Tuesday, March 26, 2019 | ePaper

Model to defeat antimicrobial resistance

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Mohan Joshi :
Management Sciences for Health, with support from the U.S. Agency for International Development, has developed and implemented an approach to help national governments kick start the coalition-building process: Mobilize support, understand the country's unique situation, develop an action plan, implement that plan on all levels, and monitor and evaluate results. We piloted the approach in Zambia in 2004 and have been refining it ever since.
This model can be applied at the national, organizational, or local level. In Jordan, we mobilized a multidisciplinary group of stakeholders from three hospitals that implemented an antimicrobial stewardship and continuous quality improvement program. The group developed protocols and procedures that improved antibiotic prophylaxis for caesarean sections and saved three hospitals a combined $15,300 in one year.
Faith-based and professional groups can lend critical support. For example, the Ecumenical Pharmaceutical Network, which supports the health services that churches and faith groups provide throughout Africa, made addressing AMR a priority and provided technical support to its members.
Coalitions need to extend beyond the human health sector to the veterinary, agricultural, and environmental sectors. Swaziland, for example, included representatives from the Ministry of Health, Ministry of Agriculture, Ministry of Natural Resources & Energy, and the Swaziland Environment Authority when it drafted its 2017-2021 National AMR Containment Strategic Plan. The plan clearly delineates priority activities for the human health, animal health, agriculture, and environment sectors.
Lastly, we need to educate patients and the public, from mass media messaging to the doctor's office. After all, per WHO, about half of all patients worldwide do not adhere to recommended medications. Ethiopia's Food, Medicine and Health Care Administration and Control Authority, for instance, developed a media relations strategy to get the word out about AMR. Broadcasters and publications produced hundreds of messages in 10 languages.
Gathering these often disparate groups can be challenging and requires strong leadership and advocacy. But it is only by coordinated action that we'll be able to provide the united front we need to defeat AMR.

(Mohan Joshi is the GHSA/AMR technical lead for the USAID-funded Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, implemented by Management Sciences for Health, a global health nonprofit).

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