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Iraq's war-battered cities grapple with rising resistance to antibiotics

Six years after the liberation of Mosul from the Islamic State, the city battles a silent enemy: abnormally high rates of multidrug-resistant infections. It's a phenomenon fueled by decades of war that poses a massive threat to global health.
A medic works at a laboratory at the Nablus hospital, run by Doctors Without Borders (MSF), in Iraq's northern city of Mosul on Dec. 16, 2021.
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MOSUL, Iraq — Sitting in a small office in the Mosul General Hospital, Emad Ahmad, a member of the hospital’s Antibiotics Committee, sighs as he consults the results of the latest antibiogram compiled by his department.

“It’s a silent tsunami. Little by little, we are losing the only medicines that we have hope in,” Ahmad says, gesturing toward a spreadsheet displaying monthly data from the hospital’s testing labs. “Here, we see that Ceftriaxone doesn’t work on 90% of samples we tested in June. We are even witnessing resistance to Meropenem, which was until now one of the most effective [antibiotics].”

Ceftriaxone and Meropenem are two antibiotics used to treat a wide range of bacterial infections like meningitis and pneumonia. But like many antibiotics used in Iraqi hospitals, they are less and less effective in treating patients because the bacteria they target are becoming resistant to them.

Antibiotic resistance occurs when bacteria become less sensitive to antibiotics designed to eliminate them. Resistance normally develops naturally over time, but the process goes much faster when drugs are misprescribed or misused, leading bacteria to be exposed to levels of antibiotics that are insufficient to kill them but that still allow them to adapt.

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