Background


Access to safe effective affordable medicines is one of the most important public health considerations in Ghana and in the African Region as a whole. However the majority of people in the region do not have regular access to good quality safe and affordable essential medicines. Governments cannot adequately regulate the local pharmaceutical sector to ensure that public health interests are safeguarded.

This leads to a proliferation of medicines on the market that may be unsafe, unaffordable and of sub-standard quality or may even be counterfeits. 
Many consumers have to rely on untrained peddlers for their supplies of medicines often of unknown origin or quality. This has led to inappropriate use of pharmaceuticals, based on demand rather than correct medical indication which is threatening to render current affordable antimicrobials useless.


The threat of antimicrobial resistance (AMR) is ever increasing with serious implication on survival of humans on earth. There are several reports indicating the failure of hitherto effective antibiotics. Septicaemia is being increasingly reported as the cause of death in many cases. Some reports indicate that antibiotics used in treating pneumonia in children are no longer giving the desired therapeutic results.


The annual reports of the pharmacy division of the MoH over the years depict high level of use of antibiotics at the Out Patient Department (OPD) at the hospitals. In some hospitals, seven (7) out of ten (10) OPD clients received antibiotics. At the community level, antibiotics are reported to be grossly abused. The abuse of antibiotics in poultry cannot be glossed over. The need to address these precarious situations now and to save future generations cannot be overemphasized.


Other immediate key factors that worsen the already worrying situation include overcrowding in hospitals, poor health care infrastructure, and inadequate hospital hygiene, poor infection control practices in hospitals, and lack of reliable diagnostic tools and laboratory facilities that negatively impact prescribing patterns.
The pharmaceutical sector strategic plan (2012 – 2014) seeks to address this phenomenon by developing a comprehensive National Anti-biotic Use and Resistance Surveillance policy that will ameliorate the situation. In order to initiate change, a national effort to analyse the local situation will be undertaken. This will be done by a multidisciplinary group with representatives from all relevant sectors, such as ministry of health, clinicians involved in hospital or outpatient care, veterinary medicine, agriculture, pharmacies and regulatory agencies. Furthermore, civil society organizations and non-governmental organizations would be engaged.



Goal, objectives and specific objectives

The goal of the project is to save lives, contain costs and improve health by improving access to and use of good quality antibiotics and manage antibiotic resistance.

objectives
Broad objective:
• Develop and implement an ABR policy

The specific objectives are to: 
• Review the knowledge attitudes beliefs and Practises (KABP) of health professionals on ABR
• Establish surveillance on antibiotic use and resistance 
• Increase capacity of health professionals and laboratories to deal with ABR issues in the health system 
• Link medicine selection to work on antibiotic surveillance
• Review and enforce the regulations on antibiotics in Ghana
• Generate data and information for behavioral change communication for rational use of antibiotics
• Work with CSOs to open up the community to ABR issues


Expected outputs

Output 1: Ghana to be better placed to meet country needs for technical support and advice on antibiotic policy development and reflect and address consumer concerns and issues on antibiotics including surveillance. 
Output 2: Capacity of civil society organizations built to influence communities for more rational use of antibiotics among consumers
Output 3: Capacity of some health care providers built to influence and work with policy makers for more rational use of antibiotics among prescribers and dispensers.
Output 4: Strengthened partnerships between policy makers, academic institutions, consumers and other stakeholders to enforce regulations on antibiotics acquisition and use to mitigate antibiotic resistance.
Output 5: A cross-learning agenda developed on how to implement programs such as antibiotic stewardship, smart use of antibiotics and other effective innovations.


Expected outcome 

By 2015 Ghana should have a sustained national agenda to respond effectively to antibiotic use and manage antibiotic resistance and become the platform for African agenda on antibiotic resistance management.

Ghana National Drugs Programme, Ministry of Health (GNDP MOH) 2015