Universitas Indonesia (UI) added three names of professors to its roster, namely Prof. dr. Anis Karuniawati, Sp.MK(K)., Ph.D; Prof. dr. Fera Ibrahim, M.Sc, Ph.D, Sp.MK(K); and Prof. dr. Yusra, Sp.PK., SubSp.GEH(K)., Ph.D; through an open session led by UI Rector, Prof. Ari Kuncoro, S.E., M.A, Ph.D, at the UI Salemba Campus, Jakarta, on November 9, 2024. At the inauguration, Prof. dr. Anis Karuniawati delivered a speech titled “Controlling Antimicrobial Resistance with the One Health Approach: The Need for Breakthroughs in Policy and Governance Between Sectors at the Global and Local Levels”.
Prof. dr. Anis Karuniawati said that a modeling study conducted by Global Research on Antimicrobial Resistance (GRAM) reported that in 2019, there were 444,800 cases of death due to sepsis in Indonesia. As many as 68% of them were caused by bacterial infections, and 38% by resistant bacteria. When compared to the Covid-19 pandemic data—there were 161,930 deaths during the 3 years of the pandemic—the number of deaths due to resistant bacterial infections is very high.
Resistant bacteria appear due to antimicrobial resistance (AMR), which is when microbes cannot be killed by antimicrobials that were previously deadly. The resistance of bacteria to an antibiotic is a natural property due to spontaneous mutation or the transfer of genetic material carrying resistance from other bacterial cells into the bacterial cells. Resistance can arise against one type of antibiotic (mono-resistant) or several antibiotics at once, known as multi-drug resistant (MDR).
According to Prof. Anis, the development and spread of drug-resistant microbes can be caused by four main things. First, antibiotic use, self-medication, and other factors in the community. Second, antibiotic use and other factors in health care facilities. Third, antibiotic use in food production, livestock, and agriculture. Fourth, the presence of resistant bacteria or other microbes in the environment, which is a result of the other three factors.
To address this, the government of the Republic of Indonesia issued the National Action Plan for Controlling Antimicrobial Resistance (RAN-AMR) for the 2017–2019 Period in accordance with the recommendations of the 68th World Health Assembly in 2017. The RAN-AMR, which was prepared by involving many ministries, was then ratified as Regulation of the Coordinating Minister for Human Development and Culture of the Republic of Indonesia Number 7 of 2021 with the concept of “one health”.
The concept of “one world-one health” which has been published since 2004 is a global strategy to emphasize the importance of a holistic, trans- and interdisciplinary approach, and combines multi-sectoral science in dealing with human, animal, and ecosystem health. In its implementation, the concept of “one health” must involve various levels of health governance, from the global to the local level, by encouraging a participatory approach that brings together communities, scientific experts including in the social sector, government, other stakeholders, as well as industry and Non-Governmental Organizations (NGOs).
However, in the reality faced by many countries, the sectoral government structure limits the development of transdisciplinary approaches and integrated actions. The main challenge in implementing the one health concept is eliminating interdisciplinary barriers between sciences, and to overcome this, evidence-based data is needed on the added value of the one health approach. This is the task of academics to build scientific and social interactions to encourage the expected integrative benefits of the one health concept.
“The commitment of various parties is very much needed in implementing the AMR control program with the one health approach. Political commitment and government leadership are needed to make the right decisions. Commitment to providing funds and cross-sector coordinators are also needed to build mutual trust, ownership, and cooperation. In addition, the implementation of RAN-AMR must be linked to programs in ministries/institutions, and must involve community leaders and religious leaders considering that Indonesia has a society with very diverse customs and cultures,” said Prof. Anis.
In addition to researching antimicrobial resistance issues, Prof. Anis’ interest in bacteriology is also evident in his previous research. Some of them are Multidrug-Resistant Bacteria Colonization in Patients Admitted to Dr. Cipto Mangunkusumo Hospital Jakarta, Indonesia (2024); Antimicrobial Resistance among Common Bacterial Pathogens in Indonesia: A Systematic Review (2024); and In Search of the Best Method to Detect Carriage of Carbapenem-Resistant Pseudomonas Aeruginosa in Humans: A Systematic Review (2024).
Prof. Anis graduated from FKUI in 1990; graduated from the doctoral program (Dr.sc.agr. equivalent to Ph.D) at the Institut fȕr Umwelt-und Tierhygiene sowie Tiermedizin und Tierklinik, Universität Hohenheim, Stuttgart, Germany, in 2001; and completed the Clinical Microbiology Specialist program at the Indonesian Clinical Microbiology Association College in 2001. Currently, he serves as Vice Dean for Resources, Ventures, and General Administration of the FKUI; Chair of the Antimicrobial Resistance Control Committee (KPRA), Ministry of Health; and Chair of the Indonesian Clinical Microbiology Specialist Association (PAMKI).
