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  • Overprescribing antibiotics poses ‘serious’ risk of antimicrobial resistance in Pakistan— health experts 


Overprescribing antibiotics poses ‘serious’ risk of antimicrobial resistance in Pakistan— health experts 

Pharmacy employees wearing facemasks as a preventive measure against the COVID-19 coronavirus attend to customers in Islamabad on March 23, 2020. (AFP/File)
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Updated 27 January 2024
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Overprescribing antibiotics poses ‘serious’ risk of antimicrobial resistance in Pakistan— health experts 

  • AMR could cause as many deaths as 10 million per year around the world by 2050, warns UN group 
  • OTC sales of antibiotics, incentive-linked prescribing causes surge in drug-resistant microbes, say experts 
Updated 27 January 2024
KHURSHID AHMED   

KARACHI: Pakistan faces a “serious” risk of Antimicrobial resistance (AMR), which refers to the ability of bacteria, viruses and parasites to develop the capability to fight drugs designed to kill them, health experts warned this week, citing indiscriminate prescription of antibiotics by health practitioners as the main reason. 

According to the World Health Organization (WHO), bacterial AMR was directly responsible for an estimated 1.27 million deaths worldwide in 2019 and contributed to 4.95 million deaths indirectly. The misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in the development of drug-resistant pathogens. the international organization says. 

Pakistani health care stakeholders say a serious risk of drug-resistant microbes exists due to Incentive-Linked Prescribing (ILP), the practice of doctors and physicians receiving personal benefits or incentives from pharmaceutical companies for prescribing specific medications. 

They also cite over-the-counter (OTC) sales of antibiotics and self-medication as reasons for the emergence of drug-resistant microbes. 

“90 percent of private doctors meet pharmaceutical sales representatives on a weekly basis, and that accepting or seeking out incentives is normalized in Pakistan,” a recently compiled report by The Aga Khan University and London School of Hygiene and Tropical Medicines, said. 

The report said 40 percent of these doctors agreed to accept incentives and prescribe medicines to patients. The doctors agree to prescribe medicines due to financial pressures and inadequate consequences for breaking rules in the country, it added. 

The UN’s Interagency Coordinating Group on AMR has estimated that by 2050, the AMR could result in the deaths of 10 million people worldwide.

Dr. Abdul Ghafoor Shoro, Pakistan Medical Association’s (PMA) general secretary who is also a member of the Sindh Healthcare Commission, acknowledged that certain doctors, due to conflict of interest, were engaged in prescribing antibiotics and other medicines to increase sales of pharmaceutical companies. 

This, he said, they do in exchange for gifts, offers to go on tours and other financial benefits. 

“Many people are involved, so when you take monetary benefit, you try to pay back,” Dr. Shoro told Arab News. “But in this case, only patients pay back and suffer.” 

Shoro said the resistance level in tuberculosis cases in Pakistan has increased from MDR (multi-drug resistance) to XDR (extensively drug-resistant) while in cases of typhoid, the resistance level has also increased to XDR. 

The world witnessed its first case of XDR typhoid in late 2016 in Pakistan’s Sindh province. 

“You have limited availability of antibiotics and going forward, all [diseases] will be resistant which would be a big problem,” Dr. Shoro warned. 

The PMA official also blamed the presence of around 600,000-800,000 “quacks“— a term frequently used to refer to someone who practices medicine without necessary qualifications, skills, or training— in Pakistan for the indiscriminate use of antibiotics. 

“The big issue is that they don’t have the knowledge themselves about its usage,” Dr. Shoro said. “What they do is that they prescribe antibiotics one day and change [it] another day.” 

The head of the National Institute of Health (NIH) in Pakistan also recognized AMR as a significant public health problem, warning of a “serious burden of multi and multi-drug resistance organism, particularly in hospitals or health care settings.” 

“There are reports of complicated surgeries due to resistant organisms,” Muhammad Salman, acting executive director of the NIH, told Arab News this week. 

“And then other health care-associated infections such as ventilator-associated pneumonia, blood stream infections, catheter-associated infections, and urinary tract infection.”

Dr. Salman said that in communities, it has been observed that diseases similar to XDR typhoid are endemic in Pakistan. “So that actually reflects that the problem is actually very serious in Pakistan.”

NIH, which is responsible for researching and monitoring Pakistan’s health status, is working on a National Action Plan (NAP) developed in 2017 in line with global objectives to contain AMR. 

“AMR containment is a rather difficult task,” Dr. Salman admitted, adding that more efforts had been put in extracting evidence of AMR’s presence in the past five to six years. 

He said collecting evidence was critical as it would generate sufficient evidence to reflect and would help in advocating for more investment to contain AMR. 

When asked to comment on the conflict-of-interest allegations related to health practitioners in Pakistan, Dr. Salman said the institute lacks sufficient evidence. 

“But there are practices, especially unnecessary prescription practices of antibiotics, by the doctors and physicians, both in private and in public sectors,” he conceded. 

Topics: antibiotics Antimicrobial resistance

Through ‘Haryali’ art exhibition, Denmark calls for urgent environmental action in Pakistan

Updated 5 sec ago
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Through ‘Haryali’ art exhibition, Denmark calls for urgent environmental action in Pakistan

  • Danish embassy organizes exhibition featuring artworks by 36 Pakistani artists against global warming, pollution
  • Pakistan consistently ranks among countries affected most by climate change, where floods killed over 1,700 in 2022
Updated 5 sec ago
Falak Mahmood Khan

ISLAMABAD: The Embassy of Denmark in Pakistan’s capital this week organized a powerful art exhibition that called for urgent environmental action to battle climate challenges, with the European country’s ambassador pledging support for Islamabad in transitioning to renewable energy. 

Pakistan is one of the world’s worst affected countries due to the impacts of climate change, despite contributing less than one percent of planet-warming emissions. Unusually heavy rains in June 2022 killed over 1,700 people, destroyed critical infrastructure in the country and affected over 33 million people which scientists attributed to climate change. 

“Haryali,” which translates to greenery in Urdu, was the name chosen for the exhibition which took place at the Danish ambassador’s residence in Islamabad on Friday night. The exhibition was held to mark 75 years of Pakistan’s diplomatic relations with Denmark at a time when various world leaders have gathered in Baku to attend the COP29 climate conference. 

The exhibition featured artworks by 36 Pakistani artists, who highlighted the disastrous effects of climate change and global warming through sculptures and paintings. 

“Pakistan is one of the countries in the world suffering the most from climate change and action needs to be taken,” Danish Ambassador Jakob Linulf told Arab News on Friday. 

“And this is not something that Pakistan can do by themselves, and from the Danish side we are ready to help with all the expertise that we have gained through our battle also to make a greener society.”

Linulf said Denmark uses solar, wind, water and biomass to generate electricity, adding that Pakistan has an abundance of all of these resources. 

“I would love to see Pakistan transforming its energy sector into a more sustainable energy sector,” he said. 
Iman Bilal, a Pakistani sculptor, highlighted the health dangers associated with microplastics. 
“We’re deteriorating our health, it’s internalized,” she said, stressing the role of art in motivating stakeholders to take action to avoid environmental degradation.
Kareem Ahmed Khan, an artist from the scenic Hunza Valley in northern Pakistan severely impacted by glacial lake outburst floods (GLOFs), reflected on climate change’s devastating impact on his region. 
“For the past seven to eight years, I’ve been working to highlight the impact of climate change on my region,” Khan told Arab News.
Pakistani Prime Minister Shehbaz Sharif, who spoke at a number of events at COP29 earlier this week, used the forum to highlight the need to restore confidence in the pledging process and increase climate finance for vulnerable, developing countries.
 

Topics: Pakistan Denmark ties pakistan climate change climate change art exhibition

Spencer Johnson takes five as Australia beat Pakistan to clinch T20 series

Updated 57 min 15 sec ago
AFP
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Spencer Johnson takes five as Australia beat Pakistan to clinch T20 series

  • Pakistan fell short by 13 runs despite Haris Rauf’s impressive 4-22, which restricted the hosts to 147-9
  • Australia, having won the rain-hit opener in Brisbane, will host the final game in Hobart on Monday
Updated 57 min 15 sec ago
AFP

SYDNEY: Speedster Spencer Johnson took 5-26 to propel Australia to a tense 13-run victory over Pakistan in Sydney on Saturday and seal their three-match T20 series with a game to go.
Set just 148 to win after Haris Rauf claimed 4-22 to keep the hosts in check, Pakistan were all out for 134 in the final over despite a lively 52 from Usman Khan.

Pakistan’s Usman Khan bats during the second T20 international cricket match against Australia in Sydney, Australia, on November 16, 2024. (AP)

Australia won a rain-hit first match in Brisbane by 29 runs with the final game at Hobart on Monday.
“We thought we were there or thereabouts and I thought the way the bowlers went about it was brilliant,” said Australian captain Josh Inglis.
“There’s so many options in this team I can go to. Every time I turned to Johnson tonight, he got a wicket. The way they played tonight was really good.”

Australia’s Marcus Stoinis shakes hands with Pakistan’s Haris Rauf after Australia won the T20 international cricket match against Pakistan in Sydney, on November 16, 2024. (AP)

Australia secured a vital breakthrough by removing Babar Azam (3) off Xavier Bartlett in the second over and Pakistan’s woes deepened when Johnson accounted for Sahibzada Farhan (5).
Runs were hard to come by and after facing 26 balls for 16, skipper Mohammad Rizwan knew he had to up the tempo.
But it cost him with Tim David taking a fine diving catch in the deep off Johnson, who then bagged Salman Agha next ball, caught behind by Inglis to leave Pakistan on 44-4 after 10 overs.
Khan played himself in and brought up his first T20 half-century.

Pakistan’s captain Mohammad Rizwan leaves the field after losing his wicket during the T20 international cricket match against Australia in Sydney, on November 16, 2024. (AP)

But Johnson struck again with Abbas Afridi (4) following soon after to earn the 28-year-old a maiden five-wicket haul in his seventh T20.
Two wickets in an over by spin king Adam Zampa piled the pressure on Pakistan who were unable to rise to the challenge.
Earlier, Australia was restricted to 147-9 after a rip-roaring start, but a slew of dropped catches cost Pakistan.
“If you take the positives, the boys bowled very well. We know Australia is not an easy team,” said Rizwan.
“But if you drop crucial catches, it will cost you the game.
“We all know the pitch wasn’t easy to bat,” he added.
Jake Fraser-McGurk and Matthew Short stitched together a highly entertaining 52-run opening stand off just 22 balls before Rauf struck twice in three deliveries.

Pakistan’s Sufiyan Muqeem (left) is congratulated by teammate Salman Ali Agha after taking the wicket of Australia’s Marcus Stoinis during the T20 international cricket match between Australia and Pakistan in Sydney, on November 16, 2024. (AP)

After tempting Fraser-McGurk (20) into another slog that was taken in the deep by Agha, he enticed a leading edge from Inglis (0).
Pakistan had their tails up and Short quickly followed for 32, bowled by Afridi, with three wickets falling for four runs.
Marcus Stoinis survived two dropped catches but finally fell on 14, reverse-sweeping to Sufiyan Muqeem, who was brought into side for Haseebullah Khan.

Australia’s Jake Fraser-McGurk bats during the T20 international cricket match between Australia and Pakistan in Sydney, on November 16, 2024. (AP)

Muqeem’s wrist-spin then took care of dangerman Glenn Maxwell (21) as the runs dried up.
David was removed by Rauf for 18 and he collected his fourth by bowling Bartlett (5).
Aaron Hardie made a handy 28 before Afridi removed him and Johnson in successive balls in the final over.

Topics: Pakistan Australia Cricket Pakistan vs Australia T20I match T20I series

Seven paramilitary soldiers killed in overnight militant attack in Pakistan’s southwest

Updated 16 November 2024
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Seven paramilitary soldiers killed in overnight militant attack in Pakistan’s southwest

  • Militants launched an armed assault on a Frontier Corps check-post in the remote district of Kalat
  • Balochistan Liberation Army claimed responsibility for the attack, which also left 12 people injured
Updated 16 November 2024
SAADULLAH AKHTER

QUETTA: At least seven soldiers of Pakistan’s paramilitary Frontier Corps (FC) were killed in an overnight attack on a security check-post in the mountainous region of Kalat district in the restive southwestern province of Balochistan, according to a local administration official on Saturday.
The province has been the site of a low-level insurgency by separatist militants for over two decades, although militant attacks have intensified significantly in recent months.
Last August, Baloch separatists launched a string of coordinated attacks targeting civilians and military forces, resulting in more than 50 deaths within a few hours. The latest attack on Pakistani security forces follows a deadly suicide bombing last week at the crowded Quetta railway station, which killed over two dozen people, including army personnel and wounded more than 50 others.
“Armed militants attacked a Frontier Corps check-post in Shah Mardan, an area located 60 kilometers from Kalat city at midnight,” Kalat’s Deputy Commissioner Bilal Shabir told Arab News over the phone.
“Seven soldiers of the paramilitary force were killed in the attack and 12 injured,” he continued, sharing the details of the armed assault. “Subsequently, a security clearance operation was carried out in the mountainous area.”
Asked how many attackers were killed in the skirmish, the deputy commissioner said authorities had not received information on that.
In a statement issued on Saturday, the banned separatist group Balochistan Liberation Army (BLA) claimed responsibility for the attack, saying its fighters had targeted the paramilitary post in Kalat.
The BLA, the largest of several Baloch ethnic insurgent groups, seeks independence for the volatile province, which is home to approximately 15 million people and borders Afghanistan to the north and Iran to the west.
The BLA and other Baloch nationalist groups accuse the Pakistani state of unfairly exploiting the province’s rich gas and mineral resources— an allegation denied by successive governments, which claim to have been undertaking development projects to improve residents’ quality of life.
Prime Minister Shehbaz Sharif condemned the attack on FC personnel, calling the attackers enemies of the province’s economic development.
The prime minister also ordered quality medical treatment for those injured in the attack in Kalat, a remote district located about 140 kilometers from Quetta.
 

Topics: militancy in Pakistan Balochistan Liberation Army Balochistan Attacks

Pakistan offers incentives to New York firms seeking South and Central Asia expansion

Updated 16 November 2024
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Pakistan offers incentives to New York firms seeking South and Central Asia expansion

  • Pakistan’s envoy to the US holds a meeting with the head of the New York Chamber of Commerce
  • The United States is already Pakistan’s largest export market for textiles, apparel and leather goods
Updated 16 November 2024
Arab News Pakistan

ISLAMABAD: Pakistan has offered New York-based businesses investment incentives to expand their footprint in South and Central Asia, citing its strategic location as a key advantage, state-run media reported on Saturday.
Seeking to position itself as a pivotal trade and transit hub, Pakistan has sought to involve other countries in its economic plans, particularly within its own neighborhood where it has offered landlocked Central Asian states access to its ports to facilitate their connection to global markets.
US-Pakistan trade relations have long been significant, with the US serving as Pakistan’s largest export market for textiles, apparel and leather goods.
Pakistan’s Ambassador to the US, Rizwan Saeed Sheikh, met with Mark Jaffe, Head of the Greater New York Chamber of Commerce, to discuss strategies for enhancing bilateral trade between the two nations.
“The Pakistani envoy underscored Pakistan’s liberal investment regime, strategic geographic location, and incentives for foreign investors, emphasizing the benefits for New York businesses seeking to expand their footprint in South and Central Asia,” the Associated Press of Pakistan (APP) news agency reported.
Jaffe expressed interest in Pakistan’s textile, leather, surgical and information technology sectors apart from outlining efforts to promote trade and investment, it added.
Ambassador Sheikh appreciated Jaffe’s support and interest in Pakistan’s 5th International Textile and Leather Exhibition 2024 held last month in the country’s southern metropolis of Karachi, APP said.
He also invited the New York City chamber to participate in the 4th Engineering and Healthcare show in Lahore next year.
The Pakistani envoy highlighted how Pakistan’s Generalized System of Preferences Plus (GSP+) status in the European Union and Free Trade Agreement with China could provide added advantages for foreign investors working in his country.
The meeting took place at a time when Islamabad is seeking to bolster trade and investment relations with allies to stabilize its fragile $350 billion economy as it faces an acute balance of payment crisis amid soaring inflation and surging external debt.
 

Topics: Pakistan US Ties

Companies employing Chinese nationals being asked to hire ex-military servicemen for security — Sindh Police

Updated 16 November 2024
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Companies employing Chinese nationals being asked to hire ex-military servicemen for security — Sindh Police

  • Sindh Police reviews security measures for Chinese nationals amid increase in attacks targeting them
  • Intelligence agencies conducting security audit of guards hired to protect Chinese nationals, say police
Updated 16 November 2024
NAIMAT KHAN

KARACHI: Companies, organizers, hosts, sponsors and any other entities in Pakistan that employ Chinese nationals are being asked to hire the services of former military personnel for security purposes, Sindh Police said this week amid increasing attacks on Chinese citizens in the country. 
A string of recent attacks on Chinese nationals in Pakistan have caused Beijing to worry about the security of its citizens. Separatist militants in Pakistan’s southwestern Balochistan province have carried out attacks against Chinese interests this year, blaming Islamabad and Beijing for exploiting the gas-and-oil-rich province. Both deny the allegations.
Last month, a suicide blast near the airport in Pakistan’s southern port city of Karachi killed two Chinese engineers while a security guard shot and injured two Chinese nationals in Karachi this month.
Sindh Inspector General of Police Ghulam Nabi Memon held a meeting at the Central Police Office in Karachi on Thursday to review the security of Chinese nationals in the province. 
“DIG Special Protection Unit, while briefing the committee formed to review security measures of Chinese citizens, said the Internal Bureau and Special Branch are conducting a security audit of the private security guards assigned to protect Chinese citizens,” a statement from the police said on Friday evening.
“While project organizers, hosts/sponsors are also being made to hire the services of ex-military servicemen.”
The statement said that the SPU would conduct joint training exercises continuously to meet any emergency security situation. 
“A hotline number has been provided for the facilitation of Chinese citizens and for immediate contact with law enforcement agencies,” it said. 
“He further said that suggestions have also been given to project owners/sponsors to strictly implement security standard operating procedures, including a security audit of private security companies.”
China is a major ally and investor in Pakistan that has pledged over $65 billion in investment in road, infrastructure and development projects under the China-Pakistan Economic Corridor (CPEC) project, at the heart of which lies the Gwadar port in Balochistan.
Pakistan says attacks targeting Chinese nationals are aimed at disrupting its relations with China and destabilizing CPEC.

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