The Fight against AMR
CCIH is fortunate to have Jamie Wagner, a student at Pepperdine University in Malibu, California with us for a two-month internship until mid-April. During her time with CCIH, Jamie developed a social media campaign to share a video on Christian work in advocacy, created an interactive online map of FBO work in family planning, went on advocacy visits on Capitol Hill, attended global health and policy events, and more.
“I have really enjoyed getting to work with CCIH over the past few months,” said Jamie (shown at left). “It has pushed me to work hard and it has allowed me to look at international health and development from a different angle. From here, I hope to graduate with a degree in international business and go into either the international health or development fields.” Jamie also wrote the article below about the growing threat of antimicrobial resistance.
The Fight against AMR
By Jamie Wagner, CCIH Advocacy and Communications Intern, Pepperdine University Student
Antimicrobial resistance is a growing problem around the world; it is currently the cause of approximately 700,000 deaths annually. In 2016, The Review on Antimicrobial Resistance published a report that predicted that this number could skyrocket to around 10 million by the year 2050. CCIH member Ecumenical Pharmaceutical Network (EPN) in Kenya has been working hard to combat antimicrobial resistance around the world for many years. We were able to catch up with the Executive Director of EPN and head of ReAct Africa, Mirfin Mpundu, PharmD, MPH, MBA (shown below) to talk a bit about the work that EPN is doing and the role that faith communities are playing in the global heath arena.
What exactly does EPN do and how do they work with ReAct?
Mirfin: EPN, like CCIH is a member organization. It is a network of faith-based organizations with members in 37 countries around the world. Our main mandate is to support members in promoting access to quality-assured medicines and quality pharmaceutical services under pharmaceutical systems strengthening. EPN is also the host of Action on Antibiotic Resistance (ReAct) Africa, a network championing action on antibiotic resistance. Together we are raising awareness of antimicrobial resistance among the general population. In health facilities we are supporting the establishment of programs aimed at containing AMR, such as antimicrobial stewardship programs, infection prevention and control programs and availability of quality antibiotics in health facilities. We also work with policy makers advocating for sustainable solutions in addressing AMR in response to WHO’s Global Action Plan (GAP) passed in 2015. The GAP called on all member countries to develop National Action Plans in alignment with the Global Action Plan to address AMR, a global health and security threat. With ReAct, we have been working alongside African countries supporting them and providing technical assistance as they develop their National Action Plans to address antimicrobial resistance.
What does EPN do apart from your work with ReAct to fight against AMR and infectious diseases?
Mirfin: EPN works at multiple levels. On the facility level, we work to help organizations find quality antibiotics for their patients and to build capacity to manage the most common infections and use medicines appropriately. We also support the running of two health programs: 1.an Antimicrobial Stewardship Program and 2. an Infection Prevention and Control Program. On the regional level, we advocate and raise awareness for AMR as well as work to make antibiotics and diagnostic tools more accessible in low- and middle-income countries. We also work for the inclusion of the faith-based organizations in government programs. At the global level, we continue to advocate and work alongside ReAct, WHO and other organizations to promote access to antimicrobials, contain AMR, and promote policies to address lack of access to health care services, which is still a major problem in developing countries.
What are some of the most prominent antimicrobial resistant and infectious diseases that EPN deals with today?
Mirfin: Currently, Malaria, Tuberculosis, and HIV are the biggest ones that we are dealing with. Tuberculosis continues to become more dangerous as two types of resistance are observed and reported: multidrug-resistant (MDR) and extensively drug resistant (XDR). Neither of these have good outcomes, but XDR has built up even more resistance than MDR and increases the cost of treatment and fatalities. HIV resistance is also being reported around the world, making treatment significantly harder to achieve.
Where do you see these resistant strains and how is EPN working in those places?
Mirfin: Sub-Saharan Africa has the highest burden of infectious diseases; malaria, TB and HIV are on top of the list. Resistance is being reported to TB, malaria and HIV medicines, which are also used for some other infections. There is lack of AMR data in African countries but with the high use of antimicrobials, one can assume or expect to see high resistance patterns. The drivers of AMR are underuse and overuse of antimicrobials. Antibiotics for example, can be bought at the market, illegal outlets and even registered outlets without a prescription. The high poverty levels also contribute to AMR due to poor sanitation, and poor infection control practices. We have also seen a great influx of poor-quality antimicrobials on the market, which contribute to AMR. Routine and random screening of medicines show antibiotics and antimalarials as the common products that fail quality tests. EPN is working on many fronts to address some of these challenges.
What are some of EPN’s goals for the next few years?
Mirfin: We have a few long-term goals that we are looking at right now. Our top goal is ensuring access to quality-assured medicines including antibiotics around the world. It is sad that in 2018 access to quality-assured antibiotics is still a dream for many. Promoting access to healthcare services is the second goal. Our third major goal is ensuring containment of AMR by ensuring infection prevention and control practices and stewardship programs are implemented in faith-based health facilities and promoting rational use of antimicrobials. This means making sure that antimicrobials are being used correctly and only when needed. Patients need to get the correct diagnosis, correct prescription, dosage, correct quantity of antimicrobials and duration of treatment. We seek to promote the use of standard treatment guidelines within church health institutions to promote desired patient outcomes.
What kind of roles and special strengths do faith-based organizations and faith communities bring when it comes to combating AMR?
Mirfin: To start off, faith-based organizations provide a large proportion of health services in Africa. Depending on the country, this is anywhere between 20 and 60 percent of health services provided by faith-based organizations. FBOs provide health services with compassion believing it is their calling and this sets them apart from other health care providers. Those working for faith-based organizations are not there for monetary gain but to serve despite the financial challenges they may face. Most FBOs are not government funded, yet they are still there providing care to everyone that they can.
Learn more about ReAct and the effort to combat AMR.