Blog by Ambassador Lawrence Mugisha
One Health Perspectives for AMR Interventions in Uganda
This blog by Dr Lawrence Mugisha from Uganda is the second blog in a new series by AMR Insights Ambassadors.
Lawrence Mugisha is an Associate Professor, Department of Wildlife and Aquatic Animal Resources, College of Veterinary Medicine, Animal Resources & Biosecurity (COVAB), Makerere University; Adjunct Professor, College of Veterinary Medicine (CVM), University of Minnesota and Mississippi State University.
Antimicrobial resistance still on rise in Uganda
Antimicrobial resistance is still on rise in Uganda with limited data to actually quantify the magnitude of the problem. Whereas it is well documented that one of the drivers of AMR is overuse and consumption of antimicrobials, limited data on the consumption trends in humans and animals remains a constraint instituting appropriate interventions. This challenge is more pronounced in the livestock sector where access to antimicrobials is open to farmers over counter even without prescription. The same challenge exists in humans at different levels with multitude of pharmacies and drug shops increasing and distributed everywhere in the country including rural areas.
Antimicrobials are easily accessed over the counter
Antimicrobials are easily accessed over the counter from these pharmacies and drug shops with very limited controls who purposes appear to be more profit-driven other than provision of professional services for improved health outcomes. Antimicrobial consumption data is not being collected at these various sales points that are widely distributed across the country leading to difficulties in monitoring consumption. Our only available data currently used to estimate consumption of antimicrobials is the import data being captured at the portal of entry by National Drug Authority (NDA) through their recently established electronic management system.
Uganda developed a National Action Plan for AMR 2018-2023
Uganda like other nations following the Global Action Plan for Antimicrobial Resistance released in 2015, developed a National Action Plan for AMR 2018-2023. This action plan is uniquely being implemented through National One Health platform bringing various stakeholders on board. The platform has organized and coordinated several consultative meetings and workshops aimed at clearly identifying the gaps in the implementation of the AMR action plan including advocacy for policy changes. The recent one health platform activities of the antimicrobial awareness week had several public engagements including media and communities. These efforts are raising awareness among various stakeholders and are igniting a cascade of various interventions ranging from research, capacity building, resource mobilization, surveillance to antimicrobial stewardship. Whereas one health approach is providing some green light towards understanding and appreciating the public health implications of antimicrobial resistance, the immediate intervention actions are constrained by limited appreciation of this approach and dedicated funding. More efforts supported with data, success stories are needed to popularize the one health approach especially among policy makers that appropriate national resources.
Lawrence Mugisha is an Associate Professor, Department of Wildlife and Aquatic Animal Resources, College of Veterinary Medicine, Animal Resources & Biosecurity (COVAB), Makerere University; Adjunct Professor, College of Veterinary Medicine (CVM), University of Minnesota and Mississippi State University. He is a Team Leader for EcoHealth Research Group under Conservation & Ecosystem Health Alliance (CEHA). He has worked and consulted with several national and international organizations in the fields of capacity building, community development, biodiversity conservation and research. He has over 16 years of experience in zoonotic disease research at human, livestock and wildlife interface. He established one health demonstration research site in Hoima District that hosts International scholars for short and long term research in zoonotic diseases and capacity building http://www.panafrican-med-journal.com/content/series/27/4/21/full/. He hosts annual One Health Zoonotic Disease Module for East African Diploma in Tropical Medicine and Hygiene offered by London School of Hygiene and Tropical Medicine. He offers One Health Leadership Trainings for One Health Central and Eastern Africa (OHCEA), participates in the implementation of the annual study abroad program under Capacity Building in Integrated Management of Transboundary Animal Diseases and Zoonoses. He is academic mentor for the Uganda Research Training Collaborative (URTC) model with Academic Health Center for Global Health and Social Responsibility at University of Minnesota. He is a committee member for the National Biosafety Committee, Uganda National Council of Science and Technology and a Scientific Committee Member for the Presidential Initiative of Epidemics (PRESIDE). Recently appointed senior editor for CABI One health Journal. His current research include but not limited to: Leptospirosis and Brucellosis; Tick-borne Pathogens (Tick Microbiome) and Antimicrobial Resistance (AMR) and other emerging infectious diseases at human-livestock and wildlife interface.