative to consider the attributes and limitations of all testing methods when formulating a case-specific response.

Taking Action

Since Fleming’s warning, measures have been taken in acknowledgement of the threat of antimicrobial resistance. Founded in 1948, the World Health Organization has been the most instrumental body to take action on a global scale. As one specific example, Operative Clause 1 of the World Health Assembly’s May 2009 lists more than 10 different measures that nations can take for the prevention and control of multidrug-resistant tuberculosis. , the and are just a few of the countries currently taking action in accordance with of the resolution in order to eliminate counterfeit medication. Such multilateral cooperation has led to the WHO’s 2017 , which will prove to be an additional asset in the fight against antimicrobial resistance.

The United States has also shown initiative, as CDC has pushed for the implementation of to significantly diminish the threat of antimicrobial resistance. First of all, preventing infections in general will limit the spread of resistance. If there are fewer infections, then fewer antibiotics will be needed, which decreases microbial exposure to antimicrobials and, therefore, limits opportunities for adaptation. The states that “There are many ways that drug-resistant infections can be prevented: immunization, safe food preparation, handwashing, and using antibiotics as directed and only when necessary.”

While individuals play a major role in the first core action, the other three measures require more resources and professional involvement. For example, developing strategies to prevent infections requires tracking data and risk factors. This is done on an expert level in order to establish strategies for the reduction of resistant bacteria. The CDC’s third pillar, antibiotic prescription and stewardship, needs to be addressed on a policy level.

Almost all antibiotic use in animals, and nearly half of its use in humans, is unnecessary. Yet, changing the role of antibiotics in society will impact many stakeholders. Another necessary action to pursue according is the development of new diagnostic tests and drugs. With technological innovation, microbiologists have shown their involvement, yet it is imperative that they observe results-oriented to continue development in this domain. Unfortunately, antimicrobial resistance is a phenomenon that can never be defeated. However, with the engagement and dedication of numerous parties, antimicrobial resistance can be better managed, and lives can be saved.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Nearing the one-year anniversary of (AU), further interpretations can be made concerning the implications of the AU’s majority 39-15 vote. Following Morocco’s historic withdrawal from the Organization of African Unity more than 30 years ago, King Mohammed VI’s desire to join the AU was seen by many as a step toward pan-Africanism and global governance. Those voting in favor of Morocco accredited their decision to principles of inclusivity and integration throughout the African continent. Loosely modeled after the European Union, the AU has discussed its potential to establish a central bank, a monetary fund and a human rights court.

With all of this in mind, some may ask: Which 15 members voted against Morocco’s admission, and what influenced their decision?

One of the most impactful countries on the African continent to vote against the Kingdom of Morocco’s request for admission was South Africa. Ironically, the reasoning Morocco gave for leaving the Organization of African Unity in 1984 was the same argument given by those opposing its entrance into the AU in 2017: the recognition of Western Sahara. Referred to by some as the Sahrawi Arab Democratic Republic (SADR), Western Sahara has been a controversial territory for over 40 years. As a result, it is not difficult to see why Morocco was disappointed to hear the surprising news that South Africa established diplomatic relations with the so-called Sahrawi Republic and offered those living in Moroccan territory a separate at the expense of cutting ties with its Moroccan ambassador.

The hostility that South Africa has showed toward Morocco is not a common sentiment of African countries. The 39 heads of state that voted in favor of Morocco have acknowledged the value of the kingdom’s readmission. These countries recognize King Mohammed VI’s positive contributions to regional development, including his speech at the , the creation of a ministerial department dedicated to African affairs, and the hosting of the . These actions have demonstrated the resources and effort that the kingdom is willing to invest in regional progress. For example, the World Policy Conference held in Marrakech in November 2017 brought together world leaders to discuss security, development and investment throughout the continent. Morocco’s commitment to the progression of Africa has been made evident through these consistent actions.

Moreover, the fact that the (ECOWAS) responded to the kingdom’s admission request with an invitation to its December meeting in Lomé, Togo, attests to the potential for further cooperation. The regional committee has even overlooked the fact that Morocco is technically not located in West Africa. By disregarding this key geographical detail, it is apparent that the committee sees a significant amount of value in Morocco’s admission. In the first quarter of 2018, the commission will dedicate a specific session to discuss its potential with Moroccan integration.

Countries across the continent have been favorable to Morocco’s readmission into the AU, request to join the ECOWAS and hosting of the World Policy Conference. Consequently, it is reasonable to presume that South Africa’s outlying position has more to do with its political power on the continent and less to do with its concern for Moroccans living in western Morocco. It is ironic to consider a country with the history of South Africa pointing fingers at its northern neighbor over a fabricated moral argument. Furthermore, it is ironic to say the least that a president with the numeric literacy of Jacob Zuma can understand the complexities associated with the annexation of a landmass over 40 years ago. It is more likely the case that South Africa views Morocco’s increasing regional hegemony as a threat.

In fact, Morocco’s ambitions of becoming a pan-African political and economic leader can be seen through its ranking in (FDI). Morocco is the second leading country on the continent for FDI in sub-Saharan Africa — second to only South Africa. Moreover, from 2008 to 2016, . It is clear that these statistics make Morocco an influential player in regional trade and development.

Not only has Morocco exhibited an economic impact throughout Africa, but it has held key political positions as well. It can be presumed that South Africa’s political concerns are also associated with . In the 70th General Debate, and stronger representation of the African continent — more specifically stronger South African representation. While South Africa yearns for the power of a permanent seat, Morocco’s increased leadership continues to threaten its political ambitions. South Africa’s self-motivated actions will continue to cause a deeper rift between Rabat and Pretoria at the expense of the continent.

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