Abstract
The World Health Organisation (WHO) and others have identified, as a priority, the need to improve antimicrobial stewardship (AMS) interventions as part of the effort to tackle antimicrobial resistance (AMR). An international health partnership model, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, was established between selected countries in Africa (Ghana, Tanzania, Zambia and Uganda) and the UK to support AMS. This was funded by UK aid under the Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education Trust (THET). The primary aims were to develop local AMS teams and generate antimicrobial consumption surveillance data, quality improvement initiatives, infection prevention and control (IPC) and education/training to reduce AMR. Education and training were key components in achieving this, with pharmacists taking a lead role in developing and leading AMS interventions. Pharmacist-led interventions in Ghana improved access to national antimicrobial prescribing guidelines via the CwPAMS mobile app and improved compliance with policy from 18% to 70% initially for patients with pneumonia in one outpatient clinic. Capacity development on AMS and IPC were achieved in both Tanzania and Zambia, and a train-the-trainer model on the local production of alcohol hand rub in Uganda and Zambia. The model of pharmacy health partnerships has been identified as a model with great potential to be used in other low and middle income countries (LMICs) to support tackling AMR.
Highlights
Antimicrobial resistance (AMR) is a globally recognised threat to humanity and has been compared to a slow-burning version of the current COVID-19 epidemic
Following the launch of the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) app for the 12 institutions across the four countries, there were 530 downloads of the app and 2795 guide opens within 12 months
Empowering pharmacists in Ghana, Tanzania, Uganda and Zambia to lead within their own healthcare settings supported by their pharmacist colleagues in the UK encouraged them to embrace their antimicrobial stewardship role and enhanced the clinical pharmacy practices within the organisations and raised the pharmacy profiles both locally and nationally
Summary
Antimicrobial resistance (AMR) is a globally recognised threat to humanity and has been compared to a slow-burning version of the current COVID-19 epidemic. Data on AMR is scarce and incomplete in many LMICs due to a lack of funding, limited guidance and lack of surveillance. This makes it hard to quantify the issues and prioritise solutions. In the UK, pharmacists play an important role in increasing the awareness of AMR and supporting the implementation of antimicrobial stewardship interventions and programmes (AMS) [4]. Trained pharmacists in LMICs have the potential to play a role in leading antimicrobial stewardship programmes like their counterparts in the UK or USA for example and to be part of the solution to overcome the global challenge of AMR. Pharmacists are often at posts for longer periods of time and so are ideally placed to lead long-term projects
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