The ever-growing human resistance to antimicrobials – agents such as antibiotic medicines that slow down the growth of or kill organisms like bacteria, viruses, fungi, and parasites – has made it increasingly important for different sectors of society to work together to curtail the extent of the resistance. This was the warning aired by Professor Natalie Schellack, Head of the Department of Pharmacology at the University of Pretoria (UP) and registered pharmacist, during her inaugural lecture.

Prof Schellack’s inaugural lecture was themed ‘The different faces of the Antimicrobial Stewardship Landscape: Mapping ways forward for low- and middle-income countries. She said antimicrobial stewardship, which refers to guarding and protecting the use of antimicrobials, has become a poignant topic, as the irresponsible use of antimicrobials is hastening the move towards complete human resistance in future.

“Africa as a continent has a different disease burden and population for that matter when compared to other continents,” Prof Schellack said. “The concept of ‘stewarding’ a resource requires investigation into the environment that you are stewarding it in. I realised very soon in my career that it seems contextualisation for this concept (antimicrobial stewardship) has not been provided for Africa, or that we are overexposed to other countries or populations. The proposals that these countries have to negate antimicrobial stewardship simply does not fit South Africa or Africa as it should.”

“Throughout I have used this concept of embracing our uniqueness and connecting with colleagues within Africa, to find different solutions from South Africa and Africa for South Africa and Africa. This is still what drives me and gets me up every morning.”

Prof Schellack said a study conducted within the taxi community of Gauteng, conducted by Tumela Mokoena, for the purposes of a master’s degree. Several misconceptions were documented amongst the minibus-taxi community and, whilst highlighting the linguistic barriers for the term antibiotic resistance, we identified several enablers for public awareness and empowerment. Further studies are required to define appropriate indigenous terms for future educational antibiotic campaigns.

Referring to humankind’s ever-growing resistance to antimicrobials, she said they investigated many different aspects, from utilisation of antimicrobials, app development, cultural context, and behavioural aspects such as over-the-counter dispensing of antimicrobials. While they made many significant findings, navigating the way forward is fraught with hurdles, as the methodology of stewardship is rather new, making it more and more difficult for researchers to act in a way that is immediate, but also follow processes that are outdated for a problem of this calibre. She said navigating the way forward would still involve scientists from almost every type of community thinking out of the box.

“It was an honour and privilege to deliver my inaugural address, and I would like to thank the Faculty of Health Sciences through the Dean’s Office, and the Faculty Manager for all of their behind-the-scenes work,” Prof Schellack said. “To see my family, friends, colleagues, the representation of the Deanery, both in-person and online, was remarkable and gave me a sense of belonging and gratitude.”