ANTIBIOTIC POLICY IN GHANA;
THE WAY FORWARD
Martha Gyansa-Lutterodt
Director Pharmaceutical Services
Outline
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The challenge and Policy assessment
Situation analysis
Global Action Plan (GAP)
Aligning the GAP to Ghana’s Policy Framework
Our Story
The Way Forward
Antimicrobial Policy in Ghana
Introduction: Access to essential
medicines
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Availability
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Ghana Drug Access Problem Ratio
Affordability
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Availability of medicines >85% for
65 tracer medicines *
Social health insurance reimbursing
548 medicines (13.1% antibiotics)
Out of pocket payments
Quality
40%
Qual i ty
40%
Accessibility: Geographical
distribution of medicines outlets
 Private Pharmacies >80% urban
 Licensed chemical sellers >80%
rural
 Public health facilities, CHPS
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Accessibility
20% Accessi20%bi l i ty
Quality
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SSFFCs and Storage conditions
*Office of the Chief Pharmacist, 2013
Antimicrobial Policy in Ghana
Affordability
40%
Af f or dabi l i ty
40%
Policy assessment:
sustaining the gains made by positive interventions on trends in RUM
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The National Drug Policy recommends routine monitoring of
Rational use of medicines (RUM)
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The WHO core indicators adopted for use in country, includes one direct
indicator for antibiotic use
Percentage of outpatient encounters with an antibiotic prescribed from
1999 to 2013 in Ghana
75.0
65.0
Ghana AMR
initiatives
56.3
55.0
45.0
40.5 41.4
45.2
43.1
36.4
48.7 49.5
40.7
37.6
42.0 43.6 43.3 41.4 39.9
35.0
25.0
15.0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Office of the Chief Pharmacist 1999 to 2013
The indicator trend,
aligns with investments
in DTC training
Situational Analysis
Irresponsible/inappropriate use of Antimicrobials
 Lack of information on the proper use of Antimicrobials
 Absence of policy on Antimicrobial use
 Spurious, Substandard, Falsified, Fake and Counterfeit
Antimicrobials
 Unregulated access to Antimicrobials
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Antimicrobial Policy in Ghana
Situational Analysis
Use in agriculture as growth promoters
 Poor infection prevention and control in health facilities
 Poor environmental sanitation
 Poor or absence of surveillance on Antimicrobials use
 Poor knowledge on Antimicrobials resistance
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Antimicrobial Policy in Ghana
Elements of Global Action Plan
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Improve awareness and understanding of
antimicrobial resistance;
Strengthen knowledge through surveillance and
research
Reduce the incidence of infection (Infection Control)
Optimize the use of antimicrobial agents
Develop the economic case for sustainable investment
that takes account of the needs of all countries
Increase investment in new medicines, diagnostic tools,
vaccines and other interventions.
Antimicrobial Policy in Ghana
Elements of Ghana’s
Policy Framework for AMR
This Policy Frame work is one of the MoH Aide
Memoire deliverables for 2014
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Responsible Use of Antimicrobials
 Use in Veterinary and Aquaculture
 Manufacturing, Supply, distribution, disposal
 Regulation and enforcement
 Surveillance
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Antimicrobial Policy in Ghana
Elements of Ghana’s
Policy Framework for AMR
Infection prevention and control
 Laboratory services
 Research and development
 Stakeholder collaboration and Governance of
Antimicrobial resistance
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Antimicrobial Policy in Ghana
Our Story !
Antimicrobial Policy in Ghana
Orientation/Sensitization of Key
Stakeholders
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Over 80 key
stakeholders sensitized in
western region
About 30 Queen
mothers in central
10 municipal health
directorate staff
Pharmacist AGM
AGM of Ward nurses
AMR TWG
Health Summit
Way Forward…1
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The need for broad policy framework
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Antimicrobial resistance vrs Antibiotic resistance
Key policy areas
Community education and Sociocultural change interventions
Potential role of Legislative instruments
Balancing access, excess and equity (inline with
distribution of appropriate cadres)
Quality of antimicrobial agents
The role of appropriate Infection control strategies
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Hospitals
Communities
Way forward…2
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Need for an expanded monitoring framework
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RUM indicators (1 indicator for Antibiotic use)
Alignment and contextualization within existing
policies on medicines
Infection control policy
 National Medicines Policy
 EML policy
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Linking surveillance data with selection of antibiotics
The Way forward…3
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Research must inform Policy and Practice- The ADMER
experience
Continue multi-stakeholder platform work
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Complete Policy Cycle and Continue with Policy
implementation
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Continue working with the Academia and research institutions in
surveillance, drug development and continuous research to
improve antimicrobial use etc
monitoring and evaluation, communication/education/advocacy
Implementation of the recommendations from KABP on
CSO’s and Health professionals
Antimicrobial Policy in Ghana
The Way forward…4
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Surveillance
Implementing the MARHLAB program
 Bench work stardardisation done to provide the baseline
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Infection control policy 2011 under review with follow
on implementation
One Health Approach to AMR issues
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Develop treatment guidelines for Animal use
Collaboration and partnerships with other countries
and Institutions as outlined in the Global Action Plan
Antimicrobial Policy in Ghana
Announcing our Work …..
4 more manuscripts ready Antimicrobial Policy in Ghana
Reports, Training Manuals, Educational
materials
Antimicrobial Policy in Ghana
www.ghndp.org/antimicrobialresistance
www.ghndp.org/reactcso
Antimicrobial Policy in Ghana
Sights and SoundsGhana AMR Alliance
Antimicrobial Policy in Ghana
Pictures
Antimicrobial Policy in Ghana
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THANK YOU TO THE GHANA AMR WORKING
GROUP AND TECHNICAL TASK TEAM
OFFICE OF THE CHIEF PHARMACIST FOR ALL THE
HARD WORK
Antimicrobial Policy in Ghana
END
Thank you