There is an invisible war being fought in Yemen. Most people know only about the war in the headlines: the armed conﬂict between the forces of the Saudi-led coalition and the Ansar Allah group that has killed and injured thousands of people and uprooted more than three million forced to ﬂee the ﬁghting. That conﬂict has decimated the country’s health system, now ill equipped to treat the growing numbers of war-wounded patients and others with urgent medical needs. Which brings us to the other war underway to ﬁght drug-resistant bacteria.
More than 60 percent of patients admitted to the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in the Yemeni port city of Aden suffer from antibiotic-resistant bacteria (ABR). These infections require complex diagnostics and prolonged treatment, further straining an already battered health system.
When our teams in Yemen saw patients who weren't improving from standard antibiotic treatments, they changed their protocols and set up a microbiology lab to begin testing for ABR. At ﬁrst, results were sent to MSF experts outside Yemen for interpretation and diagnosis. Proper diagnoses enable responsible use of the correct antibiotics—and more effective treatment.
Within two years, the microbiology and antibiotic stewardship programs in Yemen, now completely run by Yemeni staff, are among MSF’s most advanced in the world. The project in Aden has shown that the processes and protocols needed to combat the spread of ABR can be successfully implemented in even the most unstable conditions. But the ﬁght is far from over, and urgent action is still needed to halt the public health crisis of antibiotic resistance on the front lines of war and beyond.