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Can you introduce yourself and your role with COMBAT-AMR?

Bula Vinaka! My name is Karishma Nandan and I am the Fiji Project Coordinator for the COMBAT-AMR project, a Department of Foreign Affairs and Trade funded capacity building training program to support prevention and surveillance of AMR across Pacific Island Countries.

I am based in Suva, Fiji, and my role is to facilitate and coordinate the project activities between project partners internationally and locally.

What are you currently working on?

Currently, I am working on facilitating training on introduction of electronic-based reporting in the Infection Prevention and Control department, along with collecting data for the Animal Health component of the project.

In addition, we have been working with the hospital and laboratory teams in Fiji to undertake a situation assessment to inform our capacity building activities based on need.

Furthermore, I am also a youth ambassador with the Global Youth Climate Network (GYCN), an initiative of the Youth-to-Youth (Y2Y) Community of young professionals at the World Bank Group.

Before joining the COMBAT-AMR project, what were you working on?

Prior to joining the COMBAT-AMR project, I worked for an international volunteer facilitating organisation, Projects Abroad, in the capacity of Country Director. I was with them for nine years and had the opportunity to play a variety of roles. These roles allowed me to explore my passion of service to others and to the environment through managing projects in early childhood education, health & wellness, non-communicable diseases and marine conservation.

What initially attracted you to working in public health and your area of research?

Public Health is not my field of study, I have an undergraduate degree in Marine Studies and a Master’s in Business Administration both from local universities. My passion is service to others and to the environment however, to achieve this passion, I know that I need to contribute towards issues such as communicable diseases that impact our society, families and the environment. I strongly believe that humanity and our environment are linked, and if our environment suffers then this will ultimately impact our health. This project has a strong One Health focus, and aligns well with my interests.

Why is combatting AMR important to you?

Combatting antimicrobial resistance (AMR) is important to me because once our communities become resistant to antimicrobials, there would be an increased cost of medication and higher risk of fatal infection. Fiji has one of the highest death rates related to diabetes, as well as high instance of amputations due to diabetes. Without the effective and appropriate use of antimicrobials for the prevention and treatment of infections, diabetes management becomes high-risk. Developing resistance to antimicrobials will also become a societal problem which could lead to other social issues such a domestic and mental health concerns. You might ask how domestic and mental health are linked to antimicrobial resistance. Think of an average family whose sole bread winner has developed resistance to antimicrobials and his treatments will now cost beyond their capacity. The pressure of the illness, limited financial resources and peer pressure can severely impact mental health, leading to other impacts on domestic health.

I strongly believe that increasing awareness, building local facility capacity as well as having strict antimicrobial stewardship will help mitigate the threat of AMR.

What do you see as the biggest challenges in mitigating the threat of AMR in the Pacific Islands and globally?

I believe the lack of resources and capacity of the facility and staff are biggest challenges of AMR in the Pacific. Another challenge is prioritising AMR and antimicrobial stewardship within the health community. This is mainly because most Pacific Islands Countries are developing countries and their focus is usually on more immediate threats however, if there are good governance systems in place related to AMR, then I believe it can be mitigated. Regarding resources and capacity, developing countries require financial assistance and experts to assist them in building capacity and providing relevant resources, and these can be provided in partnership with projects such a COMBAT-AMR in the Pacific.

On a global scale, AMR needs to become a priority and there needs to a greater awareness within the consumers and patients so that ownership and responsibility of antimicrobial use does not only fall on pharmaceutical and medical workers. However, changing mindsets and lifestyles of people is the greatest challenge towards mitigating the threat of AMR.