The Cayman Islands has joined the international and regional community in taking steps to combat a phenomenon that has led to a troubling increase in the ineffectiveness of drugs used to treat and prevent infections in human and animal patients.

As part of this initiative the Ministry of Health, the Public Health Department, and the Department of Agriculture have partnered to increase awareness among stakeholders and within the community, as well as to develop a national action plan to fight anti-microbial resistance, also known as AMR.

Members of the national action plan development working group held their first meeting on Monday 30 January 2017. The team consists of public health, pharmacy, agriculture, infection control, laboratory, and environmental health personnel. It has been tasked by the World Health Organisation (WHO) and the Pan-American Health Organisation (PAHO) with creating an AMR national action plan draft by the end of May this year.

Representatives say they are well on their way to achieving this goal. To assist with this process the group is also reaching out to the general public through an online survey to gauge existing knowledge about practices that increase the risk and spread of AMR. The survey can be accessed at www.surveymonkey.com/r/resistance345.

Noting that AMR occurs when bacteria, parasites, viruses, or fungi change in response to the use of these medications, working group member and Department of Agriculture Veterinary Officer, Dr Samantha Dorman, explains that the primary cause of this phenomenon is the overuse of medications for human and animal health.

Globally, misuse of antibiotics by patients (e.g. not finishing a prescribed course), overuse of antibiotics in livestock rearing, fish farming and plant production contribute to the development of antimicrobial resistance, Dr Dorman says. Meanwhile spread is assisted by lack of vaccinations, poor on-farm biosecurity measures, and sub-standard hygiene practices in hospitals and during cooking.

Dr Dorman notes that in the Cayman Islands Department of Agriculture policies have resulted in minimal use of antibiotics in agriculture. In particular the Department requires that antibiotics should only be used for treatment of infections and only under the supervision of a veterinarian.

International organisations describe AMR as potentially the most concerning public health and economic threat of the 21st century. They also estimate that without serious intervention, by 2050, death tolls from resistant infections could reach 10 million annually, with an associated financial burden of US$100 trillion.

“It is not too late to reduce the impact of resistance to antibiotics and other antimicrobial medicines, and we all have a part to play in preserving their effectiveness,” Dr Dorman concludes.

The deadline to complete the survey is Friday 17 February 2017. An official report of findings will be made public and will help guide the final plan.

The Health Services Authority (HSA) lab monitors for AMR in the human population on a regular basis, and shares its findings with local physicians every six months. Among other things the national action plan development process will seek to gain better insight into the severity of any local problem and the specific drivers of resistance.

Following a request from the World Organisation for Animal Health (OIE), the Department of Agriculture has started collecting information on the amounts of antibiotics used in animals by the various animal institutions on-island, and will continue to monitor this on an annual basis.

The OIE’s objective is to develop a global database on the use of antimicrobial agents in animals.

Hard copies of the survey are available at all public health district clinics, at the general practice and public health desks at the Cayman Islands Hospital, at Faith Hospital in Cayman Brac, and the clinic in Little Cayman. Additional details are available from the Department of Agriculture at 947-3090, email [email protected], or the Public Health Department at 244-2621 or 244-2561.