Antimicrobial Resistance: The Need for Action in the East, Central and Southern Africa Region
(2009; 19 pages)


After Penicillin went into widespread use in the 1940s, antimicrobials were heralded as "miracle drugs" and "magic bullets." Today, we know that antimicrobials are more like a double-edged sword than a magic bullet. Microbes have responded to extensive antimicrobial use by evolving mechanisms to become resistant to these treatments. Antimicrobial Resistance (AMR) is indiscriminant, impacting every region and country in the world.

Antimicrobial availability and use have dramatically reduced morbidity and mortality due to infectious disease. Recent global health initiatives (The Global Fund, The President’s Emergency Plan, etc) have significantly increased availability of AIDS, malaria and TB drugs in resource-limited countries. However, increased access presents the risk of rapid escalation of AMR if the medicines are not managed and used properly.

Resource-constrained countries bear 95% of the global infectious disease burden and rely on effective antimicrobial medicines to treat these diseases. Many infectious diseases, once easily curable, are becoming increasingly difficult and costly to treat as resistance and multi-drug resistance grows. Some diseases which are difficult to treat even with effective medicines become even more complicated and expensive to cure. Additionally, life-saving medical technologies, such as organ transplants, which are dependent on antimicrobials to prevent surgical site infections, are threatened by AMR. The burden of AMR is growing across drug classes and around the world. We can no longer continue to rely mainly on the strategy of new antimicrobials coming onto the market as the research and development pipeline in this area has significantly dried in recent decades. Unfortunately, coordinated containment activities have been lacking, especially at the national and regional level. The East, Central, and Southern Africa Health Community (ECSA HC) must consider these factors and work to contain the emergence and spread of AMR in the region. Recognizing the need for increased AMR advocacy and containment in the ECSA region, the Regional Pharmaceutical Forum (RPF) held a meeting in April 2008 in Uganda in collaboration with the U.S. Agency for International Development-supported Strengthening Pharmaceutical Systems (SPS) Program of Management Sciences for Health. The main objective of this regional meeting was to review RPF’s role in AMR containment and integrate AMR advocacy and containment activities in their 2008-2012 Regional Pharmaceutical Strategy.This paper reviews and expands on much of the AMR information shared at that meeting and what must be done to fight this public health threat. It also expresses the urgency for increased advocacy and containment efforts in the region shared by stakeholders at that meeting...

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