The Role of Vaccines in Mitigating Antimicrobial Resistance in Uganda

What is the burden of antimicrobial resistance in Uganda? How can vaccines be leveraged to help control this growing health crisis?

Read the GARP-Uganda Policy Brief, The Role of Vaccines in Mitigating Antimicrobial Resistance in Uganda, and our shortened policy brief to find out.

Executive Summary

Antimicrobial resistance (AMR) is a global challenge that threatens to reverse the advances of modern medicine, potentially ushering us into a post antibiotic era. AMR occurs when medicines used to treat infections caused by bacteria, viruses, fungi, and parasites become less effective, often due to factors such as prolonged exposure to antimicrobials or adaptive changes in the organisms over time. Although many factors contribute to the emergence and spread of AMR, the overuse and misuse of antimicrobials are the primary drivers behind the widespread prevalence of resistant strains.

AMR presents a multifaceted challenge, jeopardizing the effectiveness of antimicrobial treatments and compromising our ability to manage infectious diseases. The economic burden associated with treating resistant infections further impacts individuals, health care systems, and national economies. The World Bank projects that AMR might incur an estimated US$1 trillion in additional health care costs by 2050, alongside potential annual gross domestic product (GDP) losses of US$1–3.4 trillion by 2030.

In Uganda in 2021, of the 47,821 deaths due to bacterial infections, 21,258 were associated with 6 leading drug-resistant pathogens, including Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus, pathogens that contribute significantly to its rising infectious disease burden; 5,616 deaths were directly attributable to AMR. Diseases such as malaria, acquired immunodeficiency syndrome (AIDS), lower respiratory tract infections (LRTIs), tuberculosis, measles, diarrheal diseases, and sexually transmitted infections (STIs) are major contributors to deaths and disability-adjusted life years (DALYs). The rising rates of AMR add to the already high burden of infectious diseases, making treatment more difficult. Poor health care access, limited availability of antibiotics, inadequate water, sanitation, and hygiene facilities, and environmental pollution all contribute to the rise in AMR.

Given the limited progress in developing new antimicrobials, the need for alternative strategies has intensified, making vaccination a cornerstone in the battle against AMR. Vaccines are pivotal in combating AMR and safeguarding public health by preventing infections and providing immunity against diseases. This reduces the reliance on antimicrobial treatments and minimizes the prevalence of resistant pathogens. Increased vaccine coverage reduces infections, dependence on antibiotics, and selective pressure for the emergence of resistant strains.

By preventing infections, vaccines help maintain the effectiveness of antimicrobial treatments and ensure their continued success in managing diverse medical conditions. Vaccination programs also offer a cost effective means of infection prevention, reducing the financial strain on health care systems. Given the escalating threat of AMR, it is imperative to prioritize and strengthen national immunization programs to achieve widespread coverage and protection against vaccine-preventable diseases. To guide policymakers, this policy brief presents a summary of the essential areas and priority interventions that need to be considered when formulating a national strategy to combat AMR.