Towards a national action plan for antimicrobial resistance: The Kenyan experience

Abstract

Background: From the situation analysis on Antimicrobial use and resistance in Kenya 2011, 50% of the leading causes of death in Kenya are due to infectious diseases and antimicrobial resistance to microbes indicated rising trends of resistance to commonly used antibiotics (66%, 94%, 53%, 43% to cotrimoxazole, ampicillin, fluoroquinolones and penicillins respectively. This is attributed to inappropriate use of antimicrobials in humans and animals. Methods & Materials: Desk review of recommendations made in minutes and reports of meetings, conferences and workshops on Infection prevention and control and AMR and publications from studies done in sentinel sites in Kenya. Results: In 2009 the Global Antibiotic Resistance Partnership Kenya was established. GARP-K completed and launched a Situation analysis(SA) of antibiotic use and resistance in Kenya in August 2011; In November 2013- Kenya hosted the first Antimicrobial Resistance (AMR) awareness week and a regional antibiotic stewardship workshop in December 2013 whose recommendations were submitted to the National Infection Prevention and Control Committee (NIPCC) at the MOH in Kenya; Following this, findings of the SA were disseminated to health managers in 45 counties in Kenya, In March 2014 the NIPCC recommended the appointment of an AMR focal point; Through the Infection Prevention and Control Unit the National strategic plan for IPC with two strategic objectives specific for AMR: establishing a national AMR Surveillance system and the appointment of National Antimicrobial Stewardship Advisory Committee (NASAC);November 2014- during the 2nd National AMR week the Director of Medical Services established AMR program and appointed a multisectoral NASAC. Conclusion: Low interest by leadership on AMR, lack of prioritization and resource allocation by the Ministry of Health for AMR related activities, changes in the system of governance in the country following devolution further slowed down the process of developing national strategies to fight AMR The AMR program through the leadership of NASAC is in the process of developing a National Action Plan and policy for AMR addressing recommendations in the SA and leveraging the international health regulations and the global health security agenda. Through the AMR program, revision of the National IPC policy, guidelines and IPC training curriculum have included antimicrobial resistance and antimicrobial stewardship.