Disseminating scientific-based knowledge, to foster cultural and behavior changes for combatting environmental and human health impacts associated to antimicrobial resistance during and after covid-19 epidemic in sub-Saharan Africa: case of Congo DR

Since early 2020, the entire humanity has been shaken by a major health crisis due to the emergence of the COVID-19 epidemic, affecting many areas of people lives including public health and socio-economic sectors and the psychological consequences of this unusual situation. It can also have negative environmental consequences, which are likely to lead to other global health crises in the future such as exacerbating the problem of antibiotic resistance, even though, antibiotics do not treat or prevent viral infections like COVID-19. This project proposal is therefore interested in the excessive and inappropriate use of antibiotics during this pandemic in several regions of developing countries in tropical climates, particularly in Sub-Saharan Africa which, according to our surveys carried out in Kinshasa (capital of the Democratic Republic of the Congo (RDC)) in collaboration with the World Health Organization (WHO) and reports from the field, has tripled or even quadrupled between April and November 2020. The population is self-medicating, using antibiotics for the treatment of symptoms and the prevention of COVID-19. According to the results of our research projects before COVID-19 funded by the Swiss National Fund (SNSF), large amounts of bacteria and genes of resistance to antibiotics of the latest generation, in particular classes of beta-lactams and carbapenems, are detected. in the aquatic environment of sub-Saharan Africa particularly in the DRC and southern India. This dissemination is due to several factors, including: (1) the non-regulation of the use of antibiotics in human medicine in the studied regions; (2) the lack of wastewater treatment systems; (3) open defecation; and (4) mostly the lack of strategies for communication, public awareness raising and education, and people practice of scientific results. Given this picture, the following recommendations were made in the context of our results: In addition to reinforcing the regulation for the necessary and appropriate use of antibiotics, the need to promoting the dissemination of our results to experts and especially to the unformed public about the potential impacts of chemical and bacteriological pollutions into water and the spread of pathogens and antibiotic resistance genes. Moreover, according to the WHO, although the COVID-19 pandemic is a current health priority, the existing health crises and diseases should not be neglected, and antimicrobial resistance is one of the global health crises. In this context, it therefore requires urgent attention and action. The methodology applied in our previous SNSF projects for the evaluation of the quality of urban and hospital effluents has an advantage in highlighting the epidemiology of antibiotic resistance in relation to the geographical scale. We integrate existing data from clinical settings showing antibiotic consumption trends to understand the past and present prescriptions/uses of antibiotics. Also, our results from the environmental samples show the global impact of the exposure to antibiotics, including transmission routes based on community behavior rather than on the individual receiving the antibiotics. Therefore, the main objective of this community outreach project is to maximise the impact of our research findings on practice beyond scientific publication in sharing knowledge and our scientific evidence on the issue of antibiotic resistance, in a plain language, to both scientific and non-specialist audiences, raising public awareness for behavior change, educating, and providing appropriate training on antibiotic use. The communication approach will be multisectoral including end-users (public), scientists as well as political authorities. Several communication channels will be used to reach specific audiences, including interactive workshops on implementation of good practice guidelines; field and media campaigns for knowledge mobilisation; advertising materials such as posters, T-shirts, leaflets in local language for the public, electronic and popular media outlets that provide a wider audience than peer-reviewed journals. This project offers a unique opportunity not only to communicate our scientific research results to end-users (public) but also to promote strategies for sharing knowledge to combat antimicrobial resistance through communication.