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.