(2002; 166 pages)
Implementing a strategy for the containment of antimicrobial resistance: experience in Uganda
Mr Gabriel K. Kaddu, Uganda
Drug-resistant pathogens are a growing menace to all people regardless of age, sex or socioeconomic background. Uganda is currently implementing a strategy for the containment of antimicrobial resistance, in line with the recommendations of the World Health Assembly. Several interventions have been undertaken:
Only antimicrobials that meet international standards of quality, safety and efficacy are granted marketing authorization. This is ensured by:
• inspecting manufacturing facilities before registering a product;
• inspecting drug consignments and assessing quality before releasing for distribution;
• making mandatory an analysis of all antimalarials, antituberculosis drugs, antibacterials and condoms before release for distribution.
The availability of antimicrobials is restricted by:
• protecting “drugs of last resort”;
• controlling and monitoring importation and distribution of antiretroviral drugs;
• importing rifampicin solely for the treatment of tuberculosis;
• ensuring in the registration system that packages contain the full dosages.
Standard treatment guidelines have been strengthened by:
• updating to include diagnostic guidelines;
• testing their impact.
Campaigns have been carried out using media and social marketing techniques to educate patients by:
• targeting immunization, vector control and bednets;
• emphasizing the importance of good hygiene in preventing transmission of infection;
• stressing the importance of total compliance with dosages.
Education has been provided to prescribers and dispensers (including drug sellers) through:
• support for continuing medical education programmes;
• training in rational drug use;
• encouraging training for staff with no formal medical training.
The accessibility of health care to the entire population of Uganda is ensured by:
• establishing public-private relationships;
• encouraging opening of rural pharmacies;
• recruiting medical staff for all subcounties;
• establishing health centres in all subcounties.
A vigorous fight is being conducted against counterfeit and substandard drugs.
Action is being taken against drug-hawking and the sale of medicines in open markets.
Drug needs, use and resistance patterns are being determined in each district.
There is a continuing need to work together to address the threat of antimicrobial resistance.