Republic of Macedonia, together with 75 countries in Europe, joined the initiative of the World Health Organization (WHO) for the fourth time to mark the World Week for Rational Use of Antibiotics, the week of 18 November – the European Day for the Rational Use of Antibiotics, with which we want all together to raise the awareness of the rational use of antibiotics and to urge for the promotion of the health of people, animals and the environment in the spirit of one’s health.

Resistance to antibiotics is a growing threat to global health. Every year around 700,000 people die worldwide as a result of bacterial infections that are resistant to multiple antibiotics. Resistance to antibiotics is the cause of the death of 33,000 people in the European Union each year and this number is increasing all the time.

Same bacteria can cause disease both in animals and humans, through the external environment. 60% of all diseases in humans are coming from animals. This makes the health of people, animals and the environment inseparable when it comes to combating antimicrobial resistance, that is, the “One Health” approach is the only possible way to achieve real progress in our country, the region and the world.

Therefore MUST be known that:

  • It is important to respect the antimicrobial agents used to treat infections in animals and humans and to be used with caution.
  • When preventing the development of resistance to bacteria in animals, at the same time, we protect humans.
  • The same classes of antimicrobials are used in humans and in food-producing animals
  • Food chain is an important route for transmission.
  • A single sector alone can not solve the problem
  • No changes will be made in the absence of commitment from the entire society, population and the government to undertake activities in all sectors and at all levels in the Republic of Macedonia

United in the effort to control this important problem this year’s celebration of the World Week for the Rational Use of Antibiotics, under the motto One Voice for One Health, we carried out several activities aimed at the veterinary and health sector.

On 16.11.2018 an educational meeting was held with the students of the Faculty of Veterinary Medicine, Skopje, organized by the Stewardship Union of the IWAA, and with the support of the Multisectoral Commission for Control of Antimicrobial Resistance within the Ministry of Health, RES, FAO, WHO the office in Skopje, the Faculty of Veterinary Medicine, Skopje and the Institute for Public Health (IPH).

On November 19th, in the House of Humanitarian Organizations Dare Dzambaz, in the spirit of ONE HEALTH, a joint meeting was held between the two sectors – health, primarily primary care, and veterinary medicine. New experiences with the undertaken control measures of the AMR and the situation with the AMR in both sectors and gave directions for future activities were shared on the event. Dr. Vladimir Miloshev, a State Secretary, opened the event.

Support of the activities was given by a number of institutions such as the Ministry of Health, the Multisectoral Commission for Control of AMR at the Ministry of Health, the Red Cross of the Republic of Macedonia, (which advocates future active involvement in the process of raising awareness of the rational use of antibiotics among the population), the Food and Veterinary Agency, the Institute for Public Health of the Republic of Macedonia, Faculty of Medicine at the University of Cyril and Methodius, Faculty of Medical Sciences at Goce Delcev University, Faculty of Veterinary Medicine, Association of Family Medicine Specialists – Respiratory Group, Health Insurance Fund of the Republic of Macedonia, the Center for Regional Research and Cooperation Studiorum, and the WHO regional office in Skopje. The media gave their support by sharing information on the urgent need for a reasonable use of antibiotics.

On November 23, CAESAR team, the Association of Microbiologists of Macedonia, the WHO and the civil organization “Radar” organized a meeting of the national CAESAR network for monitoring antimicrobial resistance, attended by over 150 doctors involved in the monitoring system of AMR in invasive isolates – microbiologists, epidemiologists, and representatives of secondary and tertiary health. The purpose of the meeting is to inform about the state of the antimicrobial resistance detected by invasive isolates that will help doctors in secondary and tertiary health in a decision based on national evidence to select the appropriate antibiotic in patient care, and to remind them of the principles for the responsible prescribing of antibiotics by taking an appropriate sample for microbiological analysis before prescribing an antibiotic. The meeting started with an overview of the past and future activities of the CAESAR network by Dr. B.K. Boceska – Ph.D. and Faculty of Medical Sciences, UGD-Stip, manager for CAESAR data.

A detailed overview of the results of the external quality control of the microbiological laboratories followed and the comparison of the capacities of the laboratories with those in Europe were presented by PhD Dr G. Boshevska and Faculty of Medical Sciences, UGD-Stip, national coordinator for AMR.

The situation with the AMR in the Republic of Macedonia was presented by Prof. Dr. Zh. Cekovska – Medical faculty, Skopje. Prof. Dr. N. Panovski-Medical Faculty, Skopje, the President of the Multi-Sectoral Control Commission of AMR, presented the trends of antimicrobial resistance in Macedonia compared to the Balkan and European countries. After the presentation for the first isolates of the blood cultures of carbapenem-resistant enterobacteria by Prof. Dr. A. Kaftandzieva – Medical Faculty, Skopje, followed a lively discussion.

In the fight against antimicrobial resistance, each of us should show our highest dedication and to be – One voice for one health.