Noorulain Shaikh graduated with an LLB (Hons.) degree from the University of London. She is keen on geographical, sociopolitical, and legal aspects of world affairs. She is a published author of articles concerning international law and regional policy affairs.

Pakistan is currently facing a health crisis in the form of inappropriate use of antimicrobials, a group of agents that curtail the spread of microorganisms like bacteria, viruses, fungi, protozoa, and parasites. Antimicrobial drugs are mostly prescription drugs that must be consumed according to the quantity prescribed by a medical practitioner, if at all.

Both humans, animals, and plants need antimicrobials to contain and prevent diseases and infections. Out of other agents, antibiotics are a commonly known and consumed drug in Pakistan. The first big breakthrough in the development of antibiotics came with the discovery of penicillin in 1929, which cures several bacterial diseases such as pneumonia, gonorrhea, and infections of the ear, throat, and urinary tract, among others. Not only did it improve the condition of patients, but it could also be recycled and used again as it is excreted in the patient’s urine.

As groundbreaking as the discovery of penicillin was, the first case of antibiotic resistance soon followed in 1940. Since then, antimicrobial resistance has consistently been observed over decades. However, antimicrobial resistance was not a public threat until a few years ago. According to the World Health Organization, the resistance was responsible for the death of around 5 million people, with a direct relation to the death of 1.27 million in 2019. In Pakistan, the resistance caused the deaths of around 300,000 people, directly and indirectly.

The increase in antimicrobial resistance is due to a combination of factors, with the most reported one being the overuse of antimicrobials, especially antibiotics. Evidence suggests a direct linkage between the consumption of antibiotics and the development of antimicrobial-resistant bacteria. It means that the consumption of antimicrobials creates room for restraint bacteria, let alone overconsumption.

Overconsumption is a global issue, with reports showing India, China, and the USA as the largest consumers. However, in Pakistan, the situation is no less alarming, where most antimicrobials, especially antibiotics, are sold over the counter, which means that anyone could buy antibiotics without a prescription.

This is problematic not only for health reasons but also because the national drug policy of Pakistan discourages the selling of antibiotics without a prescription. A study confirmed the presence of 80,000 retail pharmacies within the Pakistani healthcare system, and these pharmacies are responsible for 80% of the drug distribution in the country. This means that the attitude and practices of pharmacies significantly contribute to the overconsumption of antibiotics, and, therefore, the increasing resistance.........

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