Antimicrobial resistant pathogens to kill around 10 million people annually by 2050

By Elias Hakizimana.

At least 10 million people worldwide will be dying every year of Antimicrobial resistant infections, according to the UN Ad hoc Interagency Coordinating Group on Antimicrobial Resistance.

A recent study by Murray et a. (2022) revealed that in 2019, 1,3 million people died due to Antimicrobial resistant infections of bacterial origins. Of these, the majority were from low and middle-income countries (LMICs).

In 2019, the WHO with its partners classified antimicrobial resistance among the top 10 global health threats facing humanity. If no action is taken, AMR will claim a number of lives.

Rwanda’s Non-Government Organization ‘OAZIS HEALTH’ that provides health information to Rwandans has thought of a solution to the AMR burden by introducing training to healthcare providers across the hospitals and health centers in the country.

Dr. Noel Gahamanyi, Lecturer at University of Rwanda and expert in Microbiology and antimicrobial resistance (AMR) 

The training aims at reminding healthcare providers their role in emphasizing while prescribing antimicrobials including antibiotics to patients. They were reminded to give enough explanations to patients on their proper use and warn them of possible side effects or consequences if the dose is not completed or taken contrary to the prescribers’ guide. The non-compliance with medical prescriptions can leads to the development of antimicrobial resistance by the pathogens as some would survive the drugs.

Francine Uwizeyimana, a healthcare professional working in pharmacy and drug store at Gatenga Health Center in Kicukiro District attended the training. She said that sometimes, patients can put pressure to prescribers while requesting for antibiotics. This is a wrong practice because the drug could not be matching with the diagnosed illness. She recommended prescribers to follow treatment guidelines.

“For a person who used to have certain antibiotics and he usually goes to the pharmacy to ask for it, then he comes to you and asks for it, maybe you act as if you are emotional, and you give it to him/her without any convincing health reason. Therefore, we should not respect patient’s feelings and provide unnecessary medication. I am going to share the lessons learnt from the training with my colleagues,” Uwizeyimana said.

Another nurse who works in Kicukiro District explained some reasons that push for failure of a medical practitioner to give time to the patient for some explanations about the received medications. He said that nurses and other medical practitioners are always overwhelmed by a lot of work and receiving many clients (patients) and the situation requires them to go faster, which cannot allow them to have more time with each client while others are waiting on the queue.

“I should go back with some solutions to share with my colleagues and see what we can do to fix the issue of antimicrobial misuse. A medical practitioner should take a moment to explain to the client (patient) about hygiene, medication information and associated side effects or consequences if they are not well used according to the prescription,” he said.

Dr. Yvette Mutoni, a medical doctor at Kabgayi District Hospital explained that sometimes nurses can provide fake drugs.  She reiterated that failure to take a moment to explain medication to patients can be due to limited time with a big number of clients (patients). My suggestion is “to increase the number of doctors and nurses at health facility level,” Dr. Mutoni said.

Dr. Eric Mugabo, Executive Director of OAZIS HEALTH reminded healthcare professionals to play their role by explaining to patients the consequences of having wrong medicine or not adhering to prescription guide.  “The role of medical doctors and nurses is very critical as they are the ones to prescribe the medicines, we urge them to take like 1-5 minutes with a client (patient) to explain him/her about everything on provided medicines. There is a problem of few medical practitioners, but we must seek solutions from within, so that the few who are in service try to change the situation,” Dr. Mugabo said.

Dr. Noel Gahamanyi, Lecturer at University of Rwanda and expert in Microbiology and antimicrobial resistance (AMR) called for concerted efforts of different institutions. He said that sometimes clients (patients) put pressure on medical practitioners to get certain medicines of their choice.

He gave the following advice to patients: (i) Take drugs (antibiotics) as prescribed by a medical doctor, (ii) Ensure hygiene by washing hands well with a soap and clean water. He added that education and mobilization campaigns are needed to save humans, cattle and environment. 

Dr. Gahamanyi warns patients that when they don’t finish the prescribed dose, the remained are wasted and pollute people, cattle and environment. This contributes to the increase of antimicrobial resistance.

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