A shot in the arm for Kenya's antibiotics resistance battle

Kenya has received approval for a Sh600 million grant to help combat anti-microbial resistance (AMR), believed to be undermining the country's capacity to treat or control infections and putting the population at a greater risk of chronic illnesses.

The grant, from the Flemming Fund, will support the implementation of the country’s national AMR surveillance strategy, which intends to build the capacity of public health laboratories and other surveillance sites to deal with the problem.

Through this, Kenya hopes to improve laboratory performance, data quality, biosafety and biosecurity, and encourage greater clinical engagement with microbiology services to drive demand for diagnostic bacteriology services.

Antimicrobial resistance is a growing public health concern globally, as bacteria increasingly builds resistance against antibiotics.

“One of the greatest challenges that we face as a country is the lack of sufficient data to effectively deal with this problem,” said Dr Karim Wanga of the Pharmacy and Poisons Board.

Drug-resistant bacteria is thought to kill one person every minute, leading to a global death toll of 700,000 people. This number is expected to rise to nearly one million by the year 2050.

Antibiotics present in the environment at low concentrations can accumulate in human populations through long-term exposure to drinking water, food, or consumer goods with unknown health consequences, according to the Food and Agriculture Organisation (FAO).

Antibiotics are used in both human and animal health to treat various infections, and health professionals have raised concern over their availability over the counter, and the misuse of the drugs. This is one of the leading causes of resistance. Other causes are lack of access to quality healthcare for both humans and animals, and frequent movement of persons and livestock.

It is against this backdrop that Kenya is this week hosting Africa’s first Anti-Microbial Resistance Awareness Week, to educate the masses on proper use of antibiotics and the dangers of self medicating.

The campaign is supported by FAO, the African Union, the World Health Organisation, the Africa Centre for Disease Control and the World Organisation for Animal Health.

“No country can work in isolation when it comes to dealing with the threat of AMR. We don't know everything about these drug-resistant infections but we know enough to act. It is important to always seek advice from a health professional or a veterinary doctor before seeking antibiotics,” said John Oppong-Otoo, from the African Union Inter-Bureau for Animal Resources (AU-IBAR).

“No one can completely avoid the risk of resistant infections, but some people are at greater risk than others such as people with chronic illnesses. If antibiotics lose their effectiveness, then we lose the ability to treat infections and control public health threat,” said Rudi Eggars, the country representative for WHO in Kenya.

The Flemming Fund, a programme under the UK-Aid department of health, helps low- and middle-income countries fight AMR, by improving surveillance to generate data that will be shared across the world.

Since inception, the fund has approved grants to 13 countries, and helped another 31, including Kenya, to develop national action plans.

This week Kenya is hosting Africa’s first coordinated Anti-Microbial Resistance campaign, as part of the celebrations of the World Anti Microbial Resistance Week.

“It is very worrying that farmers are using antibiotics on their animals without the prescription of a veterinary officer,” said Scott Newman, a senior health and livestock production officer at the FAO’s Regional Office for Africa.

"The misuse of these drugs, associated with the emergence and spread of antimicrobial-resistant micro-organisms, places everyone at great risk and poses a threat to public health, sustainable food production, and potentially to biodiversity and ecological systems."

Dr Wanga proposes drastic action against the widespread use of antibiotics on poultry farms.

“If you ask me, there is absolutely no reason why farmers should use antibiotics to grow chicken. That should be illegal. Over time, these chicken develop resistant strains that are then passed on to humans,” he said.

Weak regulation, especially in Africa, has also been cited as a big contributor to AMR. And while the Pharmacy and Poisons Board acknowledges that there are gaps in addressing AMR, it says that the existing laws are sufficient.

“It is illegal to buy antibiotics without a prescription from a veterinary officer or human health professional. All pharmacists and agro-vets know this. But because they know that we as the poisons board lack the capacity to effectively conduct market surveillance, they get away with it. So it is an ethical problem. They know we don’t have enough inspectors,” said Dr Wanga.

In 2017, Kenya launched a national action plan and a strategic plan to combat AMR, which sought to increase public awareness, increase surveillance, prevent infections, encourage appropriate use of antibiotics and step up research and development. Under the plan, the Ministry of Health is expected to recruit 28 hospitals as surveillance sites by the year 2022.