March 25, 2011
March has been a busy and productive month for CDDEP s Global Antibiotic Resistance Partnership (GARP) in Kenya. Following the completion of the Situation Analysis: Antibiotic Use and Resistance in Kenya, the National Working Group for GARP-Kenya convened a policy development workshop to discuss next steps and identify interventions that address access to effective antibiotics. The workshop was held on 2 March, 2011, at Panafric Hotel in Nairobi and included a total of 23 participants from private, public, and mission hospital sectors, research and academic institutions, civil society organizations, and several Government departments dealing with human and veterinary use of antibiotics. Dr. Samuel Kariuki, Chief Research Officer and Director, Centre for Microbiology Research, KEMRI, who chairs the National Working Group, facilitated the meeting in collaboration with CDDEP.
The objective of the workshop was to develop strategies that target two scenarios found in Kenya: 1) lack of access to essential antibiotics that leads to unnecessary deaths from treatable diseases and 2) overuse of antibiotics that promotes the development and spread of resistant pathogens. The Situation Analysis, a report that brings together country-specific information on the issue, formed the basis for discussion during the workshop. Sub-committees of four to five experts investigated options for hospital infection control, hospital prescribing and diagnostics, community use, the veterinary sector, Government ministries and the national health system. The workshop concluded with presentations from each sub-committee highlighting their policy recommendations and concerns going forward.
The meeting came in the wake of a new survey that hit the popular media reporting once again that nearly three-quarters of pharmacies in Kenya dispense antibiotics without a prescription, despite the practice being illegal (a fuller account of this phenomenon, with historical references, is included in the Kenya Situation Analysis). Clearly, misuse and overuse of antibiotics is to be avoided especially in a country such as Kenya, where loss of first-line antibiotics may mean foregoing effective treatment because of cost. The GARP final recommendations will be crafted to move in the direction of appropriate use only. But being mindful of the lack of access that exists, how sure can we be that just cracking down on non-prescription sales is the answer? Is it possible that this will do more harm than good?
The Situation Analysis discusses this phenomenon, as well as several other challenges facing the development of an effective antibiotic policy in Kenya, including the proliferation of counterfeit drugs, lack of access to appropriate antibiotic treatments, poor adherence to treatment guidelines, and antibiotic use in the livestock industry. Yet the report and the Working Group and its partners also look forward to interventions to better optimize antibiotic use in Kenya curbing resistance while also expanding access to appropriate antibiotic therapies.
A final report from GARP-Kenya is expected in May 2011, followed by a larger stakeholder consultation to widen the circle of input and advice on which recommendations to take forward. In the next phase, the NWG hopes to tackle developing critical paths of implementation for each recommendation. The resulting national strategy and policy platform will be presented at the 1st Global Forum on Bacterial Infections, 3-5 October 2011, in New Delhi, India, which will focus on antibiotic issues across low- and middle-income countries globally, with special attention to antibiotics and childhood pneumonia.
Participants in the GARP-Kenya policy development workshop
Back (left to right): G. Muthuri, Pharmacy and Poisons Board (PPB);A. Meiburg, Ecumenical Pharmaceutical Network (EPN); S. Shah Aga Khan University Hospital (AKUH); T. Menge Kenyatta National Hospital (KNH), A. Aiken Kenya Medical Research Institute (KEMRI)-Wellcome Trust; P. Gathumbi University of Nairobi; P. Irungu, University of Nairobi); L. Gitonga, Ministry of Medical Services (MOMS); E. Abwao, PPB; M. Gichia, Department of Veterinary Services (DVS); A. Tawakal, Healthways; D. Kusemerewa, EPN; R. Kakai, Maseno University; B. Olack, Centers for Disease Control (CDC)
Front (left to right): J. Pandit, PPB; C. Winters, CDDEP; F. Yano, PPB; E. Ogaja, MOMS; G. Revathi, AKUH; S. Kariuki, KEMRI; H. Gelband, CDDEP; L. Ndegwa, CDC; E. Mitema, University of Nairobi
Not Pictured: J. Katama, KNH; J. Tole, Aga Khan University
